临床护理中医疗废物处理现状研究
摘要
目的:本课题通过对不同等级医院的护理人员对医疗废物处理的认知和行为进行调查和分析,找出影响护理人员医疗废物处理的认知和行为的因素并提出建议,为加强临床护理人员职业防护和促进临床中医疗废物的安全管理提供借鉴和参考。
方法:采用观察法、开放式访谈法、封闭式问卷法及数理统计方法对359名护理人员进行分层随机抽样调查,调查对象为乌鲁木齐市兵团医院、石河子大学第一附属医院、农六师五家渠医院、奇台医院及其周围一级团场医院的护理人员。资料管理与录入用流行病学软件Epidata3.1,数据分析用统计学软件SPSS11.5。
结果:1.护理人员对医疗废物处理的认知:(1)有31.5%的护理人员对医疗废物的危害性认知不清。(2)护理人员对所在医院有关医疗废物处理制度等总体认知较好,但是对这些制度管理监督具体执行情况认知却相对较低;对医疗废物处理相关法律条例和规章制度知识欠缺;(3)对损伤性废物、感染性废物认知较好,正确率分别为89.1%、80.8%,但对病理性废物、药物性废物、化学性废物、医疗废物分几类认知较差,分别为55.2%、44.6%、51.8%、32.6%。
2.护理人员对医疗废物处理的行为现状:75.5%的护理人员对医疗废物和生活垃圾能够做到严格分类放置,但是仍然部分护理人员对医疗废物分类执行情况较差,尤其是一级医院医疗废物和生活垃圾混放情况严重;59.1%的护理人员在处理血液、体液或污染物等废物时每次都配戴手套、口罩等防护用具,82.7%的护理人员在处理医疗废物后能够及时洗手;57.7%的护理人员在与专职人员交接医疗废物时能够履行登记制度;81.6%的护理人员参加过有关医疗废物学习或培训,在最近一年参加的培训次数为1-16次,平均为2.63±1.79。显然护理人员参加培训的次数、广度与其认知相差较远,这说明医院开展的培训没有达到预期目的。
3.影响因素:影响护理人员医疗废物处理认知的主要因素为医院级别、年龄和护龄;护理人员处理医疗废物分类、交接、防护行为的主要因素分别为医院级别、职称、学历、年龄;影响护理人员医疗废物处理认知和行为的因素排在前四位的依次是意识欠缺、经济投资较少、知识不足、措施设备落后。
结论:理论研究:从环境对健康的影响、环境护理相关理论研究以及环境与护理的关系等方面着手,首次提出环境护理并将其定义,探讨了护士在环境护理中的任务。实践研究:护理人员对医疗废物处理认知不足,对医疗废物处理分类、交接和防护行为存在不同程度的缺陷,建议加强医院医疗废物管理制度建设、建立健全医疗废物监督管理体系、加强护理管理者的重视、加强护理人员对医疗废物危害、分类处理等相关知识的认知、加强其他各类人员培训教育及评价考核体系、加强护理人员的职业防护、加强在校学生和实习生的职业防护教育、做好宣传,提高环境保护意识。
Object: Investigating and analyzing the cognition and behavior of nurses on the disposal of medical waste from different levels of hospital, We try to find impact factors which effect the cognition and behavior of nurses on the disposal of medical waste and then advance some proposals. In order to strengthen the protection of nursing career and promote the security management of medical waste.
Methods:Using methods of observation, open interviews, enclosed questionnaire and mathematical statistical, 359 nurses were selected stratified random sampling survey in the Urumqi City Hospital Corps, the first Affiliated Hospital of Shihezi University, Wujiqu Hospital, Qitai Hospital etc.Data was managed and inputted with software of Epidata3.1.All statistical analysis we reperformed using the SPSS11.5 statistical software.
Results: 1.The cognition of disposal of medical waste: (1) 31.5% of the nurses on the dangers of medical waste is unclear.(2)The knowledge of the nurses on the disposal systems of medical waste is better, but the cognition of specific performance of supervision system is relatively low;Lack of knowledge of rules and laws on disposal of medical waste.(3)The cognition of injury waste, infectious waste is better, respectively 89.1%, 80.8%, but the cognition of the pathological waste, drug waste, chemical waste, the types of medical waste is poor, respectively 55.2%、44.6%、51.8%、32.6%.
2. The behavior of disposal of medical waste: 75.5% of nurses can carry on strictly the classification of medical waste, but still partly nurses can’t, especially nurses of Primary Hospital mixed medical waste and garbage; 59.1% of the nursing staff wear gloves, masks and other protective equipment every time when they deal with the blood, body fluids,etc;82.7% of the nurses can wash their hands after handling of medical waste timely; 57.7% of nurses can fulfil its registration rules and other staff for handover of medical waste; 81.6% of nurses participated in the study or training of medical waste in the last year, the number of training: 1-16, the one of average: 2.63±1.79. Obviously the number of nurses participate in training is not consistent with the cognition of nurses on the disposal of medical waste. It suggsts the hospital did not achieve the desired objectives of training. 3.Impact factors: the main factors which effect the cognition and behavior of nurses on the disposal of medical waste: level of hospitals, differences in age, educational background ect; other factors which effect the cognition and behavior of nurses on the disposal of medical waste the lack of awareness, less economic investment, lack of knowledge, backward measures and equipment.
Conclusion: Nurses lack of enough recongntion on disposal of medical waste.There are some defects in the classification, handover and protection of disposal of the medical waste. We propose that the hospitals establish and consummate the interrelated regulations and supervision system, enhance the training of various kinds of education and the evaluation and examination system, and enhance the protection of the professional staff, regular physical examination, do publicity and raise environmental awareness.
方法:采用观察法、开放式访谈法、封闭式问卷法及数理统计方法对359名护理人员进行分层随机抽样调查,调查对象为乌鲁木齐市兵团医院、石河子大学第一附属医院、农六师五家渠医院、奇台医院及其周围一级团场医院的护理人员。资料管理与录入用流行病学软件Epidata3.1,数据分析用统计学软件SPSS11.5。
结果:1.护理人员对医疗废物处理的认知:(1)有31.5%的护理人员对医疗废物的危害性认知不清。(2)护理人员对所在医院有关医疗废物处理制度等总体认知较好,但是对这些制度管理监督具体执行情况认知却相对较低;对医疗废物处理相关法律条例和规章制度知识欠缺;(3)对损伤性废物、感染性废物认知较好,正确率分别为89.1%、80.8%,但对病理性废物、药物性废物、化学性废物、医疗废物分几类认知较差,分别为55.2%、44.6%、51.8%、32.6%。
2.护理人员对医疗废物处理的行为现状:75.5%的护理人员对医疗废物和生活垃圾能够做到严格分类放置,但是仍然部分护理人员对医疗废物分类执行情况较差,尤其是一级医院医疗废物和生活垃圾混放情况严重;59.1%的护理人员在处理血液、体液或污染物等废物时每次都配戴手套、口罩等防护用具,82.7%的护理人员在处理医疗废物后能够及时洗手;57.7%的护理人员在与专职人员交接医疗废物时能够履行登记制度;81.6%的护理人员参加过有关医疗废物学习或培训,在最近一年参加的培训次数为1-16次,平均为2.63±1.79。显然护理人员参加培训的次数、广度与其认知相差较远,这说明医院开展的培训没有达到预期目的。
3.影响因素:影响护理人员医疗废物处理认知的主要因素为医院级别、年龄和护龄;护理人员处理医疗废物分类、交接、防护行为的主要因素分别为医院级别、职称、学历、年龄;影响护理人员医疗废物处理认知和行为的因素排在前四位的依次是意识欠缺、经济投资较少、知识不足、措施设备落后。
结论:理论研究:从环境对健康的影响、环境护理相关理论研究以及环境与护理的关系等方面着手,首次提出环境护理并将其定义,探讨了护士在环境护理中的任务。实践研究:护理人员对医疗废物处理认知不足,对医疗废物处理分类、交接和防护行为存在不同程度的缺陷,建议加强医院医疗废物管理制度建设、建立健全医疗废物监督管理体系、加强护理管理者的重视、加强护理人员对医疗废物危害、分类处理等相关知识的认知、加强其他各类人员培训教育及评价考核体系、加强护理人员的职业防护、加强在校学生和实习生的职业防护教育、做好宣传,提高环境保护意识。
Object: Investigating and analyzing the cognition and behavior of nurses on the disposal of medical waste from different levels of hospital, We try to find impact factors which effect the cognition and behavior of nurses on the disposal of medical waste and then advance some proposals. In order to strengthen the protection of nursing career and promote the security management of medical waste.
Methods:Using methods of observation, open interviews, enclosed questionnaire and mathematical statistical, 359 nurses were selected stratified random sampling survey in the Urumqi City Hospital Corps, the first Affiliated Hospital of Shihezi University, Wujiqu Hospital, Qitai Hospital etc.Data was managed and inputted with software of Epidata3.1.All statistical analysis we reperformed using the SPSS11.5 statistical software.
Results: 1.The cognition of disposal of medical waste: (1) 31.5% of the nurses on the dangers of medical waste is unclear.(2)The knowledge of the nurses on the disposal systems of medical waste is better, but the cognition of specific performance of supervision system is relatively low;Lack of knowledge of rules and laws on disposal of medical waste.(3)The cognition of injury waste, infectious waste is better, respectively 89.1%, 80.8%, but the cognition of the pathological waste, drug waste, chemical waste, the types of medical waste is poor, respectively 55.2%、44.6%、51.8%、32.6%.
2. The behavior of disposal of medical waste: 75.5% of nurses can carry on strictly the classification of medical waste, but still partly nurses can’t, especially nurses of Primary Hospital mixed medical waste and garbage; 59.1% of the nursing staff wear gloves, masks and other protective equipment every time when they deal with the blood, body fluids,etc;82.7% of the nurses can wash their hands after handling of medical waste timely; 57.7% of nurses can fulfil its registration rules and other staff for handover of medical waste; 81.6% of nurses participated in the study or training of medical waste in the last year, the number of training: 1-16, the one of average: 2.63±1.79. Obviously the number of nurses participate in training is not consistent with the cognition of nurses on the disposal of medical waste. It suggsts the hospital did not achieve the desired objectives of training. 3.Impact factors: the main factors which effect the cognition and behavior of nurses on the disposal of medical waste: level of hospitals, differences in age, educational background ect; other factors which effect the cognition and behavior of nurses on the disposal of medical waste the lack of awareness, less economic investment, lack of knowledge, backward measures and equipment.
Conclusion: Nurses lack of enough recongntion on disposal of medical waste.There are some defects in the classification, handover and protection of disposal of the medical waste. We propose that the hospitals establish and consummate the interrelated regulations and supervision system, enhance the training of various kinds of education and the evaluation and examination system, and enhance the protection of the professional staff, regular physical examination, do publicity and raise environmental awareness.
引文
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