Bloodborne Pathogen Risk in Home Healthcare Workers

家庭医护人员的血源性病原体风险

• 批准号: 7244247
• 负责人: ROBYN R.M. GERSHON
• 金额: $ 51.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7244247
• 关键词: Bloodborne; Pathogen; Risk; Home; Healthcare

Proposed is a four-year collaborative and multidisciplinary epidemiological study designed to determine rates and risk factors for blood/body fluid exposure incidents in home healthcare workers. Using both qualitative and quantitative methodologies, we propose to address important knowledge gaps regarding this large and growing work population by addressing the following four specific aims: (1) to determine prevalence and incidence (using a denominator such as patient-care hours) of occupational blood/body fluid exposure incidents in a random sample of HHCWs; (2) to identify the independent and joint effects of risk factors associated with exposure incidents, HBV vaccine compliance and substandard post-exposure follow-up, including: a) worker-centered factors (demographics, union membership, psychosocial factors, etc.); b) job/task, job/control variables (work flow, work pace, workload, case/mix etc.); c) organizational variables (availability and adequacy of resources, including the availability of safety devices and other control measures; safety climate, safety training, medical surveillance programs, etc.); d) patient characteristics; and e) work environment factors (environmental conditions in the home, safety and security of the home and neighborhood, impact of family members, etc.); (3) to estimate seroprevalence of HCV, and HBV and to determine the measure of HBsAb in HBV vaccinees; and (4) to identify successful risk reduction opportunities and interventions tailored to home healthcare workers using participatory action research teams. In order to meet these specific aims we will recruit a random sample of 2500 home healthcare workers through our collaborating partners, including: (1) the New York State Public Employees Federation, (2) New York State Nurses Association, (3) Visiting Nurse Service of New York, (4) the Jewish Home & Hospital LifeCare Services, (5) American Nurses Association, (6) PennCare at Home at the University of Pennsylvania, and (7) Texas Association for Home Healthcare. This proposal extends previous risk assessment studies we have conducted over the past decade involving both hospital-based and non-hospital based health care workers. 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 available to the estimated 700,000 home health care workers is largely unknown, the public health siqnificance of this problem cannot be overstated. This study will improve our understanding of the risks facing home health care workers and allow us to focus our risk management energies and resources appropriately.

提议进行一项为期四年的协作和多学科流行病学研究，旨在确定家庭医护人员血液/体液暴露事件的发生率和风险因素。我们建议使用定性和定量方法，通过解决以下四个具体目标来解决有关这一庞大且不断增长的工作人口的重要知识差距：(1) 确定卫生保健工作者随机样本中职业血液/体液暴露事件的患病率和发生率（使用患者护理时间等分母）； (2) 识别与暴露事件、乙型肝炎疫苗依从性和不合格的暴露后随访相关的危险因素的独立和联合影响，包括： a) 以工人为中心的因素（人口统计、工会成员身份、社会心理因素等）； b) 工作/任务、工作/控制变量（工作流程、工作节奏、工作量、案例/组合等）； c) 组织变量（资源的可用性和充足性，包括安全装置和其他控制措施的可用性；安全氛围、安全培训、医疗监视计划等）； d) 患者特征； e) 工作环境因素（家庭环境条件、家庭和邻里的安全保障、家庭成员的影响等）； (3) 估计 HCV 和 HBV 的血清流行率，并确定 HBV 疫苗接种者的 HBsAb 测量值； (4) 识别成功降低风险的机会 使用参与性行动研究团队为家庭医护人员量身定制干预措施。 为了实现这些具体目标，我们将通过合作伙伴随机招募 2500 名家庭保健工作者，这些合作伙伴包括：(1) 纽约州公共雇员联合会、(2) 纽约州护士协会、(3) 纽约访问护士服务中心、(4) 犹太家庭和医院生命护理服务中心、(5) 美国护士协会、(6) 宾夕法尼亚大学 PennCare at Home 和 (7) 德克萨斯州协会 用于家庭医疗保健。 该提案扩展了我们在过去十年中进行的风险评估研究，涉及医院和非医院医护人员。鉴于存在有效的主要（例如工程设备）和次要（例如暴露后预防）预防策略来管理风险，并且考虑到风险的程度和估计 700,000 名家庭保健工作者可用的风险管理控制的普遍程度在很大程度上未知，因此这一问题的公共卫生重要性怎么强调都不为过。 这项研究将提高我们对家庭医疗保健工作者面临的风险的了解，并使我们能够适当地集中我们的风险管理精力和资源。

项目成果

Pandemic-related ability and willingness in home healthcare workers.

家庭医护人员与流行病相关的能力和意愿。

• DOI: 10.5055/ajdm.2010.0002
• 发表时间: 2010
• 期刊: American journal of disaster medicine
• 作者: Gershon,RobynRM;Magda,LoriA;Canton,AllisonN;Riley,HalleyEM;Wiggins,Faith;Young,Wayne;Sherman,MartinF
• 通讯作者: Sherman,MartinF

Violence, job satisfaction, and employment intentions among home healthcare registered nurses.

• DOI: 10.1097/01.nhh.0000356828.27090.bd
• 发表时间: 2009-06-01
• 期刊: Home healthcare nurse
• 作者: Canton, Allison N;Sherman, Martin F;Gershon, Robyn R M
• 通讯作者: Gershon, Robyn R M