Evaluation of Traumatic Injuries in HCV During Surgery

描述(申请人提供)：有超过800万的医疗保健服务 工人(美国的HCW和大约600,000-100万针发生 导致新发艾滋病、乙肝、丙型肝炎病例1000例。在最近的增长中 针刺/锐器伤和接触血液传播病原体的比率 据报道，在运营中工作的HCW中有50%以上 房间(OR)与其他环境中的其他HCW相比。最重要的是，22 手术人员报告的针刺伤占所有针刺伤的百分比 33%的受伤发生在外科领域，25% 发生在手术部位，59%发生在非显性 手。 提出了交替区组设计(4个6个月区组)以：1) 调查与针刺/锐器伤有关的因素 手术插曲和2)评估特定的手术因素(长度 手术、外科器械、惯用手、指示器手套的使用 针头/锐器伤、手术顺序)对发病率的影响 手术中母婴的创伤性(针刺性/锐性)损伤的发生率。在一次 24个月的数据采集期所有参与手术的手术室人员 将对研究人员进行使用指示器手套和医疗器械的培训(钝 缝合针和可伸缩手术刀)被设计成降低 针扎/刺伤。数据将由循环室护士收集 对于手术类型，HCW的识别，HCW的作用，使用的手术器械 在一次手术中，手套的数量在这一次中发生了变化。 手术结束后，将收集所有手套，并进行目测检查 用于缺陷、切割和孔洞，并通过 FDA标准漏水试验方法(1000cc/2分钟)。 将进行多变量分析和Logistic回归以确定 OR人员针刺伤/锐器伤的预测因素。

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.