Maria Henriqueta Rocha Siqueira Paiva

Adesão às precauções padrão pela equipe do atendimento pré-hospitalar móvel de Belo Horizonte, Minas Gerais, Brasil

This was a cross-sectional study of workers in the pre-hospital care team in Belo Horizonte, Minas Gerais State, Brazil, aimed at evaluating adherence to precautions. The study instrument included questions on knowledge, attitudes, and facilitating factors for adherence to standard precautions. Adherence was verified by percentage of adequacy: > 75% correct answers. Drivers showed the lowest degree of knowledge and physicians the highest. In self-reported answers, none of the workers demonstrated adequate use of face masks, goggles, or personal protective equipment (PPE), and drivers reported inadequate attitudes on all the items. In the univariate analysis, job position, gender, and specific rescue unit were associated with adoption of precautions. Meanwhile, in the multivariate analysis, only job position was related (drivers and nurse technicians/aides). The most frequently cited facilitating factors for improvement of adherence were: training focusing on infections, occupational risks, and use of PPE; periodic team meetings; and creation of a central unit for cleaning, disinfecting, and sterilizing equipment and materials. Workers in the pre-hospital care service demonstrated attitudes that were compatible with knowledge, but professional class affected knowledge on standard precautions and self-reported adequate attitudes.

Knowledge and attitude regarding standard precautions in a Brazilian public emergency service: a cross-sectional study

Objetivou-se avaliar a adocao das medidas de precaucao padrao por meio de conhecimento e atitude dos profissionais de um servico publico de emergencia, assim como a incidencia de acidentes de trabalho envolvendo material biologico entre tais profissionais. A pesquisa foi realizada com 238 profissionais entre Junho e Novembro de 2006. Utilizou-se analise univariada e multivariada. A possibilidade de nao-adocao das medidas de precaucao foi 20.7 (95%CI: 5,68 - 75,14) vezes maior entre motoristas, quando comparados aos medicos. Nao houve associacao significante entre a adocao as medidas de precaucao padrao. A incidencia de acidentes de trabalho foi 20.6% (40.8% envolvendo material perfuro-cortante). O risco de medicos terem um acidente de trabalho foi 2.7(95%CI:1.05 - 7.09) vezes maior que os condutores. O fato de os membros da equipe apresentarem conhecimentos adequados sobre as medidas de precaucao padrao foi insuficiente para promover atitudes compativeis a fim de reduzir o risco de transmissao de agentes infecciosos e acidentes de trabalho.The purpose of this study was to assess the knowledge and attitude of health care professionals regarding their use of universal precaution measures at a public emergency service. The study also aimed to assess the rates of occupational accidents involving biological substances among those workers. This study was performed with 238 workers, from June to November 2006, using univariate and multivariate analysis. The chance of not adopting precaution measures was 20.7 (95% CI: 5.68 - 75.14) times greater among drivers compared to physicians. No significant association was found between adopting universal precaution measures. The occupational accident rate was 20.6% (40.8% involving sharp-edged objects). The risk of physicians having an occupational accident was 2.7(95% CI: 1.05 -7.09) times higher than that of drivers. The fact that a staff member had adequate knowledge about universal precaution measures was insufficient to foster compatible attitudes towards reducing the risk of transmitting infectious agents and causing occupational accidents.

Acidentes ocupacionais por exposição a material biológico entre a equipe multiprofissional do atendimento pré-hospitalar

Estudo transversal, tipo survey, realizado com a equipe multiprofissional de Atendimento Pre-hospitalar (APh) de Belo Horizonte, entre junho e dezembro de 2006. Objetivou-se determinar a incidencia dos acidentes ocupacionais por exposicao a material biologico, condutas pos-acidente, e fatores demograficos determinantes. Utilizou-se questionario estruturado, analise descritiva, calculo de incidencias e regressao logistica. A incidencia de acidentes com material biologico foi de 20,6%: 40,8% por perfuro-cortantes e 49,0% por fluidos corporais; 35,3% entre medicos e 24,0% entre enfermeiros. Condutas pos-acidente: sem avaliacao medica, 63,3%; subnotificacao, 81,6%; nenhuma conduta, 55,0%; e, sem acompanhamento sorologico, 61,2%. Estiveram associados ao acidente: tempo na instituicao (Odds ratio-OR 2,84; Intervalo de confianca-IC 95% 1,22-6,62), lotacao na Unidade de Suporte Avancado (OR 4,18; IC 95% 1,64-10,64); interacao: tempo na instituicao e lotacao na Unidade de Suporte Basico (OR 0,27; IC 95% 0,07-1,00). Sugere-se a implantacao de protocolos pos-acidentes, visando a sua reducao; a subnotificacao e o aumento do acompanhamento pos-acidente.This transversal, survey-based research was carried out with a multiprofessional emergency care team in Belo Horizonte, between June and December 2006. The study aimed at estimating the incidence of occupational accidents by exposure to biological material, post-accidents conducts and demographic determinant factors. The study applied a structured questionnaire and descriptive analyses, as well as incidence calculations and logistic regression. The incidence of accidents with biological material reached 20.6%, being 40.8% by sharp materials and 49.0% by body fluids; 35.3% of the accidents took place among physicians and 24.0% among nurses. Post-accidents procedures: no medical assessment, 63.3%; under-notification, 81.6%; no conduct, 55.0%; and no serological follow-up, 61.2%. Factors associated with accidents: working time in the institution (Odds Ratio--OR, 2.84; Credible Interval--CI 95%-1.22-6.62); working in advanced support units (OR = 4.18; CI 95%--1.64-10.64); and interaction between working time in the institution and working in Basic Support Unit (OR 0.27; CI 95%--0.07-1.00). In order to reduce accidents, the implementation of post-accident protocols and follow-up, as well as under-notification norms, are suggested.

Occupational accidents due to exposure to biological material in the multidisciplinary team of the emergency service

Estudo transversal, tipo survey, realizado com a equipe multiprofissional de Atendimento Pre-hospitalar (APh) de Belo Horizonte, entre junho e dezembro de 2006. Objetivou-se determinar a incidencia dos acidentes ocupacionais por exposicao a material biologico, condutas pos-acidente, e fatores demograficos determinantes. Utilizou-se questionario estruturado, analise descritiva, calculo de incidencias e regressao logistica. A incidencia de acidentes com material biologico foi de 20,6%: 40,8% por perfuro-cortantes e 49,0% por fluidos corporais; 35,3% entre medicos e 24,0% entre enfermeiros. Condutas pos-acidente: sem avaliacao medica, 63,3%; subnotificacao, 81,6%; nenhuma conduta, 55,0%; e, sem acompanhamento sorologico, 61,2%. Estiveram associados ao acidente: tempo na instituicao (Odds ratio-OR 2,84; Intervalo de confianca-IC 95% 1,22-6,62), lotacao na Unidade de Suporte Avancado (OR 4,18; IC 95% 1,64-10,64); interacao: tempo na instituicao e lotacao na Unidade de Suporte Basico (OR 0,27; IC 95% 0,07-1,00). Sugere-se a implantacao de protocolos pos-acidentes, visando a sua reducao; a subnotificacao e o aumento do acompanhamento pos-acidente.This transversal, survey-based research was carried out with a multiprofessional emergency care team in Belo Horizonte, between June and December 2006. The study aimed at estimating the incidence of occupational accidents by exposure to biological material, post-accidents conducts and demographic determinant factors. The study applied a structured questionnaire and descriptive analyses, as well as incidence calculations and logistic regression. The incidence of accidents with biological material reached 20.6%, being 40.8% by sharp materials and 49.0% by body fluids; 35.3% of the accidents took place among physicians and 24.0% among nurses. Post-accidents procedures: no medical assessment, 63.3%; under-notification, 81.6%; no conduct, 55.0%; and no serological follow-up, 61.2%. Factors associated with accidents: working time in the institution (Odds Ratio--OR, 2.84; Credible Interval--CI 95%-1.22-6.62); working in advanced support units (OR = 4.18; CI 95%--1.64-10.64); and interaction between working time in the institution and working in Basic Support Unit (OR 0.27; CI 95%--0.07-1.00). In order to reduce accidents, the implementation of post-accident protocols and follow-up, as well as under-notification norms, are suggested.

Analysis of occupational accidents with biological material among professionals in pre-hospital services

OBJECTIVE To estimate the prevalence of accidents due to biological material exposure, the characteristics and post-accident conduct among professionals of pre-hospital services of the four municipalities of Minas Gerais, Brazil. METHOD A cross-sectional study, using a structured questionnaire that was developed to enable the calculation of prevalence, descriptive analysis and analytical analysis using logistic regression. The study included 228 professionals; the prevalence of accidents due to biological material exposure was 29.4%, with 49.2% percutaneous, 10.4% mucousal, 6.0% non-intact skin, and 34.4% intact skin. RESULTS Among the professionals injured, those that stood out were nursing technicians (41.9%) and drivers (28.3%). CONCLUSION Notification of the occurrence of the accident occurred in 29.8% of the cases. Percutaneous exposure was associated with time of work in the organization (OR=2.51, 95% CI: 1.18 to 5.35, p<0.017). Notification about accidents with biological material should be encouraged, along with professional evaluation/monitoring.Objetivo: estimar la prevalencia de los accidentes por exposion a material biologico, sus caracteristicas y conductas despues del accidente entre los profesionales de la Atencion Prehospitalaria de cuatro municipios de Minas Gerais, en Brasil. Metodo: estudio transversal, donde se utilizo cuestionario estructurado, se realizo calculo de prevalencias, analisis descriptivo y analitico por medio de regresion logistica. Participaron del estudio 228 profesionales, la prevalencia de accidentes por exposicion a material biologico fue de 29,4%, siendo 49,2% percutaneo; 10,4% mucosas; 6,0% piel no integra; y, 34,4% piel integra. Resultados: entre los profesionales accidentados se destacaron tecnicos de enfermeria (41,9%) y conductores (28,3%). Conclusion: la notificacion del accidente ocurrio en 29,8% de los casos. Estuvo asociada a la exposicion por via percutanea el tempo de actuacion en la institucion (OR = 2,51; IC 95%: 1,18 5,35; p<0,017). La notificacion del accidente con material biologico debe ser incentivada asi como la evaluacion/acompanamiento del profesional.

Conhecimento e atitudes de trabalhadores de um serviço público de emergência sobre adoção de precauções padrão

The aims of the study were to evaluate the adoption of the precaution measures, assessing knowledge and attitude of multiprofessional team. This is a transversal study, accomplished in an Emergency Medical Service of Minas Gerais. Univariate and multivariate analysis were used. The results showed that nurses and drivers had the highest and lowest level of knowledge regarding the standard precautions, respectively. The possibility of non-adoption of the precautionary measures was 3.76 (95% CI: 1.48 to 9.53) times higher among professionals aged over 31 years and 6.7 (95% CI: 1.81 to 24,75) times greater among workers in crowded unit of basic support. The conclusion is that is essential to implement strategies in order to improve the professionals knowledge related to infection control and safety recommendations.

Fatores determinantes e condutas pós-acidente com material biológico entre profisisonais do atentimento pré-hospitalar

This transversal study was carried out with a multiprofessional team in the pre-hospital care in Minas Gerais, Brazil. It aimed to estimate the incidence of occupational accidents by exposure to biological material and post-accidents conductsta. Descriptive analysis and logistic regression were used. Incidence of accidents was 19.8%: 39,1% perforating-cutting materials and 56.5% body fluids. Doctors (33.3%) and drivers (24.0%) were most involved. Inadequate subsequent measures were highly prevalent: no medical assessment (69.6%), no work accident communication issued (91.3%), no measures (52.2%) and no serological follow-up (52.2%). Variables associated with accidents were: age >31 years old (OR = 3,02; IC95%: 1,25 - 7,33; p = 0,014) and working in basic support units (OR = 5,36; IC95%: 1,51 19,08; p = 0,010). The implementation of post-accidents protocols is suggested in order to reduce accidents and under-notification, and increase post-accident follow-up.Estudio transversal realizado con el equipo multiprofesional de Atencion Prehospitalaria de Minas Gerais, Brasil. El objetivo fue determinar la incidencia de accidentes laborales por exposicion a material biologico y conductas post-accidente. El analisis descriptivo de regresion logistica fue utilizado. La incidencia de accidentes fue del 19,8%: 39,1% por materiales punzocortantes y 56,5% por fluidos corporales. Profesionales que mas se accidentaron fueron medicos (35,3%) y conductores (24,0%). Fueron altas las prevalencias de conductas inadecuadas pos accidente: no evaluacion medica (69,6%), no emision de Comunicacion de Accidente Laboral (91,3%), ninguna conducta pos accidente (52,2%), no realizacion de acompanamiento serologico (52,2%). Variables asociadas al accidente: edad >31 anos (OR = 3,02; IC95%: 1,25 - 7,33; p = 0,014) y actuacion en Unidad de Soporte basico (USB) (OR = 5,36; IC95%: 1,51 19,08; p = 0,010) Se recomienda seguimiento permanente para minimizar exposicion ocupacional y sub notificacion, ademas de aplicacion de protocolo de orientacion de accidentados.

Análise dos acidentes ocupacionais com material biológico entre profissionais em serviços de atendimento pré-hospitalar

OBJECTIVE To estimate the prevalence of accidents due to biological material exposure, the characteristics and post-accident conduct among professionals of pre-hospital services of the four municipalities of Minas Gerais, Brazil. METHOD A cross-sectional study, using a structured questionnaire that was developed to enable the calculation of prevalence, descriptive analysis and analytical analysis using logistic regression. The study included 228 professionals; the prevalence of accidents due to biological material exposure was 29.4%, with 49.2% percutaneous, 10.4% mucousal, 6.0% non-intact skin, and 34.4% intact skin. RESULTS Among the professionals injured, those that stood out were nursing technicians (41.9%) and drivers (28.3%). CONCLUSION Notification of the occurrence of the accident occurred in 29.8% of the cases. Percutaneous exposure was associated with time of work in the organization (OR=2.51, 95% CI: 1.18 to 5.35, p<0.017). Notification about accidents with biological material should be encouraged, along with professional evaluation/monitoring.Objetivo: estimar la prevalencia de los accidentes por exposion a material biologico, sus caracteristicas y conductas despues del accidente entre los profesionales de la Atencion Prehospitalaria de cuatro municipios de Minas Gerais, en Brasil. Metodo: estudio transversal, donde se utilizo cuestionario estructurado, se realizo calculo de prevalencias, analisis descriptivo y analitico por medio de regresion logistica. Participaron del estudio 228 profesionales, la prevalencia de accidentes por exposicion a material biologico fue de 29,4%, siendo 49,2% percutaneo; 10,4% mucosas; 6,0% piel no integra; y, 34,4% piel integra. Resultados: entre los profesionales accidentados se destacaron tecnicos de enfermeria (41,9%) y conductores (28,3%). Conclusion: la notificacion del accidente ocurrio en 29,8% de los casos. Estuvo asociada a la exposicion por via percutanea el tempo de actuacion en la institucion (OR = 2,51; IC 95%: 1,18 5,35; p<0,017). La notificacion del accidente con material biologico debe ser incentivada asi como la evaluacion/acompanamiento del profesional.

Determinant factors and conduct in post-accident with biological material among pre-hospital professionals

This transversal study was carried out with a multiprofessional team in the pre-hospital care in Minas Gerais, Brazil. It aimed to estimate the incidence of occupational accidents by exposure to biological material and post-accidents conductsta. Descriptive analysis and logistic regression were used. Incidence of accidents was 19.8%: 39,1% perforating-cutting materials and 56.5% body fluids. Doctors (33.3%) and drivers (24.0%) were most involved. Inadequate subsequent measures were highly prevalent: no medical assessment (69.6%), no work accident communication issued (91.3%), no measures (52.2%) and no serological follow-up (52.2%). Variables associated with accidents were: age >31 years old (OR = 3,02; IC95%: 1,25 - 7,33; p = 0,014) and working in basic support units (OR = 5,36; IC95%: 1,51 19,08; p = 0,010). The implementation of post-accidents protocols is suggested in order to reduce accidents and under-notification, and increase post-accident follow-up.Estudio transversal realizado con el equipo multiprofesional de Atencion Prehospitalaria de Minas Gerais, Brasil. El objetivo fue determinar la incidencia de accidentes laborales por exposicion a material biologico y conductas post-accidente. El analisis descriptivo de regresion logistica fue utilizado. La incidencia de accidentes fue del 19,8%: 39,1% por materiales punzocortantes y 56,5% por fluidos corporales. Profesionales que mas se accidentaron fueron medicos (35,3%) y conductores (24,0%). Fueron altas las prevalencias de conductas inadecuadas pos accidente: no evaluacion medica (69,6%), no emision de Comunicacion de Accidente Laboral (91,3%), ninguna conducta pos accidente (52,2%), no realizacion de acompanamiento serologico (52,2%). Variables asociadas al accidente: edad >31 anos (OR = 3,02; IC95%: 1,25 - 7,33; p = 0,014) y actuacion en Unidad de Soporte basico (USB) (OR = 5,36; IC95%: 1,51 19,08; p = 0,010) Se recomienda seguimiento permanente para minimizar exposicion ocupacional y sub notificacion, ademas de aplicacion de protocolo de orientacion de accidentados.

Análisis de los accidentes ocupacionales con material biológico entre profesionales en servicios de atención prehospitalaria

OBJECTIVE To estimate the prevalence of accidents due to biological material exposure, the characteristics and post-accident conduct among professionals of pre-hospital services of the four municipalities of Minas Gerais, Brazil. METHOD A cross-sectional study, using a structured questionnaire that was developed to enable the calculation of prevalence, descriptive analysis and analytical analysis using logistic regression. The study included 228 professionals; the prevalence of accidents due to biological material exposure was 29.4%, with 49.2% percutaneous, 10.4% mucousal, 6.0% non-intact skin, and 34.4% intact skin. RESULTS Among the professionals injured, those that stood out were nursing technicians (41.9%) and drivers (28.3%). CONCLUSION Notification of the occurrence of the accident occurred in 29.8% of the cases. Percutaneous exposure was associated with time of work in the organization (OR=2.51, 95% CI: 1.18 to 5.35, p<0.017). Notification about accidents with biological material should be encouraged, along with professional evaluation/monitoring.Objetivo: estimar la prevalencia de los accidentes por exposion a material biologico, sus caracteristicas y conductas despues del accidente entre los profesionales de la Atencion Prehospitalaria de cuatro municipios de Minas Gerais, en Brasil. Metodo: estudio transversal, donde se utilizo cuestionario estructurado, se realizo calculo de prevalencias, analisis descriptivo y analitico por medio de regresion logistica. Participaron del estudio 228 profesionales, la prevalencia de accidentes por exposicion a material biologico fue de 29,4%, siendo 49,2% percutaneo; 10,4% mucosas; 6,0% piel no integra; y, 34,4% piel integra. Resultados: entre los profesionales accidentados se destacaron tecnicos de enfermeria (41,9%) y conductores (28,3%). Conclusion: la notificacion del accidente ocurrio en 29,8% de los casos. Estuvo asociada a la exposicion por via percutanea el tempo de actuacion en la institucion (OR = 2,51; IC 95%: 1,18 5,35; p<0,017). La notificacion del accidente con material biologico debe ser incentivada asi como la evaluacion/acompanamiento del profesional.