A multi-center study on exploration of standardized management pathways for occupational exposures among health care workers in Yunnan Province

OBJECTIVE To investigate the current status,management practices and change of psychological stress of the health care workers with occupational exposures, explore standardized management pathways for occupational exposures and evaluate the necessity and feasibility of introducing psychological interventions. METHODS A total of 540 health care workers with occupational exposures who represented 9 various grades of metical institutions of Yunnan Province were recruited as the research subjects by using cluster sampling method from Jan. 2023 to Sep. 2024. The incidence of occupational exposures, features of exposures and psychological assessment were observed. The 106 health care workers with generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) total score no less than 10 points were stratified randomly as the intervention group with 53 cases and the control group with 53 cases. The psychological changes of the two groups of subjects were analyzed before and after the intervention. RESULTS There were most occupational exposures among the health care workers of the three-A hospitals (74.26%). The health care workers aged less than 30 years old(67.96%), female health care workers(77.04%), the health care workers with bachelor degree(67.22%) and workers of the hospital (58.33%) were dominant among the health care workers with occupational exposures. The proportion of nurses was highest(36.67%). The occupational exposures were most prevalent in surgery department(37.41%) and wards(52.04%). The sharp instrument injuries were dominant. The exposure to hands(82.22%) and withdrawal of needles (34.26%) were most common. The exposure source was dominated by hepatitis B virus (HBV)(36.30%). Most of the health care workers (61.48%)accepted no less than 3 times of trainings before the exposures and completely mastered the corresponding disposal measures(53.33%). The health care workers who had a little anxiety after the exposure were the most(46.48%), and 35.00% thought that appropriate psychological interventions were necessary(35.00%). The result of the psychological intervention to the health care workers with occupational exposures showed that the psychological state score of the intervention group was better than that of the control group after the exposure for 1 week and 3 months (P＜0.05). CONCLUSIONS It is feasible and effective to adopt standardized management pathways for the disposal and surveillance management of occupational exposures in the health care workers. Integrating the standardized management pathways with individualized psychological intervention can effectively improve the adverse psychological reactions of the health care workers due to occupational exposure.