Occupational Exposure To Blood-borne Pathogens And Implementation Of Prevention And Control Measures Among Health Workers In A Tertiary Hospital

Objective To investigate the incidence and influencing factors of occupational exposure to blood-borne pathogens among healthcare works in a tertiary hospital,evaluate the effectiveness of occupational health protection systems,analyze the root causes of occupational exposure to blood-borne pathogens,explore the effects of occupational exposure to blood-borne pathogens on mental health issues such as sleep and burnout,and further improve the construction of hospital occupational health protection system.Method A mixed methods study with quantitative and qualitative phases was conducted.A cross-sectional study and interview method were used to investigate the occupational exposure to blood-borne pathogens in a tertiary general hospital in the past year.The crosssectional study mainly adopts the Occupational Exposure to Bloodborne pathogens Survey Questionnaire.The interview method was mainly used to conduct semi-structured in-depth interviews with key populations in the form of telephone or face to face,in order to understand the current measures and effectiveness of psychological protection for occupational exposure among healthcare works in the hospital.Results In this study,a total of 1655 questionnaires were distributed and 1559 valid questionnaires were collected,with an effective recovery rate of 94.20%.The incidence of occupational exposure to blood-borne pathogens was 4.94%,and the annual per capita occurrence rate is 6 person per hundred years.Sharp instrument injuries are the highest incidence of occupational exposure,with an incidence rate of 4.04%,the annual per capita occurrence rate is 5 person per hundred years,the incidence rate of skin and mucosal occupational contact is 1.86%,and the annual per capita occurrence rate is 2 person hundred years.Compared with the survey results in 2016,the incidence of occupational exposure to blood-borne pathogens decreased by 67.02 percentage points,the annual per capita occurrence rate decreased by 63.16 percentage points,the incidence of occupational exposure to sharp instrument injuries decreased by 67.13 percentage points,the annual per capita occurrence rate decreased by 64.29 percentage points,and the incidence of skin and mucous membrane occupational exposure decreased by 41.88 percentage points.the annual per capita occurrence rate decreased by 60.00 percentage points.The situation of occupational health training for healthcare works has significantly improved,with an increase of 24.30 percentage points in pre-employment training,9.86 percentage points in post-employment training,and 8.40 percentage points in training related to blood borne pathogens.The reporting rate of occupational exposure has significantly improved,from 29.97%to 63.96%.95.89%of healthcare works reported occupational exposure to the department director/head nurse as soon as possible.The vaccination rate of hepatitis B vaccine and the positive rate of hepatitis B antibody decreased.After occupational exposure,healthcare works are treated according to standard precautions.More than 90%of healthcare works choose to wash with clean water,and 92.50%of healthcare works choose to treat in infection control departments.The results of multifactorial logistic analysis showed that the risk of occupational exposure to blood borne pathogens among healthcare works was related to the department,hepatitis B vaccination,the level of hepatitis B antibody,mastery level of knowledge related to occupational exposure to blood borne pathogens and their universal prevention and daily working hours level.Healthcare works had relatively little rest time,with an average sleep time of 6.46 hours per night and an average lunch break of 1.12 hours.The average score of burnout was 1.77 points,and the average score of burnout among doctors was 2.03 points,which was relatively high.The results of qualitative interviews show that the system construction has achieved effective results in organizational construction,education and training,capacity building,technological innovation,cultural construction,prevention and control of occupational hazards,and moving towards a green and healthy workplace.Healthcare works may experience varying degrees of mental health issues,as well as sleep disorders and occupational fatigue after occupational exposure.which requires sufficient attention from the hospital leadership.In the future,it is necessary to strengthen publicity and training,and make corresponding improvements at both the medical institution and the individual level of healthcare works.Conclusion Compared to the results of the 2016 survey,the incidence of occupational exposure to blood borne pathogens has decreased,the reporting rate has increased,the training situation has significantly improved,continuous intervention measures have achieved significant results,and the implementation of protective measures is good.Healthcare works have certain issues of sleep and burnout,and the impact of occupational exposure on mental health cannot be ignored.In the future,it is still necessary to continue to strengthen the construction of the occupational health protection system for healthcare works,and comprehensive measures should be taken to improve in terms of pre-prevention and post-support.