Awareness and Perspectives of Doctors on Needle Stick Injuries at Port Sudan Teaching Hospital: A Quality Improvement Project.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
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Abdelbagi Alnazeer Y, Widaa Mohamed Awad Abdalla, Yousif Ahmed Shakir Ali, Ahmed Osman Mohamed Asma, Abdalla Mohammed, Saeed Abdelrahim Saeed Shiraz, Eisa Manhal Eisa Galal, Osman Ahmed Osman Mohammed, Mohamed Abdallah Alshyma Alfatih, Hussien Amany Amin Ali, Adam Klimat Alataya Ibrahim, Ahmed Manasik Abdaldeen Mohamed, Mohammed Thoiba Mohammed Hamdnaallah, Elhaj Haifa Yousif Mohamed, Wedatalla Mohamed Abdalla Elawad, Elnour Mohey Aldien Ahmed Elamin, Mukhtar Sara Y, Ali Eman Esam Hassan, Ahmed Hadeel Omer Elhag, Ahmed Samah Elhussein Mohamed
Аннотация
METHODS: A two-cycle quality-improvement audit was held at Port Sudan Teaching Hospital. Cycle 1 defined compliance at the baseline level through review of documents, staff surveys, and observation. Interventions were education sessions, practical workshops, quick-reference materials, better access to safety-engineered devices, and promotion of a nonpunitive reporting culture. Repeat measurements were conducted in Cycle 2 using the same standards: safety device use, no recapping, sharps container practices, immediate first aid, reporting, and postexposure prophylaxis (PEP) procedures. A total of 97 HCWs participated (Cycle 1: n = 53; Cycle 2: n = 44).
RESULTS: The interventions produced significant improvements. Recognition of hepatitis B virus as a bloodborne risk increased from 33/53 (62.3%) to 39/44 (88.6%) (p = 0.003). Correct initiation of PEP within 72 hours rose from 18/53 (34.0%) to 34/44 (77.3%) (p < 0.001). Safety behaviors improved markedly: use of safety-engineered devices increased from 17/53 (32.1%) to 35/44 (79.5%) (p < 0.001); needle recapping decreased from 21/53 (39.6%) to 2/44 (4.5%) (p < 0.001); and correct use of sharps boxes (two-thirds full) increased from 15/53 (28.3%) to 34/44 (77.3%) (p < 0.001). Training uptake rose significantly: formal training increased from 6/53 (11.3%) to 21/44 (47.7%) (p < 0.001), and refresher training from 2/53 (3.8%) to 12/44 (27.3%) (p = 0.001). Awareness of a formal reporting system improved from 8/53 (15.1%) to 21/44 (47.7%) (p < 0.001). However, awareness of the hepatitis C virus and human immunodeficiency virus (HIV) as risk factors and some unsafe first-aid practices persisted as areas requiring further strengthening.
CONCLUSIONS: An education-based approach, reinforced by practical training, improved device availability, and a favorable reporting culture, led to significant improvements in NSI knowledge and safe practice. Continued refresher education and stronger communication about HCV/HIV risks are required to maintain and extend gains. Limitations include the single-center design, reliance on self-reports, and potential underreporting.