Full text
| |
| Author(s): |
Kleber dos Santos
Total Authors: 1
|
| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2015-10-31 |
| Examining board members: |
Rodolfo Andrade de Gouveia Vilela;
Ildeberto Muniz de Almeida;
Maria Regina Alves Cardoso;
Heleno Rodrigues Correa Filho;
Fausto Medeiros Mendes
|
| Advisor: | Rodolfo Andrade de Gouveia Vilela; Maria Regina Alves Cardoso |
| Abstract | |
Work accidents from exposure to biological material (ATMB) among nursing professionals are recurrent and their potential health problems make them a public health issue worldwide. The hegemonic paradigm accident analysis work, known as the traditional model, considers only the visible and specific elements present when the accident occurred. The systemic model, however, also lists the distal or latent nature to the event as possible causes of the accident. The Model of Analysis and Accident Prevention (MAPA) is an instrument developed from the systemic paradigm of causality of accidents and concepts of ergonomics of activity. The aim of this cross-sectional epidemiological study was to identify the contribution of factors at worker level (individual), variables from inside and outside work, and in the labor sector. These are stated in MAPA for the occurrence of occupational accidents involving exposure to ATMB in nursing professionals of the Instituto Central do Hospital das Clínicas (ICHC), USPs Faculdade de Medicina. The outcome was the ATMB for sharp injuries or by contact with patient fluid. A census was performed between February and September 2013 with a response rate of approximately 92 per cent (N = 1648). Six analyses were conducted using multivariate multilevel logistic regression because, for each outcome, an analysis was performed that considered all the interviewed workers. A further two analyses were realized for each shift. For each analysis, model-building was performed introducing the worker level variables in the model. The inside-work variables were introduced first followed by outside-work variables. Finally, the sector level variables were introduced. These were created from the nursing staffs schedules for each ICHC job sector. The findings showed that differences exist in the variable behavior when comparing associated factors for each outcome and comparing the associated factors between shifts in the same outcome. In order to explain the difference in outcomes, a hypothesis was formulated that the elements involved in ATMB by sharp injuries, especially during administration of intravenous medication, are essential for the improvement of patient status. In this way, regardless of the working conditions faced by nursing staff, they will be exposed to sharp elements. This is not the case with elements involved in ATMB through contact. One hypothesis to explain this difference between the outcomes is that the level of the risk perception for accidents from sharp objects is higher than those from contact with patient fluids. The difference between work shifts was basically explained by the rationale that the nurses on night shifts are more adapted to hospital work than day workers. This is supported by the difference in length of service between the two groups. (AU) | |
| FAPESP's process: | 12/24066-8 - Accidents with exposures to blood and body fluids and its association to labor factors: cohort study of nursing staff in a public hospital |
| Grantee: | Kleber dos Santos |
| Support Opportunities: | Scholarships in Brazil - Doctorate |