Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.
Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.
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DOI：
10.1186/s12889-015-1673-x
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发表时间：
2015-04-11
影响因子：
4.5
通讯作者：
Quinn M
中科院分区：
文献类型：
--
作者：
Markkanen P;Galligan C;Laramie A;Fisher J;Sama S;Quinn M
家庭医疗保健是美国增长最快的行业之一。尖锐医疗器械造成的经皮损伤是家庭卫生保健工作者和社区成员血源性病原体感染的一个来源。家庭中尖锐物的使用和处置做法变化很大，没有对家庭保健中尖锐物的采购、使用和处置系统进行全面分析。这一差距阻碍了有效的公共卫生干预措施。本研究的目的是：(1)确定利器进出家庭的全部途径，涉及的利益相关者，以及使用具有伤害预防功能的利器的障碍；ii)评估预防性干预措施的杠杆点。本研究采用定性研究方法，开发两个系统地图的使用利器和预防利器伤害在家庭保健。进行了26次深入访谈，包括家庭保健机构的临床医生、公共卫生从业人员、尖锐器械制造商、伤害预防倡导者、药剂师和其他人员。访谈记录录音，并使用NVIVO定性研究分析软件进行主题分析。并对相关档案资料进行了分析。所有这些发现都指导了这两幅地图的绘制。夏普通过涉及家庭医疗保健提供者和家庭用户的多种复杂途径进入家庭。供应商报告使用具有伤害预防功能的尖锐物。然而，家庭用户的锋利很少有伤害预防功能，锋利通常被重复使用，以方便和节省成本。丢弃不当的锋利物品会对护理人员、废物处理人员和社区成员造成危害。最有效的干预潜力存在于利器系统地图的开始，在那里干预措施可以消除或尽量减少利器伤害，特别是使用无针治疗方法和具有伤害预防功能的利器。制造商和保险提供商可以通过为家庭用户提供更实惠和更容易获得的具有伤害预防功能的尖锐物来提高安全性。锐利的处置运动，免费的处置容器，和方便的处置选择仍然是必不可少的。通过促进无针治疗方法、具有伤害预防功能的利器和安全处置做法的公共卫生行动，可以预防利器伤害。所有家庭保健利益相关者都需要就尖锐物的危害进行沟通。
Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users’ sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features. Manufacturers and insurance providers can improve safety with more affordable and accessible sharps with injury prevention features for home users. Sharps disposal campaigns, free-of-charge disposal containers, and convenient disposal options remain essential. Sharps injuries are preventable through public health actions that promote needleless treatment methods, sharps with injury prevention features, and safe disposal practices. Communication about hazards regarding sharps is needed for all home healthcare stakeholders.
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DOI：
10.1097/jom.0b013e3180326552
发表时间：
2007-03-01
影响因子：
3.2
作者：
Markkanen, Pia;Quinn, Margaret;Laramie, Angela
通讯作者：
Laramie, Angela
影响因子：
7.2
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Blanco, M;Hernandez, M T;Amaya, M
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Amaya, M
DOI：
10.1186/2213-0802-2-3
发表时间：
2014
期刊：
Translational respiratory medicine
影响因子：
--
作者：
Laube BL
通讯作者：
Laube BL
影响因子：
4.9
作者：
Gershon, Robyn R. M.;Pogorzelska, Monika;Sherman, Martin
通讯作者：
Sherman, Martin
影响因子：
158.5
作者：
Mohammed, Ali Jafer;AlAwaidy, Salah;Sutter, Roland W.
通讯作者：
Sutter, Roland W.