Judith Shu-Chu Shiao

Student nurses in Taiwan at high risk for needlestick injuries

PURPOSE To describe the prevalence and characteristics of needlestick injuries (NSI) in student nurses in Taiwan. METHODS A self-administered questionnaire was completed by 931 student nurses from 16 hospitals randomly selected from the 132 accredited hospitals. RESULTS The questionnaire was completed by 708 of 931 students who were contacted for participation in this study. NSI during internship was reported by 61.9% (438/708) of students, of whom 14.2% (62/438) made a formal report. The majority (70.1%) of NSI occurred in the patients room. Hollow-bored needles contributed to half (219/438) of the NSIs of which 86.8% were syringe needles. Just over half (53.2%) of those items involved in NSIs had been used on patients. Of the hollow-bored needles involved in NSIs, 21.5% had been used on a patient with an infectious disease. Vaccination against hepatitis B virus (HBV) was lacking in 47.6% of students. CONCLUSIONS NSIs and non-reporting of NSIs were highly prevalent in nursing students. More intensive education programs should be directed at students to increase their awareness of and compliance with Universal Precautions (UP) before commencing their practical work experience. Students need to practice prompt post-exposure evaluation so that the need for early intervention can be assessed. In addition, any public health and infection control strategy should include a universal catch-up HBV vaccination program among students before commencement of internship.

Needlestick and sharps injuries among health-care workers in Taiwan

Sharps injuries are a major cause of transmission of hepatitis B and C viruses and human immunodeficiency virus in health-care workers. To determine the yearly incidence and causes of sharps injuries in health-care workers in Taiwan, we conducted a questionnaire survey in a total of 8645 health care workers, including physicians, nurses, laboratory technicians, and cleaners, from teaching hospitals of various sizes. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 per person in the past 12 months, respectively. Of most recent episodes of needlestick/sharps injury, 52.0% were caused by ordinary syringe needles, usually in the patient units. The most frequently reported circumstances of needlestick were recapping of needles, and those of sharps injuries were opening of ampoules/vials. Of needles which stuck the health-care workers, 54.8% had been used in patients, 8.2% of whom were known to have hepatitis B or C, syphilis, or human immunodeficiency virus infection. Sharps injuries in health-care workers in Taiwan occur more frequently than generally thought and risks of contracting blood-borne infectious diseases as a result are very high.

Chinese EPINet and Recall Rates for Percutaneous Injuries : An Epidemic Proportion of Underreporting in the Taiwan Healthcare System

Chinese EPINet and Recall Rates for Percutaneous Injuries: An Epidemic Proportion of Underreporting in the Taiwan Healthcare System: Judith Shu‐Chu Shiao, et al. Department of Nursing, National Taiwan University, College of Medicine and NTU Hospital, Taiwan

Prevalence and risk factors of occupational hand dermatoses in electronics workers

The electronics industry is becoming an important mainstream in the workforce in some developed countries and in Taiwan. Among patients with occupational hand dermatitis in northern Taiwan, workers from electronics industries were one of the most important groups. We conducted a field investigation to determine the prevalence, patterns and risk factors of occupational hand dermatoses among electronics workers. The survey was conducted in five electronics plants using a self-administered questionnaire on skin symptoms and risk factors. Skin examination and patch testing were followed for those with symptoms compatible with hand dermatitis. A total of 3070 workers completed the questionnaire. Among them, 302 (9.8%) reported to have symptoms (itching and with either redness/scaling) compatible with contact dermatitis on hands. Hand dermatitis was associated with working in the fabrication unit and personal history of atopy and metal allergy, as well as the following job titles: wafer bonding, cutting, printing/photomasking, softening/degluing, impregnation and tin plating. Among those with reported hand dermatitis, 183 completed skin examination and patch testing, 65/183 (35.5%) were diagnosed as having irritant contact dermatitis (ICD) and 7/183 (3.8%) allergic contact dermatitis. The most important allergens were nickel, cobalt and phenylenediamine. In conclusion, Taiwanese electronics workers have a high risk of having hand dermatitis, especially ICD. Preventive efforts should be focused on the workers with risk factors or at certain worksites.

Morphology of glass fibers in electronics workers with fiberglass dermatitis – a scanning electron microscopy study

Abstract

National incidence of percutaneous injury in Taiwan healthcare workers

We established a standardized surveillance system using the Chinese Exposure Prevention Information Network to estimate the frequency of percutaneous injuries (PCIs) in Taiwanese healthcare workers (HCWs). Fourteen hospitals employing 8,132 HCWs participated and a total of 583 PCIs were reported. The annual number was estimated to be 8,058 PCIs per hospital size, 8,100 per HCWs, and 8,286 per inpatient-day; indicating similar estimates using different denominators. The estimated annual frequency of pathogen-specific PCIs was 1,168 for hepatitis B, 1,263 for hepatitis C, and 59 for HIV. This study documents the annual incidence of PCI among HCWs showing important potential exposure to viral hepatitis and HIV in Taiwan.

Incidence of percutaneous injury in Taiwan healthcare workers

Reporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.

OCCUPATIONAL SKIN DISORDERS AND SCISSORS-INDUCED INJURY IN HAIRDRESSERS

Abstract This study was to determine the prevalence and risk factors of occupational skin disorders and scissors-induced injuries among hairdressers in Tainan City, Taiwan. We recruited the graduates of the Department of Hairdressing from two professional schools for health evaluation. One hundred and seven current hairdressers completed the study, which included a questionnaire interview, skin and physical examination, and patch testing. The results of skin examination and patch test showed that stylists had high prevalence of scissors induced wounds or scars (81%) over the web between the index and middle fingers of the non-dominant hand. The hairdressers also had a high prevalence of hand dermatitis (72%). Occurrence of hand dermatitis is highly correlated with the frequency of shampooing. With the above findings, we recommend 1. (1) using dull-tip scissors for hair cutting to prevent scissors-induced trauma; 2. (2) wearing gloves for shampooing to prevent irritant contact dermatitis and potential cross-infection; 3. (3) including the education for prevention of scissors cuts in the hairdressers training programs.

A Qualitative Study of Psychosocial Factors Affecting Expecting Mothers Who Choose to Continue a Cleft Lip and/or Palate Pregnancy to Term

Background: Prenatal detection of cleft lip and/or palate (CL/P) leads to high rates of induced termination of pregnancy. There has been little research in Taiwan done on the psychosocial factors affecting those who decide to continue their CL/P pregnancy. Purpose: This study identified the principal psychosocial factors that affect expecting mothers who chose to continue their CL/P pregnancy to term. Methods: Purposive sampling recruited expecting mothers with CL/P-diagnosed fetuses. Recruiting took place between May 2000 and March 2002 at a tertiary referral hospital in Taipei, Taiwan. Those who had decided to continue their pregnancy to term were asked to participate. Researchers obtained oral informed consent to be interviewed during the week following CL/P diagnosis. Interviews for each participant were completed within a 2-week period. All information was given to the interviewees in written and verbal forms before providing their written informed consent to participate. Results: The five major themes central to participant experiences included (1) loss of self-value as a mother, (2) blaming the mother, (3) indecision about whether to continue the pregnancy, (4) anxiety triggered by insufficient information, and (5) burden of care and concerns about potential disadvantaged status. Conclusions: Significant psychological distress was identified among participants following their fetus’ CL/P diagnosis. It was encouraging to learn that all participants told researchers in postpartum interviews that they did not regret the decision to take their child to term.

0258 Factors predicting nurses’ consideration of leaving job (Also to be considered for mini-symposium: Early detection and management of workers under stress)

Objectives Nursing manpower shortage has long been a problem in the healthcare system in Taiwan. The main cause of this problem has been nurses’ lacking of willingness to retain in job. This study aims to identify factors for nurses’ consideration of leaving their job. Method Study participants included female nurses from a nation-wide representative sample of accredited tertiary and secondary referral hospitals, selected using stratified random sampling. To candidate participants, a structured, self-administered questionnaire was distributed, which included demographic information, description of work conditions, the Chinese Job Content Questionnaire, and the modified Chinese Copenhagen Burnout Inventory. Consideration of leaving job is defined by “having ideation of leaving job weekly or more frequent” and the estimation of not working as a nurse in two years. Results A total of 1031 female nurses completed the questionnaire satisfactorily. Among them 16.7% considered leaving job. Personal burnout, client-related burnout, and conflict with family needs predict consideration of leaving job. While inquired what work factors were important for their making decision of leaving job, overtime work was listed number one, followed by shift work, insufficient vacation time, affected personal health, unexpected or short notice in shift arrangements, low respect at work, and salary and benefits. Conclusions The problem of high percentage of nurses considering leaving job has been real. This problem was related to high burnout and conflicting with family needs in nurses, most likely caused by high work load and problems in work arrangements.