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Abstract：
Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP.
After developing a \'stat\' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs.
We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period).
We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60).
Using a \'stat\' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs\' physical and psychological health during a traumatic time.
After developing a \'stat\' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs.
We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period).
We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60).
Using a \'stat\' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs\' physical and psychological health during a traumatic time.
摘要：
建议在医护人员（HCWs）的针刺伤（NSI）数小时内开始人类免疫缺陷病毒（HIV）的暴露后预防（PEP）。与等待来源患者（其血液参与NSI）的测试结果相关的延迟可能会导致暴露的HCW的心理后果以及经验性PEP的症状毒性。
在开发了一个“统计”（立即）工作流程后，优先考虑放血和来源患者血液工作，以便立即处理和处理，我们回顾性调查了我们的新工作流程是否(i)减少了来源患者HIV血液的HIV订单-结果间隔时间,以及(ii)减少了HIVPEP处方分配给暴露HCWs的频率.
我们回顾性分析了NSI记录，以确定6年期间（包括54个月的干预前期间和16个月的干预后期间）的源患者HIV订单-结果间隔和PEP分配频率。
我们确定了251个NSI，在我们的干预前后发生的频率相似(平均每月3.54个NSI和3.75个NSI，分别)。从我们的干预后195到156分钟，HIV顺序-结果间隔中位数显着降低（P<0.05），而接受一种或多种剂量PEP的HCWs比例显着降低（P<0.001），从50％（96/191）降至23％（14/60）。
使用\'stat\'工作流程在NSI之后确定源患者测试的优先级，我们实现了排序-结果间期的适度降低和HIVPEP分配率的显著降低.这种简单的干预可能会在创伤时期改善医护人员的身心健康。
在开发了一个“统计”（立即）工作流程后，优先考虑放血和来源患者血液工作，以便立即处理和处理，我们回顾性调查了我们的新工作流程是否(i)减少了来源患者HIV血液的HIV订单-结果间隔时间,以及(ii)减少了HIVPEP处方分配给暴露HCWs的频率.
我们回顾性分析了NSI记录，以确定6年期间（包括54个月的干预前期间和16个月的干预后期间）的源患者HIV订单-结果间隔和PEP分配频率。
我们确定了251个NSI，在我们的干预前后发生的频率相似(平均每月3.54个NSI和3.75个NSI，分别)。从我们的干预后195到156分钟，HIV顺序-结果间隔中位数显着降低（P<0.05），而接受一种或多种剂量PEP的HCWs比例显着降低（P<0.001），从50％（96/191）降至23％（14/60）。
使用\'stat\'工作流程在NSI之后确定源患者测试的优先级，我们实现了排序-结果间期的适度降低和HIVPEP分配率的显著降低.这种简单的干预可能会在创伤时期改善医护人员的身心健康。
