Survey On Risks Of Nosocomial Infection Of Nurses Caring For Patients With Severe Hepatitis

ObjectiveTo survey risk differences of transmission of infectious diseases between severe hepatitis, non-severe hepatitis, and internal medicine ICU; environment risk factors of occupational nosocomial infection in general hospitals'infectious disease department and internal medicine department respectively; To compare their knowledge of their own hepatitis B virus infections, their HBV vaccination immune status, and their health consciousness; To understand and compare their occupational nosocomial infections related KAP of the two groups mentioned above. to provide and recommend some effective countermeasures.Methods1. Through random sampling, discharged patients were into three groups: severe viral hepatitis group, non-severe hepatitis group and ICU groups (hereafter referred to SVH group, NSVH group, ICU group) and examines each group's 60 medical records from January 2008 to December 2008 in the Department of Infectious Diseases in a hospital. The author reviewed the following information related to the three groups of patients: general condition, progress notes, laboratory test results of patients carrying pathogens (hepatitis viruses, syphilis, tuberculosis and other infectious agents), doctor orders, nurse orders which are related to blood-borne disease care (venous blood, central venous catheter, venipuncture, suctioning, dumping waste, etc.) and other relevant records. Then the author filled out a list of case studies to compare the differences among the three groups.2. The author looked up the year 2009 hygiene monitoring records of dispensing room, surface, medical staff hand hygiene in Infectious Diseases Department and general internal medicine department; analyzed the differences of test pass rates, the number of bacteria and bacterial species distribution. 3. Two groups of nurses were chosen for study: one group of 60 nurses were selected as observation groups through clustering sampling from 5 ward areas in infectious disease departments in the hospital; the other group of 60 nurses were selected through random sampling from 6 ward areas in non-infectious disease internal medicine departments(excluding blood medicine, oncology). The author reviewed the serum HBV-MM in the two groups of nurses'medical examination data. Therefore, the information of the status of HBV infection and the differences between the two groups are obtained. Through self-designed questionnaire, the author investigated two groups of nurses'hospital infection-related occupational KAP.All the data were fed in SPSS13.0 for statistical analysis. The result shows significant difference P<0.05.RESULTS1.SVH Group's age, days of hospitalization, times of hospitalizations are more than NSVH Group, with significant difference (P<0.01); SVH Group's HBV-DNA, HCV-RNA test results are obviously higher than Internal Medicine ICU GROUP, with significant difference (P<0.05); SVH Group's amount of daily average indwelling needles and blood products is more than NSVH Group's, with a significant difference (P < 0.01); SVH Group have more exposure to patients'pollutants, and are in risk of infection, significantly more than NVH group, with significant difference (P<0.01).2. Infectious Diseases Department's air, surface, and hand pass rates are 95%, 100%, and 100%; Internal medicine department's air, surface, and hand pass rates are all 100%; Air bacteria in Infectious Diseases Department are widely distributed; the detection rate of surface fungi in Infectious Diseases Department is 25%, higher than the internal medicine group, but with no significant difference (P> 0.05).3. The test results of HBVM of the two groups show significant difference (P<0.05); In term of the number of people voluntarily vaccinated against HBV, the infectious disease department group's is higher than the internal medicine group, 15.0% of internal medicine nurses did not receive HVBM tests; In terms of KAP related to the knowledge of occupational hospital infections, nurse group from the Infectious Diseases Department scored higher than internal medicine group, with significant difference (P<0.05); the Infectious Diseases Department nurses scored higher than internal medicine nurses in the precautious measures against hospital occupational infection with significant difference (P <0.05). ConclusionsRelatively more health-care operations are performed on SVH Group Patients than NSVH Group so SVH Group face greater risks getting infectious diseases; the level of viral replication of HBV, HCV and hepatitis virus they carry is significantly higher than the medical ICU GROUP patients, and nurse Group caring for SVH patients are at greater risk of occupational infection; The author suggests that: severe hepatitis ICU ward should be established; different sanitization, disinfection and staff protection standards should be implemented according to different environment hygiene test results.