Needlestick Injuries

针刺伤
  • 文章类型: Journal Article
    目的:探讨失效模式与效应分析(FMEA)方法在口腔医护人员针刺伤风险管理中的应用价值。
    方法:珠江医院口腔科37名医护人员,南方医科大学,被选为研究对象。2021年1月至2021年12月遵循常规风险管理程序,作为对照组,而基于FMEA的风险管理在2022年1月至2022年12月实施,代表研究组.计算了风险优先数(RPN),并对确定的前5种失效模式实施干预措施.RPN分数,针刺伤的发生率,医护人员的知识和意识水平,预防行为,比较两组患者对管理的满意度。
    结果:基于FMEA的风险管理发现保护知识薄弱,乱七八糟的放置锋利的仪器,未能遵守操作标准,操作程序不当,和不足以防止针刺伤害的规则作为前五大故障模式。研究组各模式的RPN评分均明显降低(P<0.05)。研究组出现针刺伤的频率和发生率较低(P<0.05),随着更高水平的医疗保健知识,预防意识,预防行为(P<0.05)。此外,研究组对管理的满意度高于对照组(P<0.05)。
    结论:基于FMEA的风险管理可以提高口腔医护人员预防针刺伤的能力,减少此类事件的发生,提高管理层满意度。这种方法有望得到更广泛的采用。
    OBJECTIVE: To explore the application value of the Failure Mode and Effects Analysis (FMEA) method in the risk management of needlestick injuries among oral healthcare personnel.
    METHODS: A total of 37 healthcare workers from the dental department of Zhujiang Hospital, Southern Medical University, were selected as study subjects. Routine risk management procedures were followed from January 2021 to December 2021, serving as the control group, while FMEA-based risk management was implemented from January 2022 to December 2022, representing the research group. The Risk Priority Number (RPN) was calculated, and interventions were implemented for the top five identified failure modes. The RPN score, incidence of needlestick injuries, healthcare personnel\'s knowledge and awareness levels, prevention behavior, and rate of satisfaction with management were compared between the two groups.
    RESULTS: FMEA-based risk management identified weak knowledge of protection, disorganized placement of sharp instruments, failure to adhere to operational standards, improper operational procedures, and insufficient regulations for preventing needlestick injuries as the top five failure modes. The RPN scores for these modes were significantly lower in the research group (P<0.05). The research group also experienced a lower frequency and incidence of needlestick injury (P<0.05), along with higher levels of healthcare knowledge, awareness of prevention, and prevention behavior (P<0.05). Additionally, satisfaction with management was higher in the research group compared to the control group (P<0.05).
    CONCLUSIONS: FMEA-based risk management can improve the ability of oral healthcare personnel to prevent needlestick injury, reduce the occurrence of such incidents, and enhance satisfaction with management. This approach holds promise for wider adoption.
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  • 文章类型: Journal Article
    糖尿病是一种长期的疾病,如果糖尿病患者感染了血液传播传染病,并且没有遵循适当的注射器处置方法,他们有很长一段时间将感染传染给他人的危险。而在中国,关于在家中处理尖锐物体的研究较少。因此,有必要翻译和本地化知识-态度-实践问卷关于急剧处置糖尿病患者,以评估当前的患者知识水平,态度,和实践,并改善促进安全锐器处理实践的基础。
    这项调查是一项横断面研究。对有关尖锐处置的知识-态度-实践问卷进行了本地化和调试,并进行了信度和效度测试。然后用一般特征问卷对334例患者进行调查,关于尖锐处置的知识-态度-实践问卷,并对患者锐器处置执业水平的影响因素进行分析。
    态度部分的Cronbach\'sα值为0.864,内容效度指数为0.923。知识和实践部分符合大陆语言公约,易于理解,没有任何歧义。大多数(52%)的参与者知识贫乏,对处置尖锐物体持中立态度。糖尿病患者的锐器处置实践很差,因为约90%的患者将其使用过的锐器直接丢弃到生活垃圾中。此外,我们发现教育水平,知识和态度是糖尿病患者利器处置实践的主要预测因素(R2=0.573,p<0.001).
    关于尖锐处置的知识-态度-实践问卷的中文版在中国具有适用性。在中国,目前处置用过的利器的做法是不恰当的。此外,大多数受试者的知识和态度水平较低。提高人们的认识,并鼓励糖尿病患者遵循适当的锐器处置方法,需要持续的教育和当地量身定制的安全尖锐处置替代方案。
    UNASSIGNED: Diabetes Mellitus is a long duration disease, and if a person with diabetes is infected with a blood-borne infectious disease and proper syringe disposal practices are not followed, they run the danger of transmitting the infection to others for a very long period. Whereas fewer research has been done in China on the handing of sharp objects at home. Therefore, there is a need to translate and localize the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal for diabetic patients to assess the current level of patient knowledge, attitudes, and practices and to improve the basis for promoting safe sharps handling practices.
    UNASSIGNED: This investigation was a cross-sectional study. The Knowledge-Attitude-Practice Questionnaire regarding sharp disposal was localized and debugged and tested for reliability and validity, and then 334 patients were investigated by General Characteristics Questionnaire, Knowledge- Attitude-Practice Questionnaire regarding sharp disposal, and the influencing factors of practice level regarding sharp disposal of patients were analyzed.
    UNASSIGNED: The Cronbach\'s α value of the attitude section was 0.864 and the content validity index was 0.923. The knowledge and practice sections are in line with continental language conventions and are easy to understand without any ambiguity. The majority (52%) of the participants had poor knowledge and a neutral attitude toward disposing of sharp objects. Sharps disposal practices among diabetes mellitus patients were poor since about 90% of patients dispose of their used sharps directly into the household waste. Furthermore, we found that level of education, knowledge and attitude were the major predictors of practices regarding sharps disposal among diabetic patients (R 2 = 0.573, p < 0.001).
    UNASSIGNED: The Chinese version of the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal has applicability in China. In China, current practice of disposing used sharps is improper. Additionally, the majority of the subjects had low levels of knowledge and attitudes. To raise awareness and encourage diabetic patients to follow appropriate sharps disposal practices, there needs to be ongoing education and a locally tailored safe sharp disposal alternative accessible.
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  • 文章类型: Journal Article
    目的:本研究旨在利用人为因素分析与分类系统(HFACS)的理论框架,调查临床护士针刺伤(NSI)的现状,并确定相关因素。
    方法:进行了全国横断面调查。
    方法:采用多阶段抽样的方法对中国14家医院的3336名护士进行调查。采用描述性统计以及单变量和多变量逻辑回归来揭示NSI的发生率及其相关因素。
    结果:共有970名护士(29.1%)报告在过去一年中至少经历过一次NSI。多因素logistic回归分析显示,与内科护士相比,重症监护病房(ICU)和急诊科良好的医院安全氛围和临床护士对NSI具有保护作用。护士,高级护士,与副主任或以上护士相比,主管护士显著增加了NSI的风险。视力差但戴眼镜和视力差但不戴眼镜的患者更容易患有NSI。在手术室工作与内科相比,平均每周工作时间>45h与≤40h相比,一般健康状况差导致NSI风险增加。
    结论:我国临床护士的NSI率较高。个人因素包括职称,部门,视力和一般心理健康以及组织因素,包括每周工作时间和医院安全氛围与NSI的发生显着相关。
    结论:护理管理者应关注临床护士的身心状况,需要组织支持来增强医院的安全氛围。
    患者或公众的贡献无关紧要,因为本研究旨在探讨临床护士与NSI相关的现状和因素。
    OBJECTIVE: This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS).
    METHODS: A nationwide cross-sectional survey was conducted.
    METHODS: Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors.
    RESULTS: A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs.
    CONCLUSIONS: The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs.
    CONCLUSIONS: Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere.
    UNASSIGNED: Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.
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  • 文章类型: Journal Article
    针头和锐器伤(NSI)具有传播多种血源性病原体的风险,导致健康和经济负担。医疗保健工作者(HCWs)对NSI的漏报是一个全球关注的问题,及时治疗和并发症的预防依赖于适当的报告。漏报进一步阻碍了准确的监测和适当的资源分配,发达国家和发展中国家由于医疗保健政策的差异而面临差距。
    这项研究的目的是检查NSI和NSI漏报的流行病学,以及确定与NSI的发生和此类伤害的漏报相关的决定因素。
    于2022年1月15日至1月31日在甘肃省的医护人员(HCWs)中进行了回顾性在线调查。中国。
    共有来自各个机构的7,283名医护人员(HCWs)参加了这项研究。经过质量保证检查,最终分析中包括6,464(88.77%)个应答。结果显示,受访者中自我报告的针刺和锐器伤(NSI)发生率为32.86%,28.53%的国家统计机构未报告。与普遍的信念相反,与经验不足的同行相比,经验丰富的HCW表现出更高的NSI和漏报率。NSI和漏报的主要原因是浓度下降,没有感觉到患者具有传染性。多元回归分析揭示了训练频率的显著影响,职业,关于NSI发生的部门和服务年限。相反,NSI的报告主要受培训的影响,报销,职业,科室和医院等级。与没有训练的医护人员相比,每年接受3次以上培训的人NSI发病率降低12.16%(27.12%vs.39.28%,p<0.001),漏报率降低55.68%(14.61%与70.29%,p<0.001)。
    迫切需要加强监视,量身定制的培训计划,以及更有效的报告机制来应对这一重大的职业健康挑战。
    Needlestick and sharp injuries (NSI) carry the risk of transmitting numerous bloodborne pathogens, leading to both health and economic burdens. The underreporting of NSIs among healthcare workers (HCWs) is a global issue of concern, as timely treatment and prevention of complications rely on proper reporting. Underreporting further impedes accurate surveillance and appropriate resource allocation, with developed and developing nations facing disparities due to differences in healthcare policy.
    The purpose of this research is to examine the epidemiology of NSIs and NSI underreporting, as well as to identify the determinants associated with the occurrence of NSIs and the underreporting of such injuries.
    A retrospective online survey was conducted from January 15 to January 31, 2022 among healthcare workers (HCWs) across Gansu Province, China.
    A total of 7,283 healthcare workers (HCWs) from various institutions participated in this study. After quality assurance checks, 6,464 (88.77%) responses were included in the final analysis. Results revealed a 32.86% self-reported needlestick and sharp injury (NSI) incidence among respondents, with 28.53% of NSIs going unreported. Contrary to common belief, more experienced HCWs exhibited higher rates of both NSIs and underreporting compared to their less experienced peers. The primary reasons cited for NSIs and underreporting were lapses in concentration and not perceiving patients as infectious. Multivariate regression analysis exposes the significant influence of training frequency, occupation, department and years of services on the occurrence of NSIs. Conversely, the reporting of NSIs is primarily influenced by training, reimbursement,occupation, department and hospital grade. Compared to HCWs with no training, those who received ≥3 training sessions per year showed a 12.16% lower NSI incidence (27.12% vs. 39.28%, p < 0.001) and a 55.68% lower underreporting rate (14.61% vs. 70.29%, p < 0.001).
    There is a pressing need for enhanced surveillance, tailored training programs, and more efficient reporting mechanisms to combat this significant occupational health challenge.
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  • 文章类型: Systematic Review
    目标:随着糖尿病患者数量的增加,家庭产生的尖锐废物的数量也是如此,不正确的锐器处置方法会使公众暴露于针刺伤。这项系统研究评估了糖尿病患者锐器废物处置的相关因素和现状。
    方法:在这篇综述中,我们的研究全面搜索了PubMed,MEDLINE,科克伦图书馆,EMBASE,WebofScience,和中国生物医学,万方,以及“尖锐废物处理”和“糖尿病”的概念CNKI文献。
    结果:在12篇确定的文章中,有4155名糖尿病患者。研究结果强调,糖尿病患者对尖锐废物处理持积极态度,但是缺乏锐利废物处理的知识和实践,并需要采取适当措施,提高废物在使用前和使用期间的适当处理率。糖尿病持续时间较长的患者更有可能从事不适当的锐器处置行为。
    结论:研究结果强调,大多数糖尿病患者无法安全地处理利器,因此,在未来的临床实践中,需要更多的研究来寻找与糖尿病患者尖锐废物处理相关的因素,并关注疾病持续时间较长的患者的尖锐废物处理行为。
    背景:PROSPEROID。该评论已在PROSPERO(注册号:CRD42023427592)https://www上注册。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023427592。
    OBJECTIVE: As the number of people with diabetes increases, so does the amount of household-generated sharp waste, and incorrect sharp disposal methods can expose the public to needle stick injuries This systematic study assesses the relevant factors and current situation of the disposal of sharp waste in diabetes patients.
    METHODS: In this review, our study comprehensively searched PubMed, MEDLINE, Cochrane Library, EMBASE, Web of Science, and China Biomedical, Wanfang, and CNKI for the concepts of \"sharps waste disposal\" and \"diabetes\".
    RESULTS: In 12 identified articles, there are 4155 patients with diabetes. The findings highlight that diabetic patients have a positive attitude towards sharps waste disposal, but lack knowledge and practice of sharps waste disposal, and need to take appropriate measures to improve the rate of proper waste disposal before and during use. Patients with longer duration of diabetes are more likely to engage in inappropriate sharps disposal behaviors.
    CONCLUSIONS: The findings emphasize that the majority of diabetic patients are unable to handle sharps safely, so more research is needed to find factors associated with sharps waste disposal in diabetic patients and to focus on sharps waste disposal behaviors in patients with longer duration of disease in future clinical practice.
    BACKGROUND: PROSPERO ID. The review was registered on PROSPERO (registration number: CRD42023427592) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023427592.
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  • 文章类型: Journal Article
    目的:目的了解新入职护士的职业防护行为及其影响因素。
    方法:采用便利抽样法,于2018年7月至2019年11月选取我院新入职护士。调查采用一般资料问卷,工作态度量表(Wa),和职业防护行为量表。
    结果:150名新入职护士职业防护行为总分为18.94±3.59。工作态度得分与职业防护行为呈显著负相关(r=-0.324,p<0.001)。多元线性回归分析表明,以前参加过护理技能竞赛,招募前的针刺伤经验,工作态度得分,平均每日睡眠时间(p<0.05)是影响职业防护行为的独立因素。
    结论:新入职护士职业防护意识整体相对较弱,有待进一步提高。该群体改善职业防护行为的能力可能会通过提高适应性而受到积极影响。改善睡眠,积极参与护理技能竞赛,加强职业防护指导和教育。
    OBJECTIVE: Aim The objective of this study was to understand the occupational protective behaviors of newly recruited nurses and explore the influencing factors.
    METHODS: A convenience sampling method was used to select newly recruited nurses in our hospital from July 2018 to November 2019. The survey was conducted using the general information questionnaire, work attitude scale (Wa), and occupational protective behavior scale.
    RESULTS: The total score of occupational protective behaviors of 150 newly enrolled nurses was 18.94 ± 3.59. There was a significant negative correlation between work attitude score and occupational protective behaviors (r = -0.324, p < 0.001). Multiple linear regression analysis showed that gender, previous participation in nursing skill-based competitions, experience of needlestick injuries before recruit, work attitude score, average daily sleep time (p < 0.05) were independent factors influencing occupational protective behaviors.
    CONCLUSIONS: The overall occupational protective awareness of newly enrolled nurses is relatively weak and needs to be further improved. The group\'s ability to improve occupational protective behaviors may be positively impacted through increased adaptability, improved sleep, active participation in nursing skill-based competitions, strengthening guidance and education on occupational protection.
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  • 文章类型: Observational Study
    Dental interns are vulnerable to needlestick injuries (NSI). The objectives of this study were to examine the prevalence and characteristics of NSI exposures among dental interns during their first-year clinical training, assess risk factors, and evaluate reporting behaviours.
    An online survey was conducted among dental interns of Class 2011-2017 at Peking University School and Hospital of Stomatology (PKUSS), China. The self-administrated questionnaire consisted of information on demographic profiles, NSI characteristics, and reporting practices. The outcomes were presented by descriptive statistics. A multivariate regression analysis was performed to assess NSI sources using a forward step-wise approach.
    A total of 407 dental interns completed the survey (response rate 91.9%, 407/443), and 23.8% sustained at least one NSI. The mean number of NSIs per intern was 0.28 during the first clinical year. More occupation exposures occurred from October to December, between 13:00-15:00. Syringe needles were the most frequent sources, followed by dental burs, suture needles, and ultrasonic chips. The risk of peer-inflicted NSIs in the department of Paediatric Dentistry was 12.1 times higher than that in Oral Surgery (OR 12.1, 95% CI: 1.4-101.4). Appropriately 64.9% NSIs occurred when chairside assistants were absent. Compared to working alone, the risk of peer-inflicted NSIs was 32.3 times higher when providing chairside assistance (OR 32.3, 95% CI: 7.2-145.4). The left-hand index finger was the most commonly injured site. About 71.4% of exposures were reported in paperwork.
    Dental interns are susceptible to NSIs during their first-year clinical training. Extra attention should be paid to syringe needles, dental burs, suture needles, and ultrasonic chips. The lack of chairside assistance is hazardous regarding NSIs. The training of chairside assistance of the first-year dental interns should be enhanced. First-year dental interns are required to increase their awareness of ignored behaviors related to NSI exposures.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    UNASSIGNED:研究PDCA(Plan-Do-Check-Act)过程管理对护理实习生针头损伤发生率和心理焦虑的影响。
    未经授权:本研究属于实验研究。对2020年3月至2022年4月在医院实习的180名护理实习生进行了研究。选取2020年3月至2021年3月共135名实习生作为对照组,选取2021年4月至2022年4月共175名实习生作为研究组。课题组进行了PDCA流程管理。对照组仅按照常规教学计划不进行任何干预。针头损伤的发生率,理论知识,行为得分,焦虑自评量表(SAS),职业自我效能感问卷得分,管理前后12个月进行护理实践满意度评分。
    未经批准:管理后,研究组的针刺损伤发生率低于对照组,组间差异有统计学意义(P<0.05)。理论知识的分数,态度,与对照组相比,研究组的行为更高,管理后组间差异有统计学意义(P<0.05)。经过12个月的管理,研究组SAS评分低于对照组,组间差异有统计学意义(P<0.05)。研究组职业自我效能感问卷得分高于对照组,经PDCA流程管理后,组间差异有统计学意义(P<0.05)。经过12个月的管理,研究组护理实践满意度得分高于对照组,组间差异有统计学意义(P<0.05)。
    UNASSIGNED:通过PDCA流程管理,我们可以在实践中了解护理专业学生针刺伤的情况,并更详细地分析每个护理专业学生职业暴露的根本原因和治疗结果。护生在临床实践中不仅学到了更多的实践知识,而且感受到医院对护生的重视和关怀,这大大提高了他们的满意度。
    UNASSIGNED: To research the influence of PDCA (Plan-Do-Check-Act) process management on the incidence of needle injury and psychological anxiety of nursing interns.
    UNASSIGNED: This study belonged to the experimental study. A total of 180 nursing interns who practiced in the hospital from March 2020 to April 2022 were studied. A total of 135 interns from March 2020 to March 2021 were selected as the control group and 175 interns from April 2021 to April 2022 as the research group. PDCA process management was carried on in the research group. The control group did not make any intervention only following the routine teaching plan. The incidence of needle injury, theoretical knowledge, behavior score, self-rating anxiety scale (SAS), professional self-efficacy questionnaire score, and nursing practice satisfaction score were evaluated before and after 12 months of management.
    UNASSIGNED: After management, the incidence of needle injury in the research group was lower compared to that in the control group, and there are statistically significant differences between groups (P < 0.05). The scores of theoretical knowledge, attitude, and behavior in the research group were higher compared to those in the control group, and there are statistically significant differences between groups (P < 0.05) after management. After 12 months of management, the SAS score of the research group was lower compared to that of the control group, and there are statistically significant differences between groups (P < 0.05). The score of occupational self-efficacy questionnaire in the research group was higher compared to that in the control group, and there are statistically significant differences between groups (P < 0.05) after PDCA process management. After 12 months of management, the satisfaction score of nursing practice in the research group was higher compared to that in the control group, and there are statistically significant differences between groups (P < 0.05).
    UNASSIGNED: Through PDCA process management, we can keep abreast of the situation of needlestick injuries among nursing students in practice and analyze in more detail the root cause of each nursing student\'s occupational exposure and the outcome of treatment. The nursing students not only learn more practical knowledge in clinical practice but also feel that the hospital values and cares for them, which greatly increases their satisfaction.
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  • 文章类型: Meta-Analysis
    针刺伤(NSI)是对医护人员健康的严重威胁,护士,和护理学生,因为他们会让他们接触传染病。在世界范围内的不同研究中,这种类型的伤害的患病率不同。因此,本研究旨在评估护理专业学生中NSI的合并患病率.
    这项研究是通过搜索WebofScience中的文章来进行的,PubMed,Scopus,Embase,和谷歌学者没有时间限制使用以下关键字:针刺,针刺,锐器伤,和护理学生。使用荟萃分析方法和随机效应模型对数据进行分析。采用纽卡斯尔-渥太华质量评价量表(NOS)评价文章的质量。使用I2指数检查了研究的异质性,收集的数据使用STATA软件版本16进行分析。
    最初,检索到1134篇文章,其中32篇合格文章被纳入分析。护理学生报告了35%的NSI(95%CI:28-43%)和63%(95%CI:51-74%)没有报告针刺伤。患病率最高的是在亚洲进行的研究(39.7%;95%CI:31.7-47.7%)。NSI患病率和样本年龄之间没有显着相关性,和文章发表年份。
    三分之一的护生报告经历了NSI。因此,需要考虑职业危害预防培训和学生支持措施。
    Needle-stick injuries (NSI) are a serious threat to the health of healthcare workers, nurses, and nursing students, as they can expose them to infectious diseases. Different prevalence rates have been reported for this type of injury in different studies worldwide. Therefore, this study aimedto estimate the pooled prevalence of NSI among nursing students.
    This study was conducted by searching for articles in Web of Science, PubMed, Scopus, Embase, and Google Scholar without time limitation using the following keywords: needle-stick, needle stick, sharp injury, and nursing student. The data were analyzed using the meta-analysis method and random-effects model. The quality of the articles was evaluated with Newcastle-Ottawa Quality Assessment Scale (NOS). The heterogeneity of the studies was examined using the I 2 index, and the collected data were analyzed using the STATA Software Version 16.
    Initially, 1,134 articles were retrieved, of which 32 qualified articles were included in the analysis. Nursing students reported 35% of NSI (95% CI: 28-43%) and 63% (95% CI: 51-74%) did not report their needle-stick injuries. The highest prevalence was related to studies conducted in Asia (39.7%; 95% CI: 31.7-47.7%). There was no significant correlation among NSI prevalence and age of samples, and article year of publication.
    A third of nursing students reported experiencing NSI. Consequently, occupational hazard prevention training and student support measures need to be considered.
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