Occupational Exposure of Health-Care Workers to Blood and Body Fluids in West Shewa Zone, Ethiopia, 2018: A Cross-Sectional Study

Background. Health-care workers are susceptible to acquiring blood and body fluids borne infections due to their occupations involving contact with patients and their body fluids, although studies conducted in Ethiopia are scarce. Therefore, the aim of this study was to investigate the magnitude of exposure to blood and body fluids among health-care workers in governmental health facilities in West Shewa Zone, Ethiopia. Materials and Methods. A facility-based cross-sectional study was conducted from May 19 to June 25, 2018. A total of 381 health-care workers were selected by simple random sampling from 31 sampled governmental health facilities using proportional to size allocation. Data were collected through self-administered questionnaires, entered into Epi Info version 7, and analyzed by SPSS version 21. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) calculated for variables retained in the multivariable logistic regression and significance declared at p < 0.05 . Results. Of 377 health-care workers who participated, the study found that 233 (61.2%) were exposed to blood and body fluids in their lifetime. Previous needlestick injury (AOR = 0.30; 95% CI: 0.12–0.75), type of health facility (AOR = 0.42; 95% CI: 0.26–0.68), handwashing practice (AOR = 0.15; 95% CI: 0.07, 0.31), and perceiving at risk (AOR = 0.16; 95% CI: 0.03, 0.98) were protective factors, whereas long work experience (AOR = 1.47; 95% CI: 1.13–1.93) was a risk factor for the exposure. Conclusions. Exposures to blood and body fluids during patient care were common among health-care workers in the study area. Therefore, health-care workers especially those newly hired and working in hospitals should pay due attention to their occupation’s safety and regularly practice handwashing during critical times.

Intranasal Ketorolac for Acute Pain in Adult Emergency Department Patients

Pain is a common complaint in the emergency department. An alternative to opioids is desirable. Oral medications are not feasible with gastrointestinal disorders or NPO. Intravenous medications require skill and time. Intravenous/intramuscular medications are painful with potential needlestick injury. Intranasal medications have rapid onset, easy administration, do not need skilled providers, and no risk of needlestick injury. A total of 28 adults with acute pain (numeric rating scale ≥ 4) received intranasal ketorolac. Numeric rating scale decreased in all: 32% complete pain relief, median (interquartile range) decrease −5 (−6.8 to −4) ( p < .001). Pain relief onset was median [interquartile range] 5 (2.3, 15.0) min. Vital signs remained normal. There were no nasal mucosal changes, no complications. Minor side effects, mostly nasal burning, in 43%, resolved within 5 min. Patients and nurses were satisfied with intranasal ketorolac, and would use it again. Intranasal ketorolac had a rapid onset, was effective, safe, well tolerated with minor side effects that resolved quickly.

Needlestick Injuries and Associated Psychosocial Factors Among the Students of Dental School

Background and Aim: Needlestick injury (NSJ) is a common occupational health problem among dental healthcare workers, putting them at significant risk for blood-borne infections. This study aimed to investigate occupational exposure to NSJ and the psychological factors associated with it among dentistry students. Methods & Materials: This descriptive cross-sectional study was carried out on students in the Arak school of dentistry training curriculum in the last three years in 2018. The questionnaires included questions about students’ awareness of NSJ conditions, the frequency of vaccinations, and antibody titration tests. The SCL-90 (Symptom checklist-90) questionnaire assessed psychological factors after NSJ in four dimensions of anxiety, phobia, self-morbidity, and depression. Data analysis was performed using descriptive statistical methods and a chi-square test. Ethical Considerations: The study was approved by the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1397.269). Results: Of the eighty students surveyed, 59 students had experienced NSJ at least once. However, only 25.4% of students had reported the NSJ occurrence. The highest incidence rate of NSJ was reported in the endodontics section. In addition, 80% of students had received hepatitis B vaccinations. Based on the SCL-90 test, the anxiety dimension was more affected by NSJ than the other dimensions. Conclusion: Despite the high prevalence of NSJ in dental students, the rate of reporting after the accident is very low. Also, due to the lack of attention to vaccination in some students, there is a need for more infection control training. Based on the SCL-90 test, the occurrence of NS is effective in causing psychological problems.

Evaluation of Sensitization Program on Occupational Health Hazards for Nursing and Allied Health Care Workers in a Tertiary Health Care Setting

Background: Occupational health hazard pertaining to health care providers is one of the neglected areas that need serious attention. Any compromise in their safety would result in reduction in workforce, which may affect patient care, keeping in mind the wide gap between the required number and actual health care workers (HCWs) available in the world over.Aim: This study was undertaken to evaluate the change in knowledge through a sensitization training program on occupational health hazards and vaccination for HCWs.Materials and Methods: Participants of the study included nursing and allied HCWs of a tertiary care health institute in Uttarakhand, India. Multiple training sessions, each of around 180 min, were held periodically in small groups with 20–40 participants over 2 years. Participants were assessed with pretest and posttest questionnaires, and feedback was taken. Questionnaires comprised three categories: general safety and ergonomics, biological hazards, and chemical and radiation hazards. Data of incident reporting for needlestick injury from 2017 to 2019 were retrieved. All data were compiled in Excel sheet and analyzed.Results: A total of 352 participants were included in the study. Mean ± SD for pretest and posttest scores were 5.3 ± 2.13 and 11.22 ± 2.15, respectively. There was considerable improvement in knowledge, which was found to be statistically significant with p-value of 0.001 for all categories. Participants in their feedback suggested for inclusion of psychosocial aspect in further training programs.Conclusion: Low baseline knowledge prior to attending the course highlights a need for an intervention through such structured sensitization program to create awareness and educate HCWs on common occupational health hazards and vaccination. Statistically significant improvement in posttest knowledge highlights effectiveness of the training program. A drastic rise in incident reporting for needlestick injury reflects fairly good impact of training program. Regular and appropriate form of training can reduce injuries resulting from occupational hazards and ensure healthy workforce contributing toward a positive impact on national economy.

Lymphatic Dissemination and Axillary Web Syndrome in Primary Cutaneous Tuberculosis Secondary to Needlestick Injury

Cutaneous tuberculosis secondary to skin inoculation of Mycobacterium tuberculosis is uncommon but it can occur in the healthcare settings. Herein, we report an unusual case of primary cutaneous tuberculosis of the thumb following a needlestick injury. The infection progressed with a necrotic granuloma, lymphatic dysfunction as visualized by near-infrared fluorescence lymphatic imaging, and the development of an axillary web syndrome.

Prevalence of Needlestick Injuries among Healthcare Workers in Rizgary Teaching Hospital

Needlestick injury in healthcare settings is a global issue. Despite being recognized for many years, needlestick and sharps injuries (NSIs) continue to present a risk of occupational exposure to blood-borne pathogens for health care works (HCWs). The objectives of the study were to determine the prevalence of needlestick injuries among HCWs in Rizgary Teaching Hospital and to identify the causes of needlestick injuries. A cross-sectional study was conducted on 76 healthcare workers in Rizgary Teaching hospital; there were a total of 45 males, 31 females. The data collections were administrated using face-to-face interviews to ensure a good response rate and to ensure all questions were answered. Most (52.6%) needlestick injuries occurred in wards with syringe needles being the most common causative tool; surgery ward was the most prevalent site of needlestick injuries occurrence (42.1%). The percentage of acupuncture was high and needles were the most common cause, and most injuries occurred during the re-use of the needles. The study recommends several measures to prevent and reduce acute injuries among HCWs; these measures include health education, behavior change, safer devices, and an educational program to educate these HCWs.