Investigation Into The Occupational Exposure Status Of Clinical Nursing Staff In General Hospitals And The Effect Evaluation For The Intervention Measures On Changing Their Knowledge, Attitude And Practice

Occupational exposure of medical personnel refers to the condition inwhich they have contact with toxic or harmful substance in their work.Particularly, the clinical nursing staff is the high risk group because they aremore frequently exposed to the harmful factors.Blood-borne infection, infection with respiratory pathogens, physical/chemical injury, as well as concomitant psychological troubles are the mostcommon factors closely related to the occupational exposure of medicalpersonnel. Among them, the sharp injury is the major route of blood-borneinfectious diseases transmission. According to the U.S. Centers for DiseaseControl, there are about600,000to800,000cases of sharp injury in thecountry every year, and some80%occurring in clinical nursing staff. Almostevery nurse once experienced sharp injury. In recent years, with increased tumor prevalence and continuousdevelopment of anticancer drugs, the exposure to these drugs has graduallybecome a more harmful factor. Most anticancer drugs are made of cytotoxicagents with mutagenicity, carcinogenicity and teratogenicity. They can notonly kill cancer cells, but also kill normal cells or cause damage to normalcells. Long-term low-dose exposure to the drugs will do harm to those whohave to prepare the medicine for patients if without adequate protection.Nursing staff’s awareness, knowledge and skills for occupationalprotection may have direct effect on the nurses’ health as well as the patients’.This study aimed at investigating the occupational exposure and protectionstatus of clinical nursing staff vocationally exposed to blood-borne infectionand anti-tumor drugs by means of an epidemiology research in a generalhospital. In the meantime, the corresponding intervention measures, such asoccupational protection training and testing, were employed and analyzedwith the purpose of improving the effectiveness of occupational protectionand providing a scientific basis for establishing a better protection system.Part I Investigation into the occupational exposure status of the nursingstaff vocationally exposed to blood-borne pollution and study on thecorresponding intervention measures and its protectionAims: Investigating the risk factors of occupational exposure toblood-borne infection, the related damages, and the nursing staff’s awareness,knowledge and skills for occupational protection, and evaluating theeffectiveness of the corresponding intervention measures we took.Measures: A self-designed questionnaire was used to survey all theclinical nursing staff in a Grade III Class A general hospital, involving theirknowledge for occupational exposure and behavior in working practice. Then,the corresponding intervention measures were employed, including training,testing and optimizing the allocation of human resources.6months later, same questionnaire was used, and the results of the two surveys were compared andanalyzed.Results:1. The occurrence of sharp injury is correlated negatively with the nurses’years of service（P<0.01）,while no obvious correlation was found between itand the nurses’ title or education. It suggested that sharp injury is a risk factorfor the shorter-serving nurses.2. The occurrence of glass scratch was the highest on all the sharpinjuries, and decreased from the hypodermic needle stab, suture needle stab,medical infusion set stab to blade scratch.3. The occurrence of sharp injury decreased significantly from52.2%to31.3%（P<0.01）.The nursing staff’s knowledge for the standardized protectionwas obviously improved（P<0.01）after the intervention measures wereemployed, but there was no change on the types of sharp injuries.Conclusion: The intervention measures can effectively decrease theoccupational exposure to blood-borne infection.Part II Investigation into the occupational exposure status of thenursing staff vocationally exposed to anti-tumor drugs and study on thecorresponding intervention measuresAims: Investigating the risk factors of occupational exposure toanticancer drugs, the related damages, and the nursing staff’s awareness,knowledge and skills for occupational protection, and evaluating theeffectiveness of the corresponding intervention measures we took.Measures: A self-designed questionnaire was used to survey all theclinical nursing staff in a Grade III Class A general hospital, involving theirknowledge for occupational exposure and behavior in working practice. Then, the corresponding intervention measures were employed, including training,testing and other management measures.6months later, same questionnaire wasused, and the results of the two surveys were compared and analyzed.Results:1.56.5%of the nursing staff learnt the absorption path of anticancerdrugs;57.7%of them knew how to deal with drug splashing;66.7%of themknew what to do after their skin or mucous membranes contact withanticancer drugs;60.7%of them grasped the correct methods of preparing theanticancer drugs.2.89.3%of the nursing staff never wore goggles when preparing anticancerdrugs;86.9%of them never wore protective suits;87.5%of them never woreprotective helmets.3. The nursing staff’s knowledge for the standardized protection wasobviously improved（P<0.01）after the intervention measures were employed.Conclusion: There is serious structural deficiency in the understanding andrelated protection practices of clinical nursing staff vocationally exposed toanti-tumor drugs in the target hospital．The protection measures currentlyemployed in medical practice were found to be inadequate in virtually everyaspect considered. It is recommended that full occupational protection training iseffective in improving the status.