Abstract:Objective To analyze the occurrence and risk factors of needlestick and sharps injuries (NSIs) among oral health care workers (HCWs). Methods NSIs reported by West China Hospital of Stomatology from 2020 to 2023 were collected, and factors relevant to NSIs were analyzed. Results A total of 391 cases of NSIs were reported. Only one case of injury was caused by a sterile device, while the remaining 390 cases were caused by contaminated devices. There were 85, 107, 113, and 86 cases in 2020, 2021, 2022, and 2023, respectively. Most NSIs occurred among interns (n=235, 60.1%). 294 cases (75.2%) of NSIs occurred among HCWs who had less than 3 years of clinical experience. The distribution of NSIs among 235 interns in different months showed that NSIs accounted for a relatively high proportion from April to June and July to September, and the difference was statistically significant (P<0.05). The ventral side of the left thumb was the most common site of NSIs (n=53, 13.6%), followed by the ventral side of the right index finger (n=45, 11.5%) and the ventral side of the left index finger (n=44, 11.3%). The most common devices involved in NSIs were various types of syringe needles (n=84, 21.5%), followed by various types of dental burs (n=76, 19.4%) and suture needles (n=49, 12.5%). Injuries mainly occurred during the treatment process (n=212, 54.2%) and in the department of endodontics (n=86, 22.0%). This study didn’t find any occupational bloodborne infection case caused by NSIs. Conclusion NSIs mainly occur among inexperienced oral interns, and devices causing NSIs are related to the treatment process.

Abstract:Objective To observe the effect of multi-modal hand hygiene (HH) intervention on HH compliance, as well as the relationship between HH compliance and the healthcare-associated (HA) case infection incidence. Methods From 2014 to 2022, the infection control team in a tertiary first-class hospital implemented multi-modal HH intervention for health care workers (HCWs). The changing trend of HH monitoring data, the correlation between HH compliance rate and HA case infection incidence were analyzed retrospectively. Results The consumption of HH products in the wards showed a stable upward trend; HH compliance rate increased from 64.98% in 2014 to 85.01% in 2022 (P<0.001), and HA case infection incidence decreased from 1.21% to 0.83% (P<0.05). HH compliance rate was negatively correlated with HA case infection incidence (r=-0.369, P=0.027). HH compliance rates in different regions and job posts in each quarter were increased (P<0.001). For 5 different HH moments in each quarter, HH compliance rate fluctuated slightly before sterile manipulation and after touching patient; presented rising trend after touching surroundings around patient, and decreased before touching patient and after touching patients body fluid since 2020 (P<0.001). Conclusion Multi-modal HH intervention can improve the HH compliance of HCWs, improving their HH awareness is conducive to reducing HA case infection incidence.

Abstract:Objective To analyze the cognition level of health care workers (HCWs) and the management status of various levels of medical institutions towards allergy reactions to commonly used antimicrobial agents. Methods HCWs and clinical pharmacists who were related to the diagnosis and treatment of antimicrobial agents in 14 medical institutions of city-level and autonomous prefectures in Gansu Province were randomly selected for a questionnaire survey. The survey contents included respondents basic information, criteria for judging antimicrobial allergy, awareness on procedures related to antimicrobial allergy, and antimicrobial management level of different levels of medical institutions. Results A total of 8 670 valid questionnaires from HCWs were collected, including 3 300 physicians, 5 024 nurses and 328 pharmacists. 160, 775, 2 123 and 5 612 HCWs were with senior, associate, intermediate and junior professional titles, respectively. 87.66% of the HCWs received relevant training on antimicrobial management in the past two years, the proportion of HCWs from different levels of medical institutions who have received training on antimicrobial management in the past two years was statistically significant different(χ2=42.668, P < 0.001). HCWs with senior professional titles had the highest proportion of receiving relevant training (93.75%), there was a statistically significant difference in the proportion of receiving antimicrobial management training among HCWs with different professional titles in the past two years(χ2=69.782, P < 0.001). 50.98% of HCWs were not clear about penicillin allergy, and most of whom were with junior professional titles, accounting for 68.52%. 25.19% of HCWs expressed uncertainty about whether patients with penicillin allergy could use cephalosporins, 225 of whom were with associate professional titles, accounting for 29.03% of the total number of HCWs with associate profe-ssional titles. 6.11% of HCWs had no experience in skin test procedure; 46.94% of HCWs expressed that their medical institutions had no or unclear about whether their medical institutions had an antimicrobial allergy assessment team. Conclusion HCWs judgment on allergy reactions to commonly used antimicrobial agents and awareness on antimicrobial application is not high enough, and the overall management level of antimicrobial allergy in all levels of medical institutions is poor. The popularity of antimicrobial allergy assessment teams is not high, and there is an urgent need to strengthen supervision, management, training, et al.

Abstract:Objective To understand the consumption of hand hygiene(HH) products and HH compliance in intensive care units (ICUs) of secondary and higher grade medical institutions (MIs) in Shanghai, and provide basis for further monitoring of HH among health care workers (HCWs). Methods Through healthcare-associated infection surveillance system, the consumption of HH products and HH compliance in ICUs from secondary and higher grade MIs in Shanghai in 2017-2021 were analyzed. Results 105 ICUs from 74 MIs were included in analysis, the average consumption of HH products was 79.24 (44.88-258.63) mL/(bed·day), with statistically significant difference among different types of ICUs (P < 0.001). The average consumption of HH products increased from 65.75 mL/(bed·day) in 2017 to 87.55 mL/(bed·day) in 2021, showing an increasing trend year by year (P < 0.001). HCWs HH compliance rate was 82.13%, with the highest in nurses (86.59%) and the lowest (48.90%) in medical technicians, HH compliance rates of HCWs of different occupations were statistically significant different (P < 0.001). Among the implementation modes of HH, 39.86% used running water for hand washing, 42.27% used alcohol-based hand rub to wipe hands, 13.22% didnt take HH measures, and 4.65% didnt take HH mea-sures when wearing gloves, with statistically significant differences among different HH implementation modes of HCWs (P < 0.001). There was a positive correlation between the average consumption of HH products per bed·day and HCWs HH compliance rate (r=0.703, P < 0.05). Conclusion The average consumption of HH products per bed·day and HH compliance rate of HCWs in ICUs in Shanghai presents an increasing trend year by year. There are differences in the average consumption of HH products per bed· day and HH compliance rate among different types of ICUs. The implementation of HH can be evaluated by continuously surveillance on the average consumption of HH products per bed·day.

Abstract:Objective To study the compliance and correctness of hand hygiene(HH) of staff in intensive care units (ICUs) of a tertiary first-class hospital, and provide theoretical basis for HH intervention. Methods In April 2023, staff in 17 ICUs of this hospital were performed on-site survey by infection control staff, and monitoring forms about HH compliance and correctness were filled out. Results A total of 874 HH opportunities were observed with the concealed observation method, 501 HH opportunities were implemented, the compliance rate was 57.32%, 273 HH opportunities were correctly implemented, with an correct rate of 54.49%. The compliance and correct rate of HH among staff in different ICUs varied significantly. Compliance and correct rates of HH among staff with different jobs were statistically different: HH compliance rate of cleaners (31. 97%) was lower than that of nurses (63. 83%), doctors (58.77%) and other personnel (58.14%); HH correct rate of cleaners (30.77%) was lower than that of nurses (58.17%). The causes for not implementing HH among staff with different jobs and at different HH opportunities were statistically different: the rate of not implementing any HH measures after contact with patients (84.75%) was higher than before contact with patients (41.27%), before clean and sterile manipulation (30.00%), as well as after contact with blood and body fluid (45.45%). The rate of not implementing any HH measures after contact with the patients surrounding environment (66.67%) was higher than before contact with patient as well as before clean and sterile manipulation. The rates of incomplete HH steps and insufficient HH time among staff with different jobs were statistically different: The rates of incomplete HH steps of other personnel (82.35%) was higher than that of doctors (52.63%). The rates of insufficient HH time of doctors (82.46%) and nurses (78.18%) were higher than that of cleaners (51.85%). Conclusion The implementation of HH among different occupational groups and at different HH implementation opportunities in ICU is significantly different, which should be intervened based on their characteristics.

Abstract:Objective To analyze the influencing factors for the knowledge level, cognition willingness and attitude of health care workers (HCWs) towards monkeypox. Methods A cross-sectional survey was conducted, from January to April 2023, 700 HCWs were randomly selected from a tertiary hospital in Shanghai. Based on a self-designed questionnaire, the survey was conducted anonymously through the online platform Wenjuanxing. Results A total of 612 questionnaires were collected, 581 were valid, with a response rate of 87.43% and an effective rate of 94.93%. The mean score of the questionnaire was (128.80±27.70) points, with a score rate of 58.54%. Multiple linear regression analysis showed that there were statistically significant differences in the knowledge level of monkeypox among HCWs of different ages, occupations, departments, educational levels, years of working experience, professional titles, initiative cognition on monkeypox, and participation in monkeypox-related lectures organized by the units (all P < 0.05). Conclusion HCWs cognition on monkeypox is at a moderate level. The training of HCWs on monkeypox knowledge should be strengthened to improve the emergency response capabilities during monkeypox outbreaks.

Abstract:Objective To investigate and analyze the current situation and causes of occupational exposure to acupuncture needles among health care workers (HCWs). Methods A self-designed questionnaire was used to retrospectively investigate the occurrence of occupational exposure to acupuncture needles among HCWs in 27 clinical departments of a tertiary traditional Chinese medicine hospital within the past three years, and to compare and analyze the relevant information. Results Among 1 585 HCWs surveyed, a total of 164 HCWs experienced 231 times of occupational exposure to acupuncture needles, with an incidence of 10.35%. Incidences of occupational exposure of HCWs of different ages, work experience, and professional categories showed statistical differences (P < 0.001), with the highest incidences occurred among medical students (including interns, visiting scholars, and resident physicians), HCWs under 25 years old, and HCWs with less than one year of work experience. The main type of puncture needle involved in the 231 incidents was the fine needle (106 times, 45.88%). Injury occurred mostly during the process of removing needle (68 times, 29.44%) and mainly in the ward (82 times, 35.50%). Among all the incidents, 176 cases (76.19%) were properly treated according to regulations, and 148 cases (64.07%) were reported timely. Conclusion Incidence of occupational exposure to acupuncture needles among HCWs in traditional Chinese medicine hospital is relatively high. Measures should be taken to strengthen the occupational protection training and assessment for medical students and new staff, to standardize the operating procedures for using needles, thus further prevent and reduce the incidence of occupational exposure to acupuncture needles among HCWs.

Abstract:Objective To understand the cognition on tuberculosis (TB) and its influencing factors among health care workers (HCWs) in medical institutions (MIs) in Gansu Province, and to provide a basis for improving HCWs awareness on tuberculosis prevention and control. Methods Questionnaire about HCWs cognition status on TB in MIs in Gansu Province was designed. HCWs cognition status on TB in MIs in Gansu Province was surveyed through Questionnaire Star, and influencing factors for HCWs cognition on TB was analyzed statistically. Results A total of 60 636 valid questionnaires were collected. Among the surveyed HCWs, women accounted for 78.89%. 39.64% HCWs were aged 30-39 years. Nursing staff accounted for 53.05%. 57 440 (94.73%) HCWs got qualified score on cognition on TB (total score ≥14 points), 3 196 was unqualified (total score ≤13 points), accounting for 5.27%. Univariate analysis results showed that there were statistically significant differences in HCWs cognitive qualification rate on TB in terms of hospital level and type, whether there were infectious disease department, gender, age, nationality, educational background, professionaity, professional title, years of work experience, and the number of times participating in occupational protection training (all P < 0.05). Conclusion There are multiple factors that influence HCWs cognition on TB in Gansu Province. HCWs cognition on TB can be improved by increasing the frequency of TB prevention and control knowledge training, improving HCWs academic qualification, and strengthening the learning of relevant professional knowledge.

Abstract:Objective To compare the pass rate of fitness test for arch-shaped and fold-shaped medical protective masks, and explore the relationship between facial dimension and the fitness test of mask. Methods 320 health care workers from 6 hospitals in Beijing were selected. The facial dimensions were measured by right angle gauge, bending angle gauge, and leather ruler. Quantitative fitness test of a brand of arch-shaped and fold-shaped medical protective masks was conducted by TSI 8038/8048 mask fitness test instrument. Results The pass rates of fitness tests for arch-shaped and fold-shaped masks of 320 subjects were 44.38% and 84.06%, respectively, with statistically significant differences (χ2=103.765, P < 0.001). Analysis of influencing factors showed that morphological facial length had an impact on the fitness test result of masks. People with long morphological facial length fit better in arch-shaped masks, and people with short morphological facial length fit better in fold-shaped masks. Cluster analysis showed that arch-shaped masks fit large face better than small face, while fold-shaped masks fit small face better than large face. Conclusion There are difference in the fitness of arch-shaped and fold-shaped medical protective masks. The morphological facial length and the shape of the users face are important factors influencing the fitness of masks. The results of this study can provide references to product design for mask manufacturers and guidance for health care workers in the selection of suitable masks.

Abstract:Objective To evaluate the characteristics and related influencing factors of blood-borne occupational exposure among pediatric health care workers (HCWs), so as to provide effective references for their occupational safety protection. Methods 643 cases of blood-borne occupational exposure among pediatric HCWs in a tertiary first-class childrens hospital from 2013 to 2022 were analyzed retrospectively, including basic information of occupational exposure, exposure sites, exposure occasions, exposure causes, post-exposure emergency treatments and follow-up. Results Nurses were the main occupational exposure group of pediatric HCWs (86.00%), with a relatively high proportion of occupational exposure among those aged ≤25 years (64.39%) and those with less than 5 years of service experience (77.76%). The department with the highest incidence of occupational exposure was the emergency department (27.53%), and the peak of occupational exposure throughout the year was from June to August. Through the implementation of the plan-do-check-act (PDCA) cycle projects to improve the implementation of protective measures for blood-borne occupational exposure, the overall incidence of blood-borne occupational exposure in this hospital from 2013 to 2022 showed a decreasing trend year by year (χ2=195.79, P < 0.001). The major type of exposure was sharp instrument injuries (89.89%). Hands were the most exposed sites (91.44%). The top three exposure occasions/operations were sorting/cleaning items/instruments (38.41%), blood collection (16.95%) and needle extraction (14.15%). The main sources of occupational exposure in childrens hospital were non-blood-borne pathogens (71.38%), with a certain proportion of accidental injuries by others during operations (18.66%). Conclusion The influencing factors of occupational exposure for pediatric HCWs are complex. Causes should be analyzed based on their exposure characteristics. Attention should be paid to key populations, key sites and key seasons, and targeted prevention and control measures should be taken to prevent the occurrence of blood-borne occupational exposure.