某康复医院医护人员锐器伤职业暴露现状调查
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摘要
目的了解康复医院医护人员锐器伤职业暴露的现状,为制定防护对策提供依据。方法对2014年至2017年发生锐器伤职业暴露医护人员的资料进行回顾性分析。结果该医院医护人员所发生锐器伤职业暴露42例,护士占85. 71%;工作1年内医护人员占45. 24%;工作1年内护理人员职业暴露的发生率达到23. 46%;发生暴露的主要环节在回帽、医疗废物处理、拔针,分别占23. 81%,21. 43%和19. 05%;乙肝病毒仍是职业暴露的主要暴露源,暴露后处理得当,暂未发现因职业暴露而感染疾病。结论加强工作1年内的护士职业暴露培训;加大日常督导,规范诊疗操作;了解暴露源情况,加大疫苗接种力度,是降低医院感染发生及感染的关键。
Objective To understand the current situation of occupational exposure of medical staff in rehabilitation hospital,and provide evidence for formulating preventive measures. Methods A retrospective study was conducted to analyze the situation of occupational exposure to sharp instrument injuries of medical staff in a rehabilitation hospital from 2014 to 2017. Results A total of 42 cases of occupational exposure to sharp instrument injuries occurred,and nurses accounted for 85. 71%,medical staff within 1 year of work accounted for 45. 24%. The incidence of occupational exposure of nursing personnel within one year of work was 23. 46%. The occupational exposure occurred in return caps,medical waste treatment,and needle extraction,which was 23. 81%,21. 43% and19. 05%,respectively. Hepatitis B virus is still the main source of occupational exposure. After exposure to appropriate treatment,no infection caused by occupational exposure has been found. Conclusion Strengthening occupation protection education of nursing personnel within one year of work,increasing daily supervision,standardizing the operation of diagnosis and treatment,and understanding the source of exposure and increasing vaccination are the key to reduce the incidence and infection in hospitals.
Objective To understand the current situation of occupational exposure of medical staff in rehabilitation hospital,and provide evidence for formulating preventive measures. Methods A retrospective study was conducted to analyze the situation of occupational exposure to sharp instrument injuries of medical staff in a rehabilitation hospital from 2014 to 2017. Results A total of 42 cases of occupational exposure to sharp instrument injuries occurred,and nurses accounted for 85. 71%,medical staff within 1 year of work accounted for 45. 24%. The incidence of occupational exposure of nursing personnel within one year of work was 23. 46%. The occupational exposure occurred in return caps,medical waste treatment,and needle extraction,which was 23. 81%,21. 43% and19. 05%,respectively. Hepatitis B virus is still the main source of occupational exposure. After exposure to appropriate treatment,no infection caused by occupational exposure has been found. Conclusion Strengthening occupation protection education of nursing personnel within one year of work,increasing daily supervision,standardizing the operation of diagnosis and treatment,and understanding the source of exposure and increasing vaccination are the key to reduce the incidence and infection in hospitals.
引文
1张鹏,聂绍发. 2010~2014年湖北省乙型肝炎流行病学特征及发病趋势分析[J].公共卫生与预防医学,2016,27(1):33-35.
2 张志刚,魏秋霞,杨致霈,等.医务人员职业暴露现状与防护对策研究[J].中国消毒学杂志,2017,34(3):254-256.
3 孙建,徐华,顾安曼,等.中国医务人员职业暴露与防护工作的调查分析[J].经济学(季刊),2016,15(9):681-685.
4 刘佳,胡智勇,杜永全,等.某综合医院医务人员职业暴露原因分析与防护策略[J].实用临床护理学电子杂志,2017,2(41):184,188.
5 孔令茹,孔令俊,李冰.医务人员职业暴露现状分析及防护措施[J].中华医院感染学杂志,2011,21(7):1393-1394.
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7 Beekmann SE,Vaughn TE,Mc Coy KD,et al. Hospital bloodborne pathogens programs:program characteristics and blood and body fluid exposure rates[J]. Infect Control Hosp Epidemiol,2001,22(2):73-82.
8 宋平,周建芹,王艳娜.临床护士针刺伤事件监测及分析[J].中华医院感染学杂志,2011,21(14):3005-3007.
9 王金贤,杨利亚.医务人员职业暴露调查分析与预防[J].中华医院感染学杂志,2012,22(4):763-765.
10 张亚英,姜亦虹,钱静,等.医务人员职业暴露现状调查及对策[J].中国感染控制杂志,2017,16(7):658-661.
11 赵江丽,刘军,涂显春,等.某医院2011~2012年医务人员职业暴露监测[J].中国消毒学杂志,2014,31(1):80-81.
12 赵欣宇,高培,王怀,等.成人及新生儿乙肝疫苗免疫后15年内表面抗体水平的变化[J].基础医学与临床,2017,37(6):808-811.
13 中华人民共和国卫生部.医务人员艾滋病病毒职业暴露防护工作指导原则[S]. http://www. nhfpc. gov. cn/mohbgt/pw10405/200804/18623. shtml,2004. 6. 7.
14 中华人民共和国卫生部.血源性病原体职业接触防护导则[S].http://www. nhfpc. gov. cn/zwgkzt/pyl/200909/42930. shtml,2009.9. 23.
15 李素英,韩秀芬,张秀珍.医院工作人员利器损伤调查分析[J].中华医院感染学杂志,2008,18(7):1007-1008.
16 米光丽,TANG Yan,柳萍. 379名护士针刺伤原因分析及对策[J].中华医院感染学杂志,2008,18(8):1136-1137.
17 周美儿,应月丹,周飞淦,等.某医院医务人员职业暴露监测分析[J].预防医学,2017,29(6):619-622.
18 袁纯,管建粉,陈丽华,等.医务人员锐器伤暴露现状与防控[J].中国消毒学杂志,2011,28(1):112-113.
19 王金贤,杨利亚.医务人员职业暴露调查分析与预防[J].中华医院感染学杂志,2012,22(4):763-765.
20 杨楠,高明.医务人员血源性职业暴露调查分析及防护对策[J].西北国防医学杂志,2017,38(1):62-64.
2 张志刚,魏秋霞,杨致霈,等.医务人员职业暴露现状与防护对策研究[J].中国消毒学杂志,2017,34(3):254-256.
3 孙建,徐华,顾安曼,等.中国医务人员职业暴露与防护工作的调查分析[J].经济学(季刊),2016,15(9):681-685.
4 刘佳,胡智勇,杜永全,等.某综合医院医务人员职业暴露原因分析与防护策略[J].实用临床护理学电子杂志,2017,2(41):184,188.
5 孔令茹,孔令俊,李冰.医务人员职业暴露现状分析及防护措施[J].中华医院感染学杂志,2011,21(7):1393-1394.
6 王豪,刘丁,陈萍,等.医务人员血源性职业暴露监测分析与防护对策[J].重庆医学,2010,39(24):3329-3330.
7 Beekmann SE,Vaughn TE,Mc Coy KD,et al. Hospital bloodborne pathogens programs:program characteristics and blood and body fluid exposure rates[J]. Infect Control Hosp Epidemiol,2001,22(2):73-82.
8 宋平,周建芹,王艳娜.临床护士针刺伤事件监测及分析[J].中华医院感染学杂志,2011,21(14):3005-3007.
9 王金贤,杨利亚.医务人员职业暴露调查分析与预防[J].中华医院感染学杂志,2012,22(4):763-765.
10 张亚英,姜亦虹,钱静,等.医务人员职业暴露现状调查及对策[J].中国感染控制杂志,2017,16(7):658-661.
11 赵江丽,刘军,涂显春,等.某医院2011~2012年医务人员职业暴露监测[J].中国消毒学杂志,2014,31(1):80-81.
12 赵欣宇,高培,王怀,等.成人及新生儿乙肝疫苗免疫后15年内表面抗体水平的变化[J].基础医学与临床,2017,37(6):808-811.
13 中华人民共和国卫生部.医务人员艾滋病病毒职业暴露防护工作指导原则[S]. http://www. nhfpc. gov. cn/mohbgt/pw10405/200804/18623. shtml,2004. 6. 7.
14 中华人民共和国卫生部.血源性病原体职业接触防护导则[S].http://www. nhfpc. gov. cn/zwgkzt/pyl/200909/42930. shtml,2009.9. 23.
15 李素英,韩秀芬,张秀珍.医院工作人员利器损伤调查分析[J].中华医院感染学杂志,2008,18(7):1007-1008.
16 米光丽,TANG Yan,柳萍. 379名护士针刺伤原因分析及对策[J].中华医院感染学杂志,2008,18(8):1136-1137.
17 周美儿,应月丹,周飞淦,等.某医院医务人员职业暴露监测分析[J].预防医学,2017,29(6):619-622.
18 袁纯,管建粉,陈丽华,等.医务人员锐器伤暴露现状与防控[J].中国消毒学杂志,2011,28(1):112-113.
19 王金贤,杨利亚.医务人员职业暴露调查分析与预防[J].中华医院感染学杂志,2012,22(4):763-765.
20 杨楠,高明.医务人员血源性职业暴露调查分析及防护对策[J].西北国防医学杂志,2017,38(1):62-64.