Compliance with universal precautions among emergency department personnel caring for trauma patients
Compliance with universal precautions among emergency department personnel caring for trauma patients
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DOI：
10.1016/s0196-0644(99)70389-6
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发表时间：
1999-02-01
影响因子：
6.2
通讯作者：
Fraser, V
中科院分区：
文献类型：
--
作者：
Evanoff, B;Kim, L;Fraser, V
研究目的：急诊科人员是血源性病原体职业感染的高危人群。本研究的目的是观察和分析使用屏障预防措施之间的艾德人员照顾创伤patients.Methods：本观察性研究使用的录像带的创伤病例看到在城市一级创伤中心。研究参与者为艾德和创伤团队人员。经过培训的观察员在88个I级创伤病例的录像中的前15分钟内对屏障预防措施的使用进行了评分。当艾德人员在没有手套、面罩、手术衣和足够的眼睛保护的情况下进行侵入性手术时，“重大”破裂被评分。“轻微”休息时，艾德人员邻近创伤患者（1米内）没有穿these items.Results：我们观察到33.6%的304侵入性程序的1个或多个重大突破得分。最常见的主要断裂是未戴口罩（32.2%的手术），其次是眼镜佩戴不当（22.2%）、未穿手术服（5.6%）和未戴手套（3.0%）。在752名患者中，我们观察到55.5%的患者出现轻微骨折。大的和统计学上显着的变化被视为在不同人群的人员之间的屏障预防措施的使用率;手术的居民最有可能使用的预防措施，而主治外科医生最不可能。结论：遵守普遍的预防措施是穷人在这种高风险的临床环境。这些数据为衡量改善遵守情况的干预措施的有效性提供了基线。在这种情况下，录像观察是一种新颖而有效的工具。
Study objective: Emergency department personnel are at high risk of occupational infection with bloodborne pathogens. The objective of this study was to observe and analyze the use of barrier precautions among ED personnel caring for trauma patients.Methods: This observational study used videotapes of trauma cases seen at an urban Level I trauma center. Study participants were ED and trauma team personnel. Trained observers scored breaks in the use of barrier precautions during the first 15 minutes of 88 videotaped Level I trauma cases. "Major" breaks were scored when ED personnel performed invasive procedures without gloves, mask, gown, and adequate eye protection. "Minor" breaks were scored when ED personnel were adjacent to a trauma patient (within 1 m) without wearing these items.Results: We observed 1 or more major breaks in 33.6% of 304 invasive procedures. The most common major break was failure to wear a mask (32.2% of procedures), followed by inadequate eyewear (22.2%), no gown (5.6%), and no gloves (3.0%). We observed minor breaks during 55.5% of 752 patient encounters. large and statistically significant variations were seen in use rates of barrier precautions among different groups of personnel; surgery residents were most likely to use precautions, whereas attending surgeons were least likely.Conclusion: Compliance with universal precautions is poor in this high-risk clinical setting. These data provide a baseline for measuring the effectiveness of interventions to improve compliance. Videotaped observations are a novel and effective tool in this setting.