ObjectiveNeedlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.MethodsA cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).ResultsOver the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.ConclusionIn conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.
Pendahuluan. Petugas kesehatan memiliki risiko pajanan infeksi yang cukup tinggi. Hepatitis B, hepatitis C, dan human immunodeficiency virus (HIV) adalah beberapa penyakit yang dapat menular melalui pajanan cairan atau jaringan tubuh. Rumah Sakit Umum Cipto Mangunkusumo (RSCM) telah mencanangkan profilaksis pasca pajanan terhadap HIV, hepatitis B, dan hepatitis C. Penelitian ini dilakukan untuk menilai pelaksanaan profilaksis pasca pajanan terhadap HIV, hepatitis B, dan hepatitis C pada petugas kesehatan di RSCM Jakarta. Metode. Studi potong lintang dilakukan pada petugas terpajan yang terdata melalui laporan di RSCM Jakarta pada tahun 2014-2016. Data demografis dikumpulkan melalui rekam medis dan dilanjutkan dengan wawancara untuk data tambahan. Data diolah secara statistik menggunakan SPSS versi 20. Hasil. Dari 196 subjek yang melaporkan pajanan, sebagian besar merupakan perempuan (69,9%), bekerja sebagai perawat (38,3%), dan dokter (49,5%), serta mayoritas terpajan secara per kutan (93,4%). Dari seluruh laporan tersebut didapatkan 183 pajanan berisiko, dengan anti-HIV reaktif pada 19 (10,4%), HBsAg positif pada 11 (6,0%), dan anti-HCV reaktif pada 12 (6,6%) sumber pajanan. Mayoritas petugas terpajan diketahui tidak memiliki HIV, hepatitis B, dan hepatitis C. Hanya 27,5% petugas terpajan memiliki kadar anti-HBs protektif. Dari 183 pajanan berisiko, sebanyak 44,3% mendapatkan rekomendasi antiretroviral (ARV), namun hanya 49,4% petugas yang minum ARV secara lengkap (28 hari). Capaian evaluasi anti-HIV pada bulan ke-3 dan ke-6 hanya dilakukan oleh 21,3% petugas. Rekomendasi profilaksis pasca pajanan hanya diberikan kepada 20,3% laporan, dengan capaian hanya 13,5% dan 13,3% untuk vaksinasi hepatitis B dan immunoglobulin (HBIG). Evaluasi ulangan HBsAg 3 dan 6 bulan secara lengkap hanya dilakukan oleh 13,5% petugas kesehatan, mayoritas petugas (64,9%) tidak melakukan evaluasi ulang HBsAg. Dari seluruh pajanan berisiko hepatitis C, mayoritas tidak melakukan evaluasi ulang terhadap anti-HCV (69,9%). Simpulan. Pelaksanaan profilaksis pasca pajanan terhadap HIV, hepatitis B, dan hepatitis C masih rendah, terutama pada evaluasi status serologis lanjutan. Oleh karena itu, penanganan profilaksis secara komprehensif penting dilakukan termasuk peningkatan pengetahuan dan kesadaran petugas kesehatan, peninjauan kembali standar operasional prosedur, dan komunikasi yang efektif.
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