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      Percutaneous injuries correlates in the nursing team of a Brazilian tertiary-care university hospital Translated title: Fatores associados a acidentes percutâneos na equipe de enfermagem de um hospital universitário de nível terciário Translated title: Factores asociados con heridas percutáneas en el equipo de enfermería de un hospital universitario de nivel terciario

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          Abstract

          The study aims to identify percutaneous injuries correlates in the nursing team from a Brazilian tertiary-care hospital. A case-control study was conducted from January 2003 to July 2004, including 200 cases and 200 controls. Cases and controls were paired by gender, professional category, and work section. To evaluate the relationship between potential risk/protective factors and the outcome, odds ratios were estimated, using multivariate logistic regression methods. The results shown six predictors of percutaneous injuries: "recapping needles" (OR 9.48; CI(95%): 5.29-16.96); "hours worked per week > 50 hours" (OR 2.47; CI(95%): 1.07-5.67); "years in nursing practice < 5 years" (OR 6.70; CI(95%): 2.42-18.53); "work shift in night" (OR 2.77; CI(95%): 1.35-5.70); "low self evaluation of risk" (OR 10.19; CI(95%): 3.67-28.32) and "previous percutaneous injuries" (OR 3.14; CI(95%): 1.80-5.48). The results support the recommendation of applying effective strategies to prevent percutaneous injuries in the nursing team working on tertiary-care institutions.

          Translated abstract

          O estudo teve por objetivo identificar fatores associados aos acidentes percutâneos na equipe de enfermagem de um hospital terciário. Um estudo caso-controle foi conduzido entre janeiro de 2003 a julho de 2004, com seleção de 200 casos e 200 controles, emparelhados segundo gênero, categoria profissional e setor de trabalho. As medidas de associação utilizadas foram os odds ratios, estimados por meio da regressão logística multivariada. Seis preditores para os acidentes percutâneos foram identificados: "reencapar agulhas" (OR 9.48; CI(95%): 5.29-16.96); "jornada semanal > 50 horas" (OR 2.47; CI(95%): 1.07-5.67); "experiência na enfermagem < 5 anos" (OR 6.70; CI(95%): 2.42-18.53); "trabalhar em jornada noturna" (OR 2.77; CI(95%): 1.35-5.70); "auto-avaliar como baixo o risco de acidentes" (OR 10.19;CI(95%): 3.67-28.32) e "acidentes percutâneos prévios" (OR 3.14; CI(95%): 1.80-5.48). Os resultados permitem a recomendação de estratégias efetivas para a prevenção de acidentes percutâneos na equipe de enfermagem de hospitais terciários.

          Translated abstract

          La finalidad del estudio fue identificar factores asociados a los accidentes percutáneos en el equipo de enfermería de un hospital terciario. Un estudio caso-control fue conducido entre enero de 2003 y julio de 2004, con selección de 200 casos y 200 controles, emparejados según género, categoría profesional y sector de trabajo. Las medidas de asociación utilizadas fueron las razones de momios, estimados mediante la regresión logística multivariada. Seis predictores para los accidentes percutáneos fueron identificados: "reencapsular agujas" (OR 9.48; CI(95%): 5.29-16.96); "jornada semanal > 50 horas" (OR 2.47; CI(95%): 1.07-5.67); "experiencia en la enfermería < 5 años" (OR 6.70; CI(95%): 2.42-18.53); "trabajar en jornada nocturna" (OR 2.77; CI(95%): 1.35-5.70); "auto-evaluar como bajo el riesgo de accidentes" (OR 10.19;CI(95%): 3.67-28.32) y "accidentes percutáneos previos" (OR 3.14; CI(95%): 1.80-5.48). Los resultados permiten la recomendación de estrategias efectivas para la prevención de accidentes percutáneos en el equipo de enfermería de hospitales terciarios.

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          In the absence of prior knowledge about population relations, investigators frequently employ a strategy that uses the data to help them decide whether to adjust for a variable. The authors compared the performance of several such strategies for fitting multiplicative Poisson regression models to cohort data: 1) the "change-in-estimate" strategy, in which a variable is controlled if the adjusted and unadjusted estimates differ by some important amount; 2) the "significance-test-of-the-covariate" strategy, in which a variable is controlled if its coefficient is significantly different from zero at some predetermined significance level; 3) the "significance-test-of-the-difference" strategy, which tests the difference between the adjusted and unadjusted exposure coefficients; 4) the "equivalence-test-of-the-difference" strategy, which significance-tests the equivalence of the adjusted and unadjusted exposure coefficients; and 5) a hybrid strategy that takes a weighted average of adjusted and unadjusted estimates. Data were generated from 8,100 population structures at each of several sample sizes. The performance of the different strategies was evaluated by computing bias, mean squared error, and coverage rates of confidence intervals. At least one variation of each strategy that was examined performed acceptably. The change-in-estimate and equivalence-test-of-the-difference strategies performed best when the cut-point for deciding whether crude and adjusted estimates differed by an important amount was set to a low value (10%). The significance test strategies performed best when the alpha level was set to much higher than conventional levels (0.20).
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            Infection risks following accidental exposure to blood or body fluids in health care workers: A review of pathogens transmitted in published cases

            Hospital staff and all other human or veterinary health care workers, including laboratory, research, emergency service, or cleaning personnel are exposed to the risk of occupational infection following accidental exposure to blood or body fluids (BBF) contaminated with a virus, a bacteria, a parasite, or a yeast. The human immunodeficiency virus (HIV) or those of hepatitis B (HBV) or C (HCV) account for most of this risk in France and worldwide. Many other pathogens, however, have been responsible for occupational infections in health care workers following exposure to BBF, some with unfavorable prognosis. In developed countries, a growing number of workers are referred to clinicians responsible for the evaluation of occupational infection risks following accidental exposure. Although their principal task remains the evaluation of the risks of HIV, HBV, or HCV transmission and the possible usefulness of postexposure prophylaxis, these experts are also responsible for evaluating risks of occupational infection with other emergent or more rare pathogens and their possible timely prevention. The determinants of the risks of infection and the characteristics of described cases are discussed in this article.
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              To review the principles of multivariable analysis and to examine the application of multivariable statistical methods in general medical literature. A computer-assisted search of articles in The Lancet and The New England Journal of Medicine identified 451 publications containing multivariable methods from 1985 through 1989. A random sample of 60 articles that used the two most common methods--logistic regression or proportional hazards analysis--was selected for more intensive review. During review of the 60 randomly selected articles, the focus was on generally accepted methodologic guidelines that can prevent problems affecting the accuracy and interpretation of multivariable analytic results. From 1985 to 1989, the relative frequency of multivariable statistical methods increased annually from about 10% to 18% among all articles in the two journals. In 44 (73%) of 60 articles using logistic or proportional hazards regression, risk estimates were quantified for individual variables ("risk factors"). Violations and omissions of methodologic guidelines in these 44 articles included overfitting of data; no test of conformity of variables to a linear gradient; no mention of pertinent checks for proportional hazards; no report of testing for interactions between independent variables; and unspecified coding or selection of independent variables. These problems would make the reported results potentially inaccurate, misleading, or difficult to interpret. The findings suggest a need for improvement in the reporting and perhaps conducting of multivariable analyses in medical research.
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                Author and article information

                Journal
                rlae
                Revista Latino-Americana de Enfermagem
                Rev. Latino-Am. Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo (, SP, Brazil )
                0104-1169
                1518-8345
                October 2008
                : 16
                : 5
                : 818-823
                Affiliations
                [02] orgnameWHO Collaborating Centre for Nursing Research Development Brazil
                [01] orgnameUniversity of Sao Paulo orgdiv1Ribeirao Preto College of Nursing
                Article
                S0104-11692008000500004 S0104-1169(08)01600504
                f34cd5d3-e852-4f68-af6d-c9a0177662ac

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

                History
                : 10 August 2008
                : 22 February 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 6
                Categories
                Original Articles

                lesiones por pinchazo de aguja,factores de riesgo,grupo de enfermería,accidentes de trabajo,epidemiología analítica,needlestick injuries,risk factors,nursing, team,accidents, occupational,analytic studies,ferimentos penetrantes produzidos por agulha,fatores de risco,equipe de enfermagem,acidentes de trabalho,epidemiologia analítica

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