Study On Occupational Protection Of HIV/AIDS And Intervention Model Practice Among Nurses Of Rural Hospitals In Guangxi

Background:With the AIDS epidemic around the world continue to develop, AIDS epidemic in China presents a trend of low level as a whole and high level locally. Among them, the AIDS epidemic in Guangxi is in the second place, and the farmers count the main part of new cases.It requires nurses acquire higher professional prevention level from HIV/AIDS especially in the basic-level hospitals.However,the status of nurses’HIV/AIDS occupational protection in our country is:generally lack of systemic knowledge of HIV/AIDS and do not know how to protect from HIV/AIDS, the professional protective behavior adherence is poor, high incidence of occupational exposure. Therefore, how to further improve the level of nurses occupational protection from HIV/AIDS at the grass-roots level hospitals is our extremely urgent problem to be solved.Objective:1、To research nurses’level of occupational exposure and protection to HIV/AIDS at the grass-roots hospitals in Guangxi,understand the situation of primary nurses’occupational exposure and protection to HIV/AIDS in Guangxi to provide research basis for building effective intervention model;2、To build a health education model to improve the level of nurses’ occupational exposure to HIV/AIDS;3、To practice this intervention model on nurses’occupational prevention from HIV/AIDS, in order to provide practical experience for further improving the level of occupational protection from HIV/AIDS among nurses;4、To improve nurses’level of HIV/AIDS related knowledge, awareness and behavior of occupational protection compliance and improve the level of occupational exposure and protection to HIV/AIDS.Content:1、Synthesize literature survey method, literature analysis and questionnaire investigation method, sample nurses at the grass-roots level hospitals in Guangxi and investigate their occupational exposure to HIV/AIDS and prevention knowledge,awareness and its protective behavior compliance, understand the level of nurses’occupational exposure and protection to HIV/AIDS at the grass-roots level in Guangxi to explore the reality of HIV/AIDS occupational exposure protection intervention;2、Using KABP model, HBM, the theoretical model of behavior change as the guidance, combine with health education program and method, on the basis of theory research and evidence-based research, further defined the key point and emphasis of nurses’occupational exposure protection knowledge and behavior in the process of transformation, to improve the level of nurses’occupational exposure and protection to HIV/AIDS at the grass-roots level in Guangxi;3、Regarding nurses at the grass-roots level hospitals in Guangxi as the research object, use a single set of measure method to measure the level of nurses’occupational exposure and protection to HIV/AIDS before and after the intervention.And use comparative study method to compare difference of nursing staff’s occupational exposure and protection to HIV/AIDS before and after intervention to validate the effectiveness of health education model.Methods:This study used literature research, questionnaire survey method, comparative research,statistical analysis methods to develop this scientific research.1、Literature research method:At the early stage of this study, the researchers widely collected relevant data, retrieve the relevant literature aspects of the nursing staff occupational exposure and protection to HIV/AIDS, in order to understand, and analyze the latest research progress at home and abroad to clear the research purpose and significance of this study.2、Questionnaire survey method:Using self-made questionnaire, study retrospectively nurses’occupational exposure experience and test nursing staff’s occupational protection level to HIV/AIDS, facilitate the researchers to analyze the causes and to explore the best intervention strategy.3、Comparative study method:Before and after the intervention, assess the research objects’level of occupational exposure and protection to HIV/AIDS respectively, comparing nurses’knowledge and awareness of occupational protection and the change of the protective behavior compliance, analyze and compare the intervention effect to verify the effectiveness of the proposed intervention model.4、Statistical analysis method:Late in the study, use statistical methods to describe and analyze the results, and conclude the statistical inference to make the research conclusion statistically scientific value.5、Consulting method:The research is all under the guidance of experts in various fields,especially during formulating questionnaire and designing the intervention program,researchers consul experts many times to ensure the smooth progress in this research.Results:1、295 participates in this survey,31 (10.51%) of the nursing staff have experience of occupational exposure. Analysis on these 31 occupational exposed nurses showed that the present certain regularity:(1)A high incidence age of occupational exposure:①19-25 year(56.67%);②greater than 35year (43.33%);(2)A high incidence nursing age of occupational exposure①nursing age within 3 years accounted for 56.67%;②nursing age greater than 16 years accounted for 43.33%;(3)The higher academic degree and titles, the lower the incidence of occupational exposure (P<0.05).①technical school education accounted for 67.74%;②college education accounted for 29.03%;③3.23% are undergraduate course;(4)Main way of occupational exposure:(Dby contaminated needles stabbed skin is the main way of exposure (accounted for 87.10%);②containing patients’blood, body fluids splashing into the mucosa (accounted for12.90%);(5)Process of exposed to HIV/AIDS:①when pull out the needle accounted for 90.32%;②injection accounted for 9.68%;(6)Analyzing occupational exposure reasons found that:①for not familiar with the nursing operation, accounting for 48.4%;②for the big workload and violation of nursing practice, accounting for 32.26%;③in face of patients and knowing them were with infectious disease feel too nervous, accounting for 19.34%.2、The level of nursing staffs’occupational protection to HIV/AIDS is low:This research questionnaire are designed the total score of HIVAIDS occupational protection knowledge part is 70 points, Occupational exposure protection behavior compliance section total score 50 points;(1)occupational protection knowledge part:nursing staffs score averaged (48.21±4.73);(2)exposure protection behavior compliance section:nursing staff score averaged (31.52±3.74).(3)In below aspects,the scores are especially low:①HIV is sensitive to all chemical disinfectants (2.08±0.97)、②the difference between the window and the incubation period (2.27±1.33、③HIV diagnostic method (3.12±0.32)、④hands to set the needle cap (1.63±1.17)⑤wearing double glove (2.54±1.20)、⑥regularly replace the mask (2.48±1.20)3、All kinds of nurses’occupational protection to HIV/AIDS level is respectively:(1)different gender, age, nursing age, record of formal schooling, job title, the level of hospital nurses’ occupational protection knowledge and protective behavior compliance are with statistical significance (P<0.05);(2)secondary hospital nurses’occupational exposure protection level is higher than the first level of the hospital (P<0.05);(3)the higher the degree and title, the higher of nursing staffs’occupational exposure protection level (P< 0.05)。4、After carrying out this intervention model, the level of nursing staffs’ occupational protection to HIV/AIDS:(1)after the intervention,nurses’HIV/AIDS prevention knowledge scored (62.69±3.88) points, compared with before (48.21±4.73)points, score increased significantly, the difference was statistically significant (t=24.26, P<0.001);(2)at HIV/AIDS occupational protection compliance aspects, the study objects’ scored(31.52±3.74) points up to (37.54+3.73), the difference was statistically significant (t=4.79, P< 0.001);(3)especially in existence and inactivate HIV, window concept, in the operation of the main way of exposure, hands back to the set of needle cap, pollution tool insert, Fitzgerald or infusion bottle dropper bottle,occupational safety training regularly attend hospital all increased significantly (all P<0.001).Conclusion:1、Nurses’incidence of occupational exposure in rural hospital of Guangxi is still high,and the main factors influencing the occupational exposure are:age, working years, record of formal schooling and title.The main way of exposure is by contaminating needles stabbed the skin; pull out the needle is the primary exposure process; the main reason of exposure is not familiar with nursing operation and so big workload that violation of operating procedures;2、Nurses’occupational protection and exposure to HIV/AIDS in rural hospitals of Guangxi delays to be in low-level,for example:nurses’HIV/AIDS knowledge is not comprehensive,adherence to occupational exposure protection behavior is low.It is not conducive to take effective nursing AIDS occupational protection work, is not conducive to maintaining the nursing staffs physical and mental health and occupational safety, is not conducive to the development of health;3、The intervention model constructed by this study improved the level of nursing staff occupational protection to HIV/AIDS, effectively improved the nurses’ occupational protection knowledge of HIV/AIDS and protection behavior compliance, for improving nursing staffs’ occupational exposure to HIV/AIDS protection level research provides practical experience.