Use Of Safety Devices Research Articles

Causation, Types and Outcome of Road Traffic-related Ocular Injury in University of Llorin, Kwara, Nigeria

Introduction: Despite transportation liberating man and making him mobile, his increasing reliance on vehicular movement has conferred great facilities on him and his activities. The most profound culprit of all modes of transport is the road, of which traffic accidents are the most disturbing consequence of its use. Road traffic-related ocular injuries often have severe consequences and form a significant part of ophthalmic emergencies. These injuries may be missed and are therefore often underreported. Aim: To determine the causation, types, and outcomes of road traffic-related ocular injuries at the University of Ilorin Teaching Hospital, Kwara, Nigeria. Materials and Methods: This was a cross-sectional study conducted on 78 eyes of consecutive patients with road trafficrelated ocular injuries who presented at the Accident and Emergency unit of the University of Ilorin Teaching Hospital, Kwara, Algeria, between September 2012 and August 2013. The materials included the HOTV chart for vision assessment, which is a standardised, easy-to-use assessment method for both literate and illiterate individuals, a pen torch, direct ophthalmoscope, binocular indirect ophthalmoscope, slit lamp biomicroscope, Perkins tonometer, 2% fluorescein strip, 0.5% GuttTetracaine, and a handheld portable slit lamp ophthalmoscope. Patients’ demographics, duration of ocular injury before presentation, Visual Acuity (VA) at presentation, type of vehicle, place of injury, classification of ocular injury, treatment, and outcome on follow-up were recorded. Results: There were 78 eyes (72 patients) with road trafficrelated ocular injuries. The age range of the subjects was 3-55 years with a mean of 31.10 years. Forty-four (61.1%) patients were young men between 20-39 years. Fifty-one (70.8%) patients were males, and 21 (29.2%) were females, with a maleto-female ratio of 2.4:1. Most of the victims were traders (22, 30.6%), and fifty-two eyes (72.2%) presented within 12 hours of ocular injury. Motorcycles were associated with ocular injury in 37 (51.4%) patients. The most common injuries were of closed globe type (contusion, lamellar laceration, superficial foreign body) in 70 patients (89.7%). Conclusion: Road traffic-related injuries have increased over the past eight years in Nigeria. Males are more commonly injured in Road Traffic Injury (RTI), and motorcycles were the most common cause of injury to road users. Three out of 36 people injured in a vehicle at the time of injury used seat belts, while none of the riders and passengers on motorcycles wore helmets. The importance of prevention, the use of safety devices, and the avoidance of risk behaviors on the road need to be emphasised.

Identifying and Decreasing Sharps Injuries Through Root Cause Analysis in a Large Urban Hospital System.

Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of this quality improvement project was to identify root causes of sharps injuries for RNs at a large urban hospital system. A retrospective evaluation of sharps injuries sustained by RNs, identification epsication of themes or root causes, and the development of a fishbone diagram to sort the causes into categories to identify workable solutions were conducted. Fisher's exact tests were performed to identify association between variables and root causes. A total of 47 sharps injuries were reported from January 2020 through June 2020. Among sharps injuries sustained by nurses, 68.1% were among nurses 19 to 25 years of age and 57.4% reported job tenure of 1 to 2 years. There was a statistically significant association between root causes and tenure range, gender, and procedure type (p < .05) with moderate effect size (Cramer's V = 0.35-0.60). Technique also was a primary cause of sharps injuries for blood draw (77%), discontinuing line (75%), injection (46%), intravenous (IV) start (100%), and suturing (50%). Technique and patient behavior were primary root causes of sharps injuries in this study. More sharps injuries caused by technique occurred among nurses with job tenure of 1 to 10 years, female, blood draw, discontinuing line, injection, IV start, and suturing procedures. The root cause analysis identified tenure, technique, and behavior as potential root causes of sharps injuries specifically occurring most during blood draw and injections at a large urban hospital system. These findings will inform nurses, especially new nurses in the proper use of safety devices and behaviors to prevent injury.

Perfusion Practice in Kenya.

Standards and guidelines for cardiopulmonary bypass have been established by various professional societies. They serve as an instrument to guide safe and effective patient care. We conducted a survey of practicing perfusionists in Kenya to learn about their background, education, current clinical practice and about their knowledge, and attitude regarding standards and guidelines. Two multiple-choice surveys were distributed to all known practicing perfusionist in Kenya using SurveyMonkey (San Mateo, CA). Multiple-choice questions related to professional background, training, annual procedure volume, staffing models, clinical practices, the use of safety devices, and the use of checklists were included in the questionnaires. The survey also inquired about familiarity with American and European perfusion practice standards and guidelines and opinions on establishing standards in Kenya. Responses were received from 12 perfusionists practicing at 10 centers. Professional backgrounds included anesthesia nursing, clinical officers, and critical care nursing. Sixty-seven percent (8/12) received formal training and 33% (4/12) trained primarily through clinical instruction. Of those that received formal training, 63% (5/8) received 1-2 years of training, 25% (2/8) <1 year but more than 6 months, and 12.5% (1/8) received 6 months of formal training. The median clinical experience was 5 years (range 1-22). The median annual case load was 54 (range 0-100). Use of safety devices was reported as follows: level sensor 75% (9/12), air bubble detector 17% (2/12), one-way vent valves 67% (8/12), continuous venous oxygen saturation monitoring 25% (3/12), and gas supply analyzers 33% (4/12). More than one-third of the respondents had no knowledge of the American and European perfusion practice standards, and nearly two-thirds were aware of or had read them. This survey provides contextual information about perfusion practice in Kenya in 2021. There was consensus among perfusionists to develop standards and practice guidelines for Kenya.

Newly Hired Health Workers during the Peak of COVID-19 show no Burnout: Resilience as a Protective Factor

Background: Burnout syndrome is a condition in which health workers pour out very frequently, especially due to the 2020 pandemic. Aims: To deal with a possible risk of burnout due to the psychological and social pressure of the pandemic, it is good to have personal resources that work as a protective factor, such as resilience. The objective of this study is to investigate the differences between a sample of new hospital hires in 2019 and a sample of new hospital hires in 2020, in Lodi, Italy. Methods: To fulfill these purposes, a burnout test and a resilience test were used, and a dummy variable representing the condition of COVID-19 was created. Results: The results indicate that COVID-19 did not significantly affect burnout in the two samples. Limitations: Since the tests were carried out on hiring, the operators may not have been conditioned by the work weight, although Lodi was the epicenter of the pandemic in Italy. Conclusions: These data suggest that newly hired health workers would measure their work stress on personal resilience rather than the danger of COVID-19, despite government restrictions such as lockdowns, the mandatory use of safety devices, media reports on deaths and the risk of contagion.

Seatbelts Save Lives, and Spines, in Motor Vehicle Accidents: A Review of the National Trauma Data Bank in the Pediatric Population.

Database study. The purpose of this study was to use a large, nationwide database to determine prevalence of pediatric spine fractures in the United States, associated injuries, mechanisms of injury (MOI), use of safety devices, and mortality rates. Spinal fractures account for 1% to 2% of pediatric injuries. However, they are associated with significant comorbidities and complications. Motor vehicle accidents (MVAs) are most responsible for increased incidence observed. Retrospective review of National Trauma Data Bank between 2009 and 2014 (analysis in 2019) for all vertebral fractures in patients under 18 years of age. Subanalysis included those in MVAs where protective device use data were available. Patient demographics, MOI, geographical and anatomical region of injury, concomitant musculoskeletal/organ injury, protective device usage, hospital length of stay, surgical procedures, and mortality were all analyzed. A total of 34,563 patients with 45,430 fractured vertebrae included. Median age was 15 years. Most fractures (63.1%) occurred in patients aged 15 to 17 years, most frequent MOI was MVA (66.8%), and most common geographic location was the South (38%). Males sustained more spine fractures than females, overall (58.4% vs. 41.6%; P < 0.001) and in MVAs (54.4% vs. 45.6%; P < 0.001). Those in MVAs wearing seatbelts had lower odds of cranial (29.6% vs. 70.4%; odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.82-0.89; P < 0.001) and thoracic (30.1% vs. 69.9%; OR = 0.88, 95% CI: 0.84-0.91; P < 0.001) organ injury, multivertebral (30% vs. 70%; OR = 0.78, 95% CI: 0.73-0.83; P < 0.001) and concomitant nonvertebral fractures (30.9% vs. 69.1%; OR = 0.89, 95% CI:0.73-0.83; P < 0.001), and 21% lower odds of mortality (29.3% vs. 70.7%; OR = 0.79, 95% CI: 0.66-0.94; P = 0.009). Over 70% of drivers were not restrained during MVA, with majority of seatbelt violations incurred by males, ages 15 to 17, in the South. Over 60% of pediatric spinal fractures occur in children aged 15 to 17 years, coinciding with the beginning of legal driving. MVA is the most common cause and has significant association with morbidity/mortality. Nearly two- thirds pediatric spinal fractures sustained in MVAs occurred without seatbelts. Absence of seatbelts associated with >20% greater odds of mortality. Ensuring new drivers wear protective devices can greatly reduce morbidity/ mortality associated with MVA.Level of Evidence: 3.

Occupational Health Hazards Among Medical Waste Handlers in Ahmadu Bello University Teaching Hospital Zaria Northwest Nigeria

Background: Occupational injuries are important public health issues, especially among healthcare workers. The medical waste handler is at risk of hazards posed by medical waste as well as from the environment. The aim of the study was to determine occupational hazards that hospital waste handlers in Ahmadu Bello University Teaching Hospital, Zaria, were exposed to and to assess their knowledge and practice of safety measures. Methods: A cross-sectional descriptive study was conducted among 79 medical waste handlers in Ahmadu Bello University Zaria using a multistage sampling technique. Data were collected using structured self-administered and interviewer administered questionnaire and analyzed using SPSS version 20 software with significance set at P &lt; .05. Results: More than half of the respondents (56.4%) were men, and most (70.3%) had &lt;5 years work experience. Most of the respondents (60.8%) had had an injury in the previous 6 months. The most common injuries were falling on a slippery floor (48.1%), contact/irritant dermatitis (40.5%), and 34.2% from stress. Only 45.6% received treatment following injury at the work place. Most respondents (75.9%) were aware of safety devices, and more than half (51.9%) received their information from special safety training. More than half of the respondents (51.1%) had poor knowledge of use of safety devices, and 60% had special training in occupational safety. Most respondents (89.9%) used heavy-duty rubber hand gloves, but only 5.1% used aprons. Also, 82.3% of respondents used these devices regularly at work, and more than half of respondents (62%) had been immunized against hepatitis. Also, 65.8% practiced universal precautions. Occupational injury was higher among those aged 15–19 years (occupational injury rate, 75%) compared to those aged 34–39 years (occupational injury rate, 16%). A positive association was detected between gender and injury in the last 6 months; injury was more common among men (43%) than among women (15%). Conclusions: Among respondents, there was a high level of injury and poor knowledge of the use of protective devices. Regular use of protective measures was not commensurate with the reported level of awareness. Concerted efforts are needed to ensure the safety of the medical waste handlers in his work place.Funding: NoneDisclosures: None

Blunt Cerebrovascular Injury Screening Criteria Should Include Motor Vehicle Crash Characteristics.

Current screening criteria miss 30% of blunt cerebrovascular injuries (BCVIs). Motor vehicle collisions (MVCs) are the leading BCVI mechanism, and delineating MVC characteristics associated with BCVI formation may augment current screening criteria. We retrospectively identified BCVI Denver injury screening criteria as able from the Crash Injury Research and Engineering Network (CIREN) database. Severe MVC markers were considered: mean change in velocity (delta-v) greater than 40 km/hour, steering wheel airbag deployment, ejection, or rollover. 93 BCVIs were included. Injury screening criteria were not present in 37/93 (39.8%) BCVIs. Vertebral BCVI more often had injury screening criteria than internal carotid BCVIs (73.2% vs 26.8%, P = .001). There was a significant difference in delta-v (30.78 km/hour vs 51.00 km/hour, P < .001) between BCVI with and without injury screening criteria. BCVI without injury screening criteria more often had safety device use through seatbelt position snug across the hips (94.6% vs 74.5%, P = .01) and pretensioner deployment (92.6% vs 70.2%, P = .04). Examining only drivers, BCVI without injury screening criteria more often had steering wheel airbag deployment (89.7% vs 68.9%, P = .05). Markers of severe MVC were seen in 36/37 (97.3%) BCVIs without injury screening criteria. BCVI without injury screening criteria occurred during higher deceleration MVCs with more frequent/appropriate safety device use, suggesting crash deceleration as a mechanism of BCVI formation. Expanding BCVI screening criteria to encompass severe MVCs may lessen the number of BCVI missed.

Do beverage workers in Enugu state Nigeria comply with health safety measures? A cross sectional study of two breweries

Background: Some workplace accidents happen because workers fail to do their work in the safest possible way. Human beings have an innate desire to be safe, and their commitment to maintaining safe work environment is imperative for occupational health. However, employees’ contributions to workplace accident and injury is underexplored.Methods: Cross-sectional quantitative study was undertaken in two beverage industries in Enugu state. In order to observe a proportion of 50% in staff compliance to safety measures with precision of 5% and confidence level of 95%, 217 full-time employees were selected from each industry. Stratified sampling technique was used to select respondents across 5 units/departments. Data was collected using pre-tested structured questionnaire and analyzed using descriptive statistics. Statistical significance was set at p&lt;0.05.Results: Use of any form of safety device was reportedly high among respondents, 413 (97.4%). However, only 278 (67.3%) reported using them on a daily basis. Aprons 103 (24.9%), helmets 163 (39.5%), and hand gloves 197 (47.4%) were the least commonly used safety devices. The only reason reported for inconsistent use of safety devices was discomfort. Consistent use of safety devices correlates significantly with demographic characteristics such as age, sex, level of education, length of years of work and unit/department (p&lt;0.001), as well as previous history of workplace injury (p=0.01).Conclusions: Consistent compliance with safety measures among factory workers is suboptimal and correlates significantly with demographic characteristics and previous history of workplace injury.

Integrating Real-Time Monitoring Data in Risk Assessment for Crane Related Offshore Operations

The oil and gas sector is one of the most dangerous and stringent workplaces, due to the hazardousness of materials involved as well as the critical tasks that workers have to perform. Cranes are widely used in this sector for several activities. A wrong load lifting or handling often is due to a limited visibility of working area and could bring to severe accidental scenarios, for this reason safety of these operations becomes of paramount importance. The use of safety devices, that provide an augmented vision to the crane-operator, is essential to avoid potential accidents, moreover risk analysis could benefit from the acquisition of real time information about the process. This work aims to extrapolate and adapt dynamic risk assessment concepts for crane-related operations of a typical oil and gas industry by means of the support of safety devices. To achieve this objective, a set of risk indicators, reporting continuous information about the operations that are carried out, will be defined; successively, a technique of aggregation of these indicators will also be applied with the aim to update the frequency of critical events by a proper Risk Metric Reduction Factor that accounts for the effect of the use of safety barriers.

Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008–2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.

Understanding sharps use in an Australian Emergency Department: A mixed methods organisational case study

BackgroundDespite the introduction of a range of safety policies and sharps equipment designed to protect healthcare workers, rates of percutaneous injuries from occupational exposure to sharps remains high. This study examined the availability and use of various types of sharps devices in a tertiary hospital emergency department, to understand clinician choice between non-safety and safety devices; and to document their safe and unsafe use of sharps. MethodsThis mixed methods study consisted of areview of stock levels, a survey of staff usage, and a content analysis of semi-structured interview data to explore factors which impact on staff preferences for different sharps devices. ResultsStaff identified a range of sharps risks, as well as barriers and enablers to the use of safety devices. Availability of, and preference for, familiar devices influenced choice of devices used in clinical practice, despite awareness of associated risks. ConclusionsThis understanding of equipment use and the factors that motivate such use have informed the first stage of the knowledge-to-action cycle. Knowledge translation, should include the development of policies to help reduce the risk of sharps injury. Culture change and ongoing skills development might help to overcome entrenched procedures and increase voluntary engagement with safer sharps.

Prevalenza nell’uso di dispositivi di sicurezza su veicoli motorizzati in italia. Uno studio osservazionale multicentrico sulle strade

to give an overview of the use of safety devices in motorized vehicles in Italy in the years 2015-2017. road side observational study. a sample of 232,283 road users in 28 cities across the Italian territory with a resident population of more than 10 million inhabitants (17% of the Italian population) was considered. the use of seat belts (front and rear), child restraints, and motorcycle helmets were monitored. For each city, the survey was carried out in urban, sub-urban, and extra-urban areas. Data were aggregated by three geographic areas: North, Centre, and South. Data for front seat belts was also provided for drivers and passengers separately. the use of front seat belts shows a dramatic geographical trend ranging from 82.6% (North) to 36.3% (South). Drivers use seat belts more frequently than passengers (63.3% vs 57.4%). The same North-South trend shows the use of rear seat belts (from 19.0% to 3.3%) and child restraints (from 59.9% to 16.6%). Helmet use was high everywhere in Italy (more than 94%). despite the use of safety devices, which has been mandatory for many years, compliance seems to depend on the voluntary behaviour of drivers and passengers influenced by socioeconomical and cultural patterns. The use of rear seat belts and child restraints is still far from an acceptable level, as well as the use of front seat belts in the South and in the Centre. The increased use of safety devices would have significant public health and traffic safety implications, as a potential of 327 deaths/year could be saved.

Injectable medications: self-reported practices of nursing professionals.

To identify the self-reported injectable medications of nursing professionals in the state of São Paulo. Survey study that assessed the self-reported frequency of injection medications through a validated electronic questionnaire, applied from September to December 2017. The 1,295 computed responses showed non-compliances such as sharing multidose vials for two or more patients (10.8%), reusing single-use supplies, such as use of saline flush syringes for different patients (1.2%) and needle recapping after use (4.9%). Greater adherence to glove use for administration of intravenous injections (80.5%) and lack of training for handling safety devices (13%) were reported. Correlational data showed that, the older the age, the better the self-reported injecting practices. Although most practices are within Safe Injecting practices, there are reports of risky practices, such as sharing single-use supplies. Training for the use of safety devices is not yet a reality for all professionals, since many reported it as rare.

Prevalence and Pattern of Adult Maxillofacial Injuries: An Institutionbased Retrospective Study.

ABSTRACTIntroduction:Maxillofacial injuries are more prevalent in road traffic accidents (RTAs). The incidence of RTAs tends to vary with geographical location, socioeconomic status, religion etc.Aim:The main aim of this study is to determine the pattern and prevalence of maxillofacial injuries reported to our institution.Materials and Methods:Data were obtained from medical records of the patients from January 2007 to December 2017 reported in CSI College of Dental Sciences and Research, Madurai, Tamil Nadu were retrieved and analyzed. Data include age, gender, etiology, site of injury, anatomical site associated injuries and their management were recorded and analyzed with STATA software version 14 (StataCorp LLC, College Station, TX, USA).Results:Maxillofacial injuries occur more commonly in 2nd and 3rd decade (40.44%) with mean age of 32.58 ± 11.15 years. RTA (77.21%) and alcohol influence (51%) were considered as the most common cause of maxillofacial injuries and was statistically significant. Mandible (44.85%) was most commonly involved and 62.5% required a surgical intervention.Conclusion:RTA with mandibular fracture is predominant in men between the age group of 20-30 years. Expansion in road network, increase in motorization, alcohol consumption and urbanization in developing countries had accompanied with rise in RTAs. Thus the use of safety devices and educating people by conducting preventive camps about traffic rules will reduce the number of RTA.

Patient and injury characteristics associated with road traffic mortality in general hospitals in southern Thailand

Abstract Background Road traffic injuries are a major public health burden in developing countries. Thailand has the highest fatality rate from road traffic injuries in southeast Asia so that prevention of unintentional injuries is important. Objective To identify patient and injury characteristics associated with road traffic mortality in the southern provinces of Thailand. Methods Data on a total of 78,862 road traffic injuries recorded by the general hospitals in 5 southern provinces of Thailand, during 2008–2013, were obtained from the Office of Disease Prevention and Control. Chi-squared test was used to determine the association between patient/injury characteristics and road traffic mortality, and logistic regression was used to identify the strength of associations. Results In this study, road traffic mortality was found to be 1.8% of all injuries. Most of the deaths occurred in males (61.7%), who were aged 25–44 years (35.8%), being drivers (68.6%), using motorcycle (78.4%), and not wearing a helmet (61.0%). Road traffic mortality was higher among males, older age people, those who were not wearing a helmet or not fastening a seat belt, pedestrians and when people crashed with or by motor car, with wound being penetrating or blunt with penetrating, and when they were having head or neck, chest, or abdominal or pelvic cavity injuries. Conclusion Policies and measures for reducing road traffic mortality should focus on males and older aged persons, use of safety devices, and occurrence of multiple injuries.

Incidence and analysis of sharps injuries and splash exposures in a tertiary hospital in Southeast Asia: a ten-year review.

We aimed to report the ten-year incidence and trend of sharps injuries and splash exposures (SISE), and analyse the causative instruments and risk factors leading to these injuries to identify potential areas of improvement. A retrospective review of self-reported SISE incidents from 2005 to 2014 was conducted in Singapore General Hospital. Data was extracted from the electronic database of the Department of Infection Prevention and Control. Incidence of SISE was calculated per 1,000 healthcare workers (HCWs) per year. Over the ten-year period, a total of 1,901 SISE were reported. The average SISE incidence per year was 110.5 per 1,000 doctors and 22.8 per 1,000 nursing staff, with an overall incidence of 28.9 per 1,000 HCWs. The incidence of SISE decreased from 30.3 to 22.0 per 1,000 HCWs per year from 2005 to 2014, while that for splash exposures increased from 1.9 to 3.7 per 1,000 HCWs per year. Doctors reported the highest number of SISE (43.7%), followed by nurses (37.7%). Top mechanisms of injury were intraoperative procedures (22.8%), drawing blood (14.4%) and splash exposures (13.7%). Overall incidence of SISE decreased over the decade. Improved training and increasing use of safety devices, education and awareness could have contributed to the fall in incidence of sharps injuries; these measures should be reinforced and continued. However, the incidence of splash exposures increased over the same period. Preventive measures such as the use of protective goggles and face shields, together with personal protective equipment, should be emphasised and encouraged.

Factors affecting use and nonuse of child safety car seats in Gorgan, Iran

Objective: Motor vehicle accidents, which are among the main causes of child mortality in Iran and the Middle East, impose staggering costs for the community. Ignoring use of safety devices for children in most motor vehicle crashes will lead to death or serious injury. Because few studies have been performed on effective and predictive factors regarding use of child safety seats, the purpose of this study was to examine the factors affecting the use and nonuse of child safety seats, along with the factors that can facilitate how a child safety seat is used.Method: This study was conducted in the urban area of Gorgan using a questionnaire. Through random selection, 204 parents with at least one child, aged 8 years or younger, reported their knowledge about the benefits of using a child safety seat.Results: The results showed that 80% of parents never use a child safety seat, and 13% always use a child safety seat. More than 93% thought that it was necessary to make usage of the child safety seat obligatory. In addition, 80% of parents believed that a child safety seat prevents children from injury in crashes. In addition, 38% of parents were not aware of child safety devices and child safety, less than 20% said that they did not use a child safety seat because their spouse did not support its use, and 28% of them thought that a child safety seat does not affect the safety of the child. In general, 91% of parents reported that if child safety seat use were mandated, the frequency of use would increase. A law on the use of child safety seats is a very important variable in their use, which can enhance the chance of using a child safety seat by 6.5 times.Conclusion: Special instructions should be developed to create incentive strategies for using a child safety seat. Mandating the use of a child safety seat, equipping cars with a child safety seat, encouraging children to use it, and providing continuous education and training are important factors for increasing the use of child safety seats.

Seroprevalence of anti-HBc, risk factors of occupationally acquired HBV infection and HBV vaccination among hospital staff in Poland: a multicenter study

BackgroundDue to numerous blood exposures hospital staff are at risk of acquiring hepatitis B virus (HBV) infections. This study aimed at estimating prevalence of HBV, associated risk factors and HBV vaccination among Polish health care workers (HCWs).MethodsA cross-sectional sero-survey was conducted (October 2016–January 2018) in 10 randomly selected hospitals from two provinces: of low and high incidence of HBV, with the use of an anonymous, self- administered questionnaire. Blood samples were screened for hepatitis B core antibodies (anti-HBc) with enzyme immunoassay.ResultsOf the 306 participating HCWs, 88.6% were females, 69.9% nurses (mean age 47.8 ± 9.0 years). HBV vaccination was reported by 94.2%, participants (4.7% with 2 doses, 58.1% with 3 doses, 37.2% took a booster), but of these 75.1% reported no post-immunization serology. The sero-prevalence of anti-HBc was 12.1% (95%CI 8.4–15.7%); only 11.1% had ever screened themselves for HBV infection. Out of 37 anti-HBc positive HCWs, 29 reported being vaccinated for HBV; 10.5% vaccinated HCWs were anti-HBc positive. Regarding other occupational risk factors, 27.8% had experienced a sharp injury (SI) in the last year, 80.0% of incidents were not reported. The use of safety devices (SD) was 86.3%; 35.9% participants used to recap a needle. Older age (OR = 4.24), lack of HBV vaccination (OR = 7.42), working at the province of high HBV incidence in the general population (OR = 2.69) were each predictors of participant’s HBV infection.ConclusionsHigh anti-HBc seroprevalence was found in hospital staff with older generation particularly constituting a risk group. Unsatisfactory vaccination coverage and the use of SDs, needle recapping and under-reporting of SIs were main modifiable risk factors regarding HBV infection. The study provides evidence of the protective role of HBV vaccine, as well as the possible effect of HBV incidence in the general population on HCW’s anti-HBc seropositivity. Universal vaccination, followed by strict policies to confirm immunity, better compliance with infection-control practices and widespread implementation of SDs should be enforced to protect hospital staff from occupationally acquired HBV infections.

Wednesday, September 26, 2018 1:00 PM – 2:00 PM Spinal Trauma: 52. Spine fractures in pediatric population: causes, comorbidities, and complications. A review of the National Trauma Data Bank (NTDB)

BACKGROUND CONTEXT Spinal fractures account for only 2% to 3% of pediatric injuries. However, they're associated significant comorbidities and complications. PURPOSE This population-based study seeks to determine associated injuries and use of safety devices in pediatric spinal fractures. STUDY DESIGN/SETTING NTDB study. PATIENT SAMPLE A total of 6,008 pediatric patients. OUTCOME MEASURES Mechanism of injury, associated injuries, length of stay, neurological compromise. METHODS Pediatric spinal fractures were gathered from the National Trauma Data Bank for 2012. Data was found using ICD-9 805.xx or 806.xx, external cause of injury and procedure codes frequency, and median analyses were performed. RESULTS A total of 6,008 unique patients presented with 7,732 fractured vertebrae. A total of 2,179 (28.1%) cervical vertebrae, 2,151 (27.8%) lumbar, 2,052 (26.5%) involved the thoracic vertebrae, and the remainder involved sacro-coccyx. A total of 3,482 were male and 2,523 female; 4.2% of patients had an associated spinal cord injury. The most common associated musculoskeletal injury was femur fracture (6.7%), the most common associated organ injury was a lung contusion (4.6%) and 980 (16.3%) patients had associated skull fractures. A total of 15,285 fractures occurred in this patient population. Of the total vertebrae involved, 2,825 (31.7%) were repaired surgically. A total of 164 (2.7%) patients died from complications. A total of 2,708 (45.1%) patients were injured as an occupant of a motor vehicle accident (MVA); 25.8% were the drivers of the motor vehicle and 965 (35.7%) of these did not have a protective device present at the time of injury. More than half, 52.4%, of MVA patients were female. The median age of patients in MVA was 15 years (13-17). Interestingly, 48.9% of these were 16 or 17 years of age; the legal age of driving. Seventy-five (2.8%) of MVA patients died from complications. CONCLUSIONS MVA are the most frequent cause of spinal fractures in pediatric patients. Based on the numbers in this study, this amounts to 7.4 patients who present to ER daily with spine fractures from MVA. Approximately a third of these fractures occurred in patients without a protective device present. Nearly half of these fractures occur in children 16 or 17 years of age, the age when children become legally allowed to operate a motor vehicle. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Organizational factors related to the adoption of an injury prevention program by U.S. children's hospitals.

Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children's hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children's hospitals in the USA. IP specialists at 232 U.S. children's hospitals were invited to complete a baseline survey, and then offered Safe N' Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity-having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.