Work accidents with exposure to biological material in nursing in emergency rooms

Objective: to analyze work accidents with biological material occurred with exposure of workers in nursing units of Emergency Rooms (UPAs). Method: descriptive and exploratory study of qualitative approach, with 10 nursing workers who work in units of Emergency in the city of Mossoró/RN. The data were obtained from semi-structured interviews between March and May of 2011 and analyzed according to thematic analysis. The study had approval of the project by the Committee of Ethics in Research, CAAE 0007.0.428.000-10. Results: Four thematic categories were shown: 1) Relation between the nursing working conditions and accidents; 2) Characterization of the accidents at work; 3) Behavior after accidents; and 4) Feelings against the accidents. Conclusion: the precarious conditions and the existence of excessive workloads contributed to the occurrence of the accidents that occurred as a result of a scenario characterized by structural problems that go through own precarious work in the SUS. Descriptors: Workers’ Health; Nursing; Exposure to Biological Agents; Occupational Risks; Working Conditions. RESUMEN Objetivo: analizar los accidentes de trabajo con exposición a materiales biológicos ocurridos con trabajadores de enfermería en Unidades de Pronto Socorro (UPAs). Método: estudio exploratorio y descriptivo de enfoque cualitativo, con 10 trabajadores de enfermería que actúan en Unidades de Pronto Socorro en el municipio de Mossoró/RN. Los datos fueron producidos a partir de entrevistas semi-estructuradas entre marzo y mayo de 2011 y analizados según el Análisis temático. El estudio tuvo aprobación del proyecto por el Comité de Ética en Investigación, CAAE 0007.0.428.000-10. Resultados: se evidenciaron cuatro categorías temáticas: 1) Relación entre condiciones de trabajo de enfermería y los accidentes; 2) Caracterización de los accidentes de trabajo; 3) Conductas después de los accidentes; e 4) Sentimientos frente a los accidentes. Conclusión: las condiciones precarias y la existencia de cargas de trabajo excesivas contribuyeron para la ocurrencia de los accidentes que ocurrieron como resultado de un escenario caracterizado por problemas estructurales que pasan por la propia precarización del trabajo en el SUS. Descriptores: Salud del Trabajador; Enfermería; Exposición a Agentes Biológicos; Riesgos Ocupacionales; Condiciones de Trabajo. Nurse, Specialist, Midwife Women Hospital Maria Corrêa. Mossoró (RN), Brazil. E-mail: [email protected]; Nurse, Master Professor, Nursing School/ State University of Rio Grande do Norte/UERN. Mossoró (RN), Brazil. E-mail: [email protected]; Nurse, Doctor Professor, Nursing Department / Post-Graduation Program in Nursing Academic Master and Doctorate / Science Health Center, Fedral University of Rio Grande do Norte/UFRN. Natal (RN), Brazil. E-mail: [email protected]; Nurse, Master Professor, Nursing School/ State University of Rio Grande do Norte/UERN. Mossoró (RN), Brazil. E-mail: [email protected]; Student, Nursing Graduation, State University of Rio Grande do Norte/UERN. Mossoró (RN), Brazil. E-mail: [email protected] ORIGINAL ARTICLE Leite AR, Pontes AGV, Silva RAR da et al. Work accidents with exposure to biological material… English/Portuguese J Nurs UFPE on line., Recife, 8(4):910-8, Apr., 2014 911 ISSN: 1981-8963 DOI: 10.5205/reuol.5829-50065-1-ED-1.0804201416 Accident at work is what happens when working, causing personal injury or functional disturbance that causes the death, loss, or reduction, permanent or temporary, of the capacity for work. This definition also includes the accident that happened off-site and working hours, such as the journey. Accidents at work are inserted into contemporary capitalist society context, marked by a model of development that advances in globalization with productive restructuring in which neoliberalism brings changes for the world of work, such as insecurity, structural unemployment and the increase in the informal sector and services. These technological and organizational changes in the productive sphere are intensifying the work, the exploitation of workers and worker health wear, having as purpose the advancement of capital productivity. When we adopt the category reference work for nursing, we are taking it as a social practice, because we understand that Nursing establishes relations with other works, with the economic, cultural and social dimensions of the boards that make up the structure of a society. Accordingly, studies show that the conditions and the organization of work of nursing are providing a health-disease profile characteristic of this group of workers. That profile includes accidents at work with exposure to biological materials. These are defined as accidents involving blood and other organic fluids occurred with healthcare workers during the development of their work, which are exposed to potentially contaminate biological materials. The wounds made with needles and bladed cutting material in general are considered extremely dangerous because they are potentially capable of transmitting more than 20 types of different pathogens, being the human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) infectious agents most commonly involved. Nurses, especially the auxiliaries and technicians have been singled out as the professional category most affected by this type of accident for being the most manipulating these materials, needles and scalps in drug delivery activities and sorotherapy. To analyze the Brazilian scientific production, it was observed that several surveys address the issue of work related to accidents with exposure to biological material in healthcare workers, with a focus on nursing staff and hospital sectors, and of urgent and emergency. In general, they are investigations that use quantitative approaches and attributed the occurrence of the accident to the worker’s fault. In addition, it is indicated prevention measures, such as use of personal protective equipment and health education for workers’ awareness about the Standard Protective Measures. In this sense, it is realized the importance of politicizing and give visibility to accidents, which requires special efforts to replace the practice of assigning blame. This seems to require the revision of the terms of regulatory rule NR-01 of the Ministry of Labor and Employment and the Brazilian Standard on Accidents at Work, among others, removing them references to the idea of “unsafe acts” as causes of accidents. The persistence of this concept contributes to the construction of the guilt of the victims and the inhibition of the prevention from a political point of view. This study anchors in Worker ́s Health theorist contribution seeking to identify the mediations between accidents at work with exposure to biological material and the constituent elements of the work process as object, technology and activity; and the organization and division of labor within the contemporary capitalist society. The justification of this study is due to this problem and statistics of the Reference Center on Worker’s Health – CEREST State of Rio Grande do Norte that shows that Nursing was the professional category that suffered accidents at work with more exposure to biological material. And that, in the municipality of Mossoro, the ER units are workplaces with the largest notification of these accidents.