Prise en charge des accidents d'exposition au sang au Centre Hospitalier de Libourne : une évaluation des pratiques professionnelles

Abstract : Introduction: blood exposure represents a risk of blood-borne viruses transmission to health care workers (HCW); there is a significant under-reporting of these accidents. The main objective of this study was to improve the initial management of the occupational exposure of the HCW of Libourne's Hospital. Materials and methods: this is an approach of occupational practices assessment carried out at the Libourne's Hospital using the clinical audit and the clinical pathway method. Patients included were those with occupational blood exposure from January to June 2016 and from January to June 2017. The clinical pathway method resulted in the realization of a new protocol for the management of occupational blood exposure. An analysis was then conducted to observe the benefits of the new protocol. The primary endpoint was the existence of an initial medial consultation for the assessment of the risk of blood-borne viruses transmission. Results: 48 cases of occupational blood exposure were included between January and June 2016 (phase 1) and 36 between January and June 2017 (phase 2). Only 37 files were analyzed in phase 1 versus 27 in phase 2. There was no significant difference in the number of initial medical consultations between phase 1 and 2. However, a more effective evaluation of the source patient's serological status can be observed (p <0.05). In addition, the standard observation set up in the phase 2 suggests a better overall risk assessment. Conclusion: this study shows a trend towards improved practices following the set up of the new protocol. Longer follow-up and further information meetings will be needed to confirm this trend.
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Master Thesis
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Cécile Lebrun. Prise en charge des accidents d'exposition au sang au Centre Hospitalier de Libourne : une évaluation des pratiques professionnelles. Médecine humaine et pathologie. 2017. ⟨dumas-01665292⟩

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