美国调查发现，40%医护人员身患流感继续工作

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美国调查发现，40%医护人员身患流感继续工作

检索：濮阳市油田总医院 刘金淑

翻译：赵 博

审核: 濮阳市油田总医院 刘金淑

一项新的研究表明，专业医护人员（HCPs）应该听从他们自己的身体劝告：生病时呆在家里。根据《美国感染控制杂志》（AJIC）11月刊上发表的研究结果，在10个专业医护人员中，有4个在患流感样症状的同时仍然工作。就像在所有的工作场所一样，有传染性的人员上班时可能会感染其他人。然而，在医疗机构中高龄患者、免疫抑制患者或严重慢性疾病患者，由专业医护人员传播的流感病毒会对其公共健康造成严重危害。

“统计数据令人担忧。至少有一项早期的研究表明，接触过生病医护人员的患者,患相关感染的几率是其他患者的五倍。”疾控中心国家职业安全与健康研究所首席研究员Sophia Chiu博士说：“我们建议所有的医疗机构采取措施支持并鼓励他们的员工在生病期间不要工作”。

这项年度研究是通过国家在线调查进行的，在2014年-2015年流感季节期间搜集了1914个专业医护人员数据。受访者自述患流感，其定义为发烧、合并咳嗽或喉咙痛，并列出促使他们去上班的因素。

该调查评估了多个机构的各种卫生职业：医生、执业护士和助理医师、护士、药剂师、助理/助手、其他临床专业医护人员、临床前的专业医护人员和学生。评估了四种工作环境：住院、门诊或医生办公室、长期护理设施、其他临床设施。

调查结果

•在接受调查的1914名专业医护人员中，414人报告了流感。在这些报告中，有183例（41.4%）在患流感的同时工作了三天。

与长期护理设施的专业医护人员（28.5%）相比，医院的专业医护人员患流感的工作频率最高（49.3%）,临床专业医护人员为（44.3%），药剂师为(67.2%)、内科医生为（63.2%）。

与此相反，调查发现助理和助手为（40.8%）、非临床专业医护人员为（40.4%）、护理从业人员/医生助理为（37.9%）和其他临床专业医护人员为（32.1%）在患病期间工作。

专业医护人员选择放弃休病假最常见的原因包括：觉得自己仍然可以做自己的工作；感觉没有“足够糟糕”而呆在家里；感觉好像他/她没有传染性；感觉自己有义务和同事工作；很难找到让一个同事来替他/她理由。在那些认为自己仍然可以完成工作任务的专业医护人员中，39.0%的人因自身的症状而寻求医疗服务，54%的人不认为自己有传染性。49.8%的长期护理机构的专业医护人员在生病仍然工作，因为他们不能失去工资。

•此前公布的调查结果显示，只有77.3%的受访者表示接受过流感疫苗注射。美国卫生与公众服务部(U.S. Department of Health and HumanServices)2020年的健康人群计划为专业医护人员接种流感疫苗达到90%。

•据报道，专业医护人员的缺席工作天数的中位数为2个工作日。在这群人中，有57.3%的人咨询了医疗机构以缓解症状；25.2%的人被告知患有流感。美国疾病预防与控制中心(Centers for Disease Control and Prevention，简称CDC)建议，任何有流感症状的人都要在发烧休息24小时后再返回工作。

“当具有传染性的专业医护人员选择不在家里休息的时候，患者的健康和幸福就会岌岌可危。”“每个职业和健康机构的量身定制的策略，包括更新带薪病假政策，可以让专业医护人员不仅为自己，也为他们的同事和患者的健康做出选择。”Linda Greene,RN,cmp,FAPIC,2017年APIC总裁如是说。

从1976年到2007年，在美国与流感相关的死亡人数最高可达16.7/10万人（从每10万分1.4到16.7之间不等），与流感相关的死亡主要影响到65岁及以上的人。流感可能在发病前的一天开始传播，在出现症状后的7天内传播。

参考文献:“与流感样疾病一起工作：在2014 - 2015年流感季节期间，美国医务人员的压力，” Sophia Chiu, MD, MPH; Carla L. Black, PhD;XinYue, MPS, MS; Stacie M. Greby, DVM, MPH; A. Scott Laney, PhD; Angela P.Campbell, MD, MPH; and Marie A. de Perio, MD，《美国感染控制杂志》，第45卷，第11期(2017年11月)。

来源:APIC

原文

Survey Finds 4 in 10 HealthcareProfessionals Work While Sick

Yesterday

A new study suggests that healthcareprofessionals (HCPs) should heed to their own advice: stay home when sick. Some four in 10 HCPs work whileexperiencing influenza-like illness (ILI), according to findings published inthe November issue of the American Journal of Infection Control (AJIC). As inall workplaces, contagious employees risk infecting others when they turn upfor work. But with higher concentrations of older patients and individuals withimmunosuppression or severe chronic diseases in healthcare facilities, ILItransmission by HCPs presents a grave public health hazard.

“The statistics are alarming. At least oneearlier study has shown that patients who are exposed to a healthcare workerwho is sick are five times more likely to get a healthcare-associatedinfection,” said lead researcher Sophia Chiu, MD, MPH, CDC’s National Institutefor Occupational Safety and Health. “We recommend all healthcare facilitiestake steps to support and encourage their staff to not work while they aresick.”

The annual study, conducted via a nationalonline survey, collected data from 1,914 HCPs during the 2014-2015 influenzaseason. Respondents self-reported ILI, defined as the combination of a feverand cough or sore throat, and listed factors that prompted them to turn up forwork.

The survey assessed a variety of healthoccupations across multiple institutions: physicians; nurse practitioners andphysician assistants; nurses; pharmacists; assistants/aides; other clinicalHCP; nonclinical HCPs; and students. Four types of work settings were assessed:hospitals; ambulatory care or physician offices; long-term care facilities; orother clinical settings.

Among the findings:
• Of the 1,914 HCPs surveyed, 414 reportedILI. Of these, 183—or 41.4 percent—reported working for a median duration ofthree days while experiencing influenza-like symptoms.
• Hospital-based HCPs had the highestfrequency of working with ILI (49.3 percent), compared to HCPs at long-termcare facilities (28.5 percent). Clinical professional HCPs were the most likelyto work with ILI (44.3 percent), with pharmacists (67.2 percent) and physicians(63.2 percent) among those with the highest frequency.
• In contrast, the survey found thatassistants and aides (40.8 percent), nonclinical HCPs (40.4 percent), nursepractitioners/physician assistants (37.9 percent), and other clinical HCPs(32.1 percent) worked while sick.
• The most common reasons for HCPs to optfrom taking sick leave included feeling that s/he could still preform his/herjob duties; not feeling “bad enough” to stay home; feeling as if s/he were notcontagious; sensing a professional obligation to be present for coworkers; anddifficulty finding a coworker to cover for him/her. Among the HCPs who feltthey could still preform their job duties, 39.0 percent sought medicalattention for their ILI symptoms, as did 54.0 percent of those who did notthink they were contagious. 49.8 percent of HCPs in long-term care settings whoreported for work when sick reported doing so because they couldn’t afford tolose the pay.
• Previously published results from thissurvey described that only 77.3 percent of respondents reported receiving a flushot. The U.S. Department of Health and Human Services’ Healthy People 2020 aimsto reach a 90 percent influenza vaccination rate for HCPs.
• HCPs with self-reported ILI missed a mediannumber of two work days. Of this cohort, 57.3 percent visited a medicalprovider for symptom relief; 25.2 percent were told they had influenza. The Centersfor Disease Control and Prevention recommends that anyone with ILI wait24-hours after a fever breaks before returning to work.

“Patients’ health and wellbeing are atstake when contagious HCPs opt not to stay home. Tailored strategies peroccupation and health institution, including updating paid sick leave policies,can empower HCPs to make healthy choices not only for themselves, but for theircoworkers and patients,” said Linda Greene, RN, MPS, CIC, FAPIC, 2017 APICpresident.

From 1976-2007, influenza-associatedfatalities accounted for up to 16.7 (ranged between 1.4 and 16.7) deaths per100,000 people in the U.S. Flu-related deaths predominantly impact individuals65 years and older. Influenza may be transmissible from one day before, and up toseven days after, symptoms onset.
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Reference: “Working with influenza-likeillness: Presenteeism among US health care personnel during the 2014-2015influenza season,” by Sophia Chiu, MD, MPH; Carla L. Black, PhD; Xin Yue, MPS,MS; Stacie M. Greby, DVM, MPH; A. Scott Laney, PhD; Angela P. Campbell, MD,MPH; and Marie A. de Perio, MD, appears in the American Journal of InfectionControl, Volume 45, Issue 11 (November 2017).

Source: APIC

鱼儿飞

现在带病上班的现象太多了，不值得鼓励啊！

枫桥三贤

都是轻伤不下火线呀，一手吊瓶，一手工作。

lyluoxiuhua

现在医务人员多数不足因为放开二孩等诸多原因，小毛病不可能请假休息！

ynosmile

为了我们的健康，希望我们健康工作，快乐生活。