Evaluation of Traumatic Injuries in HCV During Surgery

描述（由申请人提供）：有超过800万的医疗保健 工人（美国的HCW和大约600，000 - 100万针刺伤发生 导致HCW中新增1000例HIV、HBV、HCV病例。最近增加的 针刺伤/锐器伤和接触血源性病原体的比率 据报道，超过50%的HCW工作人员在操作 与其他环境中的其他HCW相比，最重要的是，22 据报道，所有针刺伤中， 33%的受伤发生在手术区域， 发生在手术部位，59%发生在非显性 手 建议采用交替区组设计（4个6个月区组）：1） 调查与针刺/锐器损伤相关的因素， 手术事件和2）评估特定的手术因素（手术时间） 手术，手术器械，利手，指示手套的使用 针刺/锐器损伤，手术顺序），影响发生率 手术期间HCW中的创伤性（针刺/锐器）损伤。期间 24-一个月的数据收集期，所有手术室人员参与 将对研究进行使用指示手套和医疗器械（钝头）的培训 缝合针和可伸缩手术刀），旨在降低 针刺伤/锐器伤。数据将由巡回室护士收集 手术类型、HCW识别、HCW的作用、使用的手术器械 在手术事件期间，以及在该事件期间手套更换的次数。 手术后，将收集所有手套，并进行目视检查 缺陷、切口和孔洞，并通过 标准化FDA漏水测试方法（1000 cc/2分钟）。 将进行多变量分析和逻辑回归以确定 手术室人员针刺/锐器伤害的预测因素。

DESCRIPTION (provided by the applicant): There are over 8 million health care workers (HCW in the U.S. and approximately 600,000-1 million needlesticks occur resulting in 1000 new cases of HIV, HBV, HCV among HCW. Recent increases in the rate of needlestick/sharp injuries and exposure to bloodborne pathogens has been reported to be greater than 50 percent in HCW who work in the operating room (OR) as compared to other HCW in other settings. Most important, 22 percent of all needlestick injuries have been reported by surgical personnel with 33 percent of the injuries occurring in the surgical field, 25 percent occurring at the surgical site, 59 percent occurring with the non-dominant hand. An alternating block design (four six month blocks) is proposed to: 1) investigate the factors associated with needlestick/sharp injury during a surgical episode and 2) to evaluate specific surgical factors (length of surgery, surgical instrumentation, handedness, use of indicator gloves for needlestick/sharp injury, sequence of surgical cases) that impact on the rate of traumatic (needlestick/sharp) injury among HCW during surgery. During a 24-month data collection period all operating room personnel involved in the study will be trained to use an indicator glove and medical devices (blunt suture needles and retractable scalpels) engineered to reduce the rate of needlestick/sharp injuries. Data will be collected by circulating room nurses for type of surgery, HCW identification, role of HCW, surgical instruments used during a surgical episode, and numbers of glove changes during the episode. Following the surgical event, all gloves will be collected, visually inspected for defects, cuts, and holes and tested for barrier integrity via the standardized FDA waterleak test method (1000cc/2 min.). Multivariate analysis will be conducted and logistic regression to determine the factors predictive of needlestick/sharp injuries to OR personnel.