BBP EXPOSURE AND RISK FACTORS IN NON-HOSPITAL BASED HCWS

非医院 HCWS 中的 BBP 暴露和风险因素

• 批准号: 6446055
• 负责人: ROBYN R.M. GERSHON
• 金额: $ 32.5万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6446055
• 关键词: clinical research; cooperative study; correctional institutions; disease /disorder proneness /risk; emergency health services; health care personnel; health surveys; hospices; human subject; mental health facility; nosocomial infections; nursing homes; occupational hazard; occupational health /safety

Proposed is a three-year collaborative, multidisciplinary, study designed to determine rates and risk factors for blood/body fluid exposure incidents in non-hospital based health care workers (HCWs). This proposal is an extension of studies we have conducted over the past decade involving hospital-based and non-hospital based HCWs. This work augments earlier research by focusing on a large and diverse range of non-hospital settings, including several for which data are particularly sparse. Given that there are both effective primary (e.g., engineering devices) and secondary (e.g., post- exposure prophylaxis) preventive strategies for managing risk and given that the extent of risk and the prevalence of risk management controls in many non-hospital settings is largely unknown, the public health significance of this problem cannot be overstated. This study is designed to address important knowledge gaps by collecting data from a wide variety of non- hospital settings, including: 1) mental disabilities facilities, 2) nursing homes, 3) drug treatment facilities, 4) AIDS clinics, 5) emergency medical services (EMS) , 6) doctors' offices and clinics, 7) hemodialysis clinics, 8) police departments, 9) correctional facilities, and 10) home health care and hospice facilities. These groups were chosen either because of published reports that they may be at high risk (e.g., EMS) or anecdotal reports of potential risk (e.g., correctional officers) or because recent data suggest that they may be at risk (police officers) or simply because there is a lack of information on this population (hospice employees). In order to meet the specific aims and goals of the study we will randomly select a sample of 6000 employees (600 per group) to receive a confidential self-administered mailed survey. Additionally, a sample of 1000 hospital based nurses will also be randomly selected to allow for occupational comparisons between hospital and non-hospital work settings. Participants will be recruited from the following agencies: (a) the New York Public Employees Federation, (b) the New York Patrolmen's Benevolent Association, (c) the New York State Nurses Association, and (d) the New York State Department of Correctional Services. Our overarching goal of the study is to identify data-driven opportunities for risk reduction. This will be accomplished by innovative Participatory Action Research teams, comprised of both researchers and study participants. An important and novel product of this study will be the development of a Risk grid a simple tool that employees and employers can use to determine exposure risk and, importantly, the steps to take to reduce that risk. This study will improve our understanding of the risks facing non-hospital HCWs and allow us to focus our energies and resources appropriately.

提议进行一项为期三年的多学科合作研究，旨在确定非医院卫生保健工作者（HCWs）血液/体液接触事件的发生率和危险因素。这项建议是我们在过去十年对医院和非医院卫生保健员进行的研究的延伸。这项工作通过关注大量不同的非医院环境（包括一些数据特别稀少的环境）来增强早期的研究。鉴于既有有效的一级（如工程装置）和二级（如暴露后预防）预防策略来管理风险，又鉴于风险的程度和风险管理控制在许多非医院环境中的普遍程度在很大程度上是未知的，这个问题的公共卫生重要性怎么强调都不为过。本研究旨在透过收集各种非医院环境的资料，以解决重要的知识空白，包括：1)精神残障机构、2)疗养院、3)药物治疗机构、4)爱滋病诊所、5)紧急医疗服务（EMS）、6)医生办公室和诊所、7)血液透析诊所、8)警察部门、9)惩教设施，以及10)家庭保健和临终关怀设施。之所以选择这些群体，要么是因为已发表的报告表明他们可能处于高风险（例如，EMS），要么是因为潜在风险的轶事报告（例如，惩教人员），要么是因为最近的数据表明他们可能处于风险中（警察），要么仅仅是因为缺乏关于这一人群的信息（临终关怀员工）。为了达到研究的具体目的和目标，我们将随机选择6000名员工（每组600人）来接受一份保密的自我管理的邮寄调查。此外，还将随机选择1000名医院护士的样本，以便在医院和非医院工作环境之间进行职业比较。参与者将从以下机构招募：(a)纽约州公共雇员联合会，(b)纽约州巡警慈善协会，(c)纽约州护士协会，以及(d)纽约州惩教署。我们研究的首要目标是确定数据驱动的降低风险的机会。这将由创新的参与式行动研究小组完成，该小组由研究人员和研究参与者组成。这项研究的一个重要而新颖的成果将是风险网格的开发，这是一个雇员和雇主可以用来确定暴露风险的简单工具，更重要的是，可以采取措施降低风险。这项研究将提高我们对非医院医护人员面临的风险的认识，使我们能够适当地集中精力和资源。