陕西省渭南市城区医务人员锐器伤现况调查分析
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摘要
目的了解渭南市城区医务人员锐器伤的发生情况,分析锐器伤发生的原因,提出针对性的防控措施。方法抽取临渭(主城)区8家医院医务人员共计341人,采用自填式问卷调查方法对2016年7月～2017年6月锐器伤的发生情况进行回顾性调查分析。结果调查对象中有60. 12%(205/314)在最近一年内有过锐器伤经历,发生密度为1. 79次/(人·年)(612/341);护士(63. 13%)和手术室的医务工作者(74. 44%)是锐器伤发生的高危人群;锐器伤发生最多的地点为手术室(34. 15%);头皮钢针(25. 33%)、一次性注射器(25. 16%)是医务人员锐器伤的主要医疗器具;双手回套针帽(31. 70%)、手术缝针(13. 73%)是医务人员锐器伤的主要环节;单因素分析发现学历、科室以及医院级别是其有关的影响因素,多因素分析发现科室、医院级别是其独立影响因素;在已知暴露源的情况下,血源性疾病暴露率达66. 67%(132/198),锐器伤后上报率为17. 65%(108/612)。结论医务人员锐器伤发生频率高,对锐器伤的危害认识仍然不足,医院管理部门应进一步加大对职业安全管理的教育力度。
Objective To understand the occurrence of sharp instrument injuries in medical staff in Weinan City,analyze the causes,and propose targeted prevention and control measures. Methods A total of 341 staff from 8 medical institutions in Linwei district,the main urban area of Weinan,were collected to fill in the questionnaire that contained the incidence of sharp instrument injury from July 2016 to June 2017. Results A total of 60. 12%( 205/314) of the respondents had sharp instrument injuries in the past year,with a density of 1. 79/( person·year)( 612/341); nurses( 63. 13%) and medical staff in the operating room( 74. 44%) were at high risk. Most of the injuries occurred in the operating room( 34. 15%). The scalp needles( 25. 33%) and disposable syringes 25. 16%( 31. 70%) and surgical stitches( 13. 73%) were the main causes of the injury. Univariate analysis showed that education level,departmental level and hospital level wererelated influences. Multivariate analysis found that department and hospital level were independent influencing factors. The exposure rate of blood-borne diseases was66. 67%( 132/198) and the rate of sharps injury was 17. 65%( 108/612). Conclusion The frequency of sharp instrument injuries among medical staff is high,and the awareness of the danger of sharp injuries is still insufficient. The hospital management department should further increase the education on occupational safety management.
Objective To understand the occurrence of sharp instrument injuries in medical staff in Weinan City,analyze the causes,and propose targeted prevention and control measures. Methods A total of 341 staff from 8 medical institutions in Linwei district,the main urban area of Weinan,were collected to fill in the questionnaire that contained the incidence of sharp instrument injury from July 2016 to June 2017. Results A total of 60. 12%( 205/314) of the respondents had sharp instrument injuries in the past year,with a density of 1. 79/( person·year)( 612/341); nurses( 63. 13%) and medical staff in the operating room( 74. 44%) were at high risk. Most of the injuries occurred in the operating room( 34. 15%). The scalp needles( 25. 33%) and disposable syringes 25. 16%( 31. 70%) and surgical stitches( 13. 73%) were the main causes of the injury. Univariate analysis showed that education level,departmental level and hospital level wererelated influences. Multivariate analysis found that department and hospital level were independent influencing factors. The exposure rate of blood-borne diseases was66. 67%( 132/198) and the rate of sharps injury was 17. 65%( 108/612). Conclusion The frequency of sharp instrument injuries among medical staff is high,and the awareness of the danger of sharp injuries is still insufficient. The hospital management department should further increase the education on occupational safety management.
引文
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[11]张梦辉,赖晓全,张新平,等.医疗机构锐器伤漏报及影响因素分析[J].中国医院管理,2017,37(11):43-45.
[12]王超,戴俊丽,丁晓文,等.医务人员职业紧张与其发生锐器伤的关联效应分析[J].工业卫生与职业病,2018,44(3):185-188,194.
[2] BLASIUS KR,NEUSTEIN SM. An unexpected needlestick injury[J].Middle East Journal of Anesthesiology,2012,21(5):751-752.
[3]李卫华.手术室医护人员职业暴露损伤及防护现状调查[D].济南:山东大学,2015.
[4]刘水桂,季苏萍.医护人员锐器伤调查与分析[J].医学理论与实践,2016,29(18):3270-3271.
[5]孔春芽,王飞,王飞筠,等.医务人员锐器伤现状调查与管理[J].中华医院感染学杂志,2015,25(24):5736-5738.
[6]封秀琴,方萍萍,张波,等.我国三级甲等医院急诊医务人员锐器伤发生现状与对策分析[J].中华医院感染学杂志,2017,27(14):3335-3338.
[7]姜萍,顾艳荭,季诚,等.护士锐器伤暴露后的处理与影响因素分析[J].中华医院感染学杂志,2016,26(6):1412-1414.
[8]王靖,樊宏英,程芸,等.医务人员血源性传染病职业暴露危险因素调查分析与防范对策[J].中国消毒学杂志,2015,32(4):374-376.
[9]王慧,马京华,杨荣芳,等.手术室血源性职业暴露与职业防护调查[J].中华医院感染学杂志,2015,25(7):1670-1672.
[10]周家梅,江智霞,袁晓丽,等.遵义市医务人员锐器伤流行现状调查与分析[J].重庆医学,2015,44(20):2824-2826.
[11]张梦辉,赖晓全,张新平,等.医疗机构锐器伤漏报及影响因素分析[J].中国医院管理,2017,37(11):43-45.
[12]王超,戴俊丽,丁晓文,等.医务人员职业紧张与其发生锐器伤的关联效应分析[J].工业卫生与职业病,2018,44(3):185-188,194.