Impact of Needlestick Safety & Prevention Act (HR5178) on Hospital Worker Injury

描述（由申请人提供）：菲利普斯博士，其背景是流行病学和卫生保健系统，正准备重新进入卫生保健研究，专注于一个新的领域，职业安全与健康，特别是卫生保健工作者安全和血源性病原体。拟议的研究和相关资金将促进她的职业发展。与弗吉尼亚大学医学院、国际医疗工作者安全中心，特别是Janine Jagger博士合作，确保Phillips博士的研究将以负责任的方式完成，并且研究结果将对该领域产生影响。对卫生保健工作者来说，职业接触HBV、HIV和HCV仍然是最危及生命的工作场所风险。在过去的二十年中，美国通过降低最常见的病原体传播方式——锐器伤的风险，在初级预防方面处于领先地位。干预措施旨在保护高危人群在进行常规（尽管危险）手术时免受伤害。国际卫生保健工作者安全中心发挥了关键作用，引入了更安全设备的概念，并设计和传播了EPINet监测系统，以记录设备特征在伤害原因中的作用。1993年建立了第一个基于EPINet的多医院、多州研究网络，共包括85家医院。它是记录与针和利器有关的不断变化的伤害模式的国家资源。2000年针头安全和预防法案（HR 5178）有望改变标准实践中的伤害模式。利用EPINet数据库，拟议的研究将量化由于采用安全工程设备而减少的伤害，并记录自愿（2000年以前）与强制性（2000年以后）政策对采用安全工程医疗设备的相对影响。受伤率的变化将与同期报告的血液暴露率进行比较，后者不受立法的约束。研究还将根据地理区域、医院类型、工作类别、受伤发生的部门和特定设备来比较受伤率的差异。从业人员、医院和公众的健康将通过更安全的工作做法得到加强，包括使用安全设计的装置，减少伤害和病原体传播。在更普遍的层面上，了解机构收养模式如何受到自愿和强制性医疗保健政策的影响，以及相关的伤害和暴露结果，将指导美国未来的合规工作，并作为更有效的全球模式。

DESCRIPTION (provided by applicant): Dr. Phillips, whose background is in epidemiology and health care systems, is preparing to reenter health care research, focusing in a new area, occupational safety and health, particularly health care worker safety and bloodborne pathogens. The proposed research and related monies will facilitate this development of her career. Working with the University of Virginia School of Medicine, International Healthcare Worker Safety Center, and especially Dr. Janine Jagger, makes certain that Dr. Phillips' research will be completed in a responsible manner and that the findings will have an impact on the field. Occupational exposure to HBV, HIV and HCV remains the most life-threatening workplace risk to healthcare workers. During the last two decades, the US has led the way in primary prevention by reducing the risk of sharp injuries, the most common means of pathogen transmission. Interventions were intended to protect a high-risk population from injury while performing a routine, albeit hazardous procedure. The International Healthcare Worker Safety Center played a key role by introducing the concept of safer devices and designing and disseminating the EPINet surveillance system to document the role of device characteristics in injury causation. The first multi-hospital, multi-state research network based on EPINet was established in 1993 and includes a total of 85 hospitals. It is a national resource for documenting changing injury patterns related to the needles and sharps. The Needlestick Safety and Prevention Act of 2000 (HR 5178) was expected to change patterns of injuries during standard practice. Using the EPINet database, the proposed research will quantify injury reductions attributable to the adoption of safety-engineered devices and document the relative impact of voluntary (pre-2000) versus mandatory (post-2000) policy on the adoption of safety-engineered medical devices. Changes in injury rates will be compared to contemporaneous rates of reported blood exposures,which were not subject to legislation. Research will also compare differences in injury rates by geographic region, type of hospital, job category, department where injury occurred, and specific device. The health of practitioners, hospitals and the public will be enhanced by safer work practices, including the use of safety-engineered devices by decreasing injuries and pathogen transmission. At a more universal level, an understanding of how institutional adoption patterns are affected by voluntary and mandatory health care policies and the associated injuries and exposure outcomes will guide future compliance efforts in the U.S. and serve as a more effective global model.