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      Influencia de la jornada laboral en la ocurrencia de accidentes biológicos en el ámbito hospitalario Translated title: Influence of the works shifts on the occurrence of biological accidents in the hospital field

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          Abstract

          Resumen Introducción: La exposición laboral a agentes biológicos afecta a gran variedad de ocupaciones, siendo el sector sanitario uno de los más expuestos, especialmente al VIH, VHB y VHC. En la actualidad, en el ámbito sanitario hay una tendencia creciente a cambiar el turno de 7 horas por el de 12 horas. Método: El objetivo de este estudio es conocer la influencia de las jornadas de 12 horas en la ocurrencia de accidentes con riesgo biológico en enfermeros/as y auxiliares de enfermería de hospital. Es un estudio de cohorte retrospectiva de los accidentes biológicos ocurridos en 3 hospitales públicos entre el 1/1/2017 y el 31/12/2018. Resultados: La incidencia de accidentes fue mayor en trabajadores con jornadas de 12 horas (3,6 por cada 100 trabajadores), en enfermeros/as (4,8 por cada 100 enfermeros/as) y en hombres (4,1 por cada 100 hombres). En las plantas de hospitalización, el área quirúrgica y urgencias la incidencia de accidentes fue mayor en trabajadores con jornada de 12 horas. Conclusiones: La realización de jornadas de 12 horas en el ámbito hospitalario entre los enfermero/as se asocia con una mayor ocurrencia de accidentes biológicos. No suponiendo un riesgo estadísticamente significativo en hospitalización, quirófano ni urgencias, pero si un factor protector en UCI. Por ello, serán necesarios más estudios para valorar la influencia de la duración de la jornada en la salud de los trabajadores sanitarios.

          Translated abstract

          Abstract Introduction: Occupational exposure to biological agents affects a wide variety of occupations, with the health sector being one of the most exposed, especially to HIV, HBV and HCV. At present, in the health sector there is a growing trend to change the 7-hours shift to the 12-hours shift. Method: The objective of this study is to know the influence of 12-hours days on the occurrence of accidents with biological risk in nurses and nursing assistants of hospitals. It is a retrospective cohort study of biological accidents that occurred in 3 public hospitals between 1/1/2017 and 31/12/2018. Results: The incidence of accidents was higher in workers with 12-hours shifts (3,6 per 100 workers), in nurses (4,8 per 100 nurses) and in men (4,1 per 100 men). In the hospitalization wards, the surgical and emergency areas, the incidence of accidents was higher in workers with a 12-hours shift. Conclusions: The realization of 12-hours shifts in the hospital environment among nurses is associated with a higher occurrence of biological accidents. Not assuming a statistically significant risk in hospitalization, surgical area and emergency area, but a protective factor in ICU. Therefore, more studies will be needed to assess the influence of the length shift of work on the health of health workers.

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          Most cited references35

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          How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel

          OBJECTIVE To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care METHODS A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$). RESULTS A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations. CONCLUSIONS NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs. Infect Control Hosp Epidemiol 2016;37:635–646
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            Hepatitis B virus and hepatitis C virus infection in healthcare workers.

            Approximately 3 million healthcare workers per year receive an injury with an occupational instrument, with around 2000000 exposures to hepatitis B virus (HBV) and 1000000 to hepatitis C virus (HCV). Although an effective HBV vaccine has been available since the early eighties, and despite the worldwide application of universal vaccination programs started in the early nineties, HBV still remains a prominent agent of morbidity and mortality. There is no vaccine to limit the diffusion of HCV infection, which progresses to chronicity in the majority of cases and is a major cause of morbidity and mortality worldwide due to a chronic liver disease. Healthcare workers are frequently exposed by a mucosal-cutaneous or percutaneous route to accidental contact with human blood and other potentially infectious biological materials while carrying out their occupational duties. Mucosal-cutaneous exposure occurs when the biological material of a potentially infected patient accidentally comes in contact with the mucous membranes of the eyes or mouth or with the skin of a healthcare worker. Percutaneous exposure occurs when an operator accidentally injures himself with a sharp contaminated object, like a needle, blade or other sharp medical instrument. About 75% of the total occupational exposure is percutaneous and 25% mucosal-cutaneous, the risk of infecting a healthcare worker being higher in percutaneous than in mucosal-cutaneous exposure. All healthcare workers should be considered for HBV vaccination and should meticulously apply the universal prophylactic measures to prevent exposure to HBV and HCV.
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              Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety.

              12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift in order to reduce their work/home conflicts, however, at the expense of the patient's safety, as well as their own health and safety. Therefore, it is important to develop measures, such as extended child care, association of nurses to the elaboration of their rota, 9- or 10-hour shifts in the afternoon, allowing naps during night shifts, and reduction of changing shifts with short notice. Work schedules must be organized in order to allow time for shift handover, social support and team building.
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                Author and article information

                Journal
                mesetra
                Medicina y Seguridad del Trabajo
                Med. segur. trab.
                Escuela Nacional de Medicina del Trabajo. Instituto de Salud Carlos III (Madrid, Madrid, Spain )
                0465-546X
                1989-7790
                September 2020
                : 66
                : 260
                : 154-170
                Affiliations
                [1] Gran Canaria orgnameHospital Universitario de Gran Canaria Doctor Negrín orgdiv1Unidad Docente Multiprofesional de Salud Laboral de Canarias España
                [2] Gran Canaria orgnameHospital Universitario de Gran Canaria Doctor Negrín orgdiv1Unidad Docente Multiprofesional de Salud Laboral de Canarias España
                [3] Oviedo Asturias orgnameHospital Universitario Central de Asturias-Ibermutua orgdiv1Unidad Docente Multiprofesional de Medicina del Trabajo de Asturias España
                Article
                S0465-546X2020000300003 S0465-546X(20)06626000003
                5adfabe3-0d9c-4766-91a5-d2b86be501a2

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 15 June 2020
                : 29 June 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 17
                Product

                SciELO Spain

                Categories
                Revisión Sistemática

                12-hours shift,work accident,nurse and nursing assistants,turno de 12 horas,accidente de trabajo,enfermera/o y auxiliares de enfermería

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