临床护理人员锐器伤现状和防治措施研究进展_West China Medical Journal

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余梅

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Keywords：

护理; 锐器伤; 影响因素; 预防; 治疗措施

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锐器伤在国内外医务人员中发生率均非常高，极易传播血源性感染疾病，对医务人员造成较大的生理、心理和社会危害。文章综述了国内外临床护理人员锐器伤的流行病学情况、影响因素及危害，并全面阐述了护理人员锐器伤发生后的治疗和预防措施，包括SHEL管理模式、建立风险管理机制、加强防范管理、加强标准预防知识培训、提倡使用安全医疗器具和及时接种等等措施，给感染预防控制管理工作和临床护理管理工作及保证医护人员的职业健康提供参考依据。

Citation： 余梅. 临床护理人员锐器伤现状和防治措施研究进展. West China Medical Journal, 2012, 27(10): 1591-1594. doi: Copy

1.	徐世兰, 吴西亿, 饶莉, 等. 840例医务人员锐器伤现状调查[J]. 中国循证医学杂志, 2011, 11(6): 636-639.
2.	Smith DR, Smyth W, Leggat PA, et al. Needlestick and sharps injuries among nurses in a tropical Australian hospital[J]. Int J Nurs Pract, 2006, 12(2): 71-77.
3.	米光丽, 唐彦, 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.
4.	林焕新, 余红梅, 梁卫萍. 2005-2009年医务人员锐器伤调查分析[J]. 中华医院感染学杂志, 2010, 20(17): 2612-2613.
5.	Smith DR, Mihashi M, Adachi Y, et al. Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital[J]. J Hosp Infect, 2006, 64(1): 44-49.
6.	Clarke SP, Rockett JL, Sloane DM, et al. Organizational climate, staffing, and safety equipment as predictors of needlestick injuries and near-misses in hospital nurses[J]. Am J Infect Control, 2002, 30(4): 207-216.
7.	Mc Cormick RD, Maki DG. Epidemiology of needlestick injuries in hospital personnel[J]. Am J Med, 1981, 70(4): 928-932.
8.	崔艳, 王彦. 国内外医务人员锐器伤研究进展[J]. 实用心脑肺血管病杂志, 2011, 19(9): 1623-1625.
9.	Bryce EA, Ford J, Chase L, et al. Sharps injuries: defining prevention priorities[J]. Am J Infect Control, 1999, 27(5): 447-452.
10.	Beekmann SE, Vlahov D, Koziol DE, et al. Temporal association between implementation of Universal precautions and a sustained, progressive decrease in percutaneous exposures to blood[J]. Clin Infect Dis, 1994, 18(4): 562-569.
11.	Mercier C. Reducing the incidence of sharps injuries[J]. Br J Nurs, 1994, 3(6): 897-901.
12.	Dobie DK, Worthington T, Faroqui M, et al. Avoiding the point[J]. Lancet, 2002, 359(9313): 1254.
13.	Aziz AM. Subcutaneous injections: preventing needlestick injuries in the community[J]. Br J Community Nurs, 2012, 17(6): 258, 260-264.
14.	Ippolito G, Puro V, Petrosillo N, et al. Surveillance of occupational exposure to bloodborne pathogens in health care workers: the Italian National programme[J]. Euro Surveill, 1999, 4(3): 33-36.
15.	Whitby RM, Mclaws ML. Hollow-bore needlestick injuries in a tertiary teaching hospital: epidemiology, education and engineering[J]. Med J Aust, 2002, 177(8): 418-422.
16.	Algie BA, Arnold L, Fowler CL. Needlestick injuries and subsequent disease: first-person accounts from 3 nurses[J]. J Emerg Nurs, 1999, 25(2): 93-101.
17.	Pournaras S, Tsakris A, Mandraveli K, et al. Reported needlestick and sharp injures among health care work in a Greek general[J]. Occup Med (Lond), 1999, 49(7): 423-426.
18.	郑洁芳, 姜建新, 贾骏. 医务人员锐器伤监测分析及其对策[J]. 中华医院感染学杂志, 2012, 22(14): 3120-3122.
19.	王佩萍, 黄俊音. 护理人员锐器伤危险因素的分析及对策[J]. 中国实用医药, 2010, 5(20): 266-267.
20.	杨广清, 赖兰萍, 张翠云. 医疗行为中锐器伤调查分析[J]. 护理研究, 2008, 22(6): 1527-1528.
21.	戴青梅, 王立英, 刘素美, 等. 医护人员职业性损伤的危险因素及防护对策[J]. 中华护理杂志, 2002, 37(7): 532-534.
22.	高菲. 护生在静脉输液中发生锐器伤的原因及对策[J]. 现代医药卫生, 2011, 27(7): 1072-1073.
23.	孙花子, 刘颖. 临床护士发生锐器伤的危险因素及预防对策[J]. 中华医院感染学杂志, 2011, 21(7): 1398-1399.
24.	吴俊琪, 马拥军, 徐瑞龙. 临床实验室锐器伤的危害性与控制对策[J]. 中华医院感染学杂志, 2010, 20(3): 376-377.
25.	Khuri-Bulos NA, Toukan A, Mahafzh A, et al. Epidemiology of needlestick and sharp injuries at a university hospital in a developing country: a 3-year prospective study at the Jordan University Hospital, 1993 through 1995[J]. Am J Infect Control, 1997, 25(4):322-329.
26.	龚光明. 临床护士发生锐器伤的调查分析及预防对策[J]. 中华医院感染学杂志, 2010, 20(5): 680-682.
27.	Takagi H, Uehara M, Kakizaki S, et al. Accidental transmission of HCV and treatment with interferon[J]. J Gastroenterol Hepatol, 1998, 13(3): 238-243.
28.	黄雄招, 孙波. SHEL模式在手术室护士锐器伤防范中的应用[J]. 护理学杂志, 2009, 24(10): 56-57.
29.	Smith DR, Mihashi M, Adachi Y, et al. Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses[J]. Am J Infect Control, 2009, 37(7): 545-550.
30.	钟翠坤. 临床护士发生锐器伤的原因分析及防护对策[J]. 吉林医学, 2011, 32(12): 2481-2482.
31.	CDC. U.S. Public Health Service. Updated U.S. public health service guidelines for the management of occupationl exposures to HBV, HCV and HIV recommendations for postexposure prophylaxis[S]. MMWK Recomm Rep, 2001, 50(RR-11): 1-52.
32.	李映兰. 美国护士预防经血液传播疾病的意识和措施[J]. 中华护理杂志, 2002, 37(8): 633-634.
33.	杨丹, 王定壁. 临床护理人员医疗锐器伤的调查与干预措施[J]. 西部医学, 2010, 22(2): 372-374.
34.	张镇静, 周丽荣, 林征, 等. 综合性医院护士医疗锐器伤调查分析[J]. 中国护理管理, 2008, 8(10): 57-59.

1. 　徐世兰, 吴西亿, 饶莉, 等. 840例医务人员锐器伤现状调查[J]. 中国循证医学杂志, 2011, 11(6): 636-639.
2. 　Smith DR, Smyth W, Leggat PA, et al. Needlestick and sharps injuries among nurses in a tropical Australian hospital[J]. Int J Nurs Pract, 2006, 12(2): 71-77.
3. 　米光丽, 唐彦, 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.
4. 　林焕新, 余红梅, 梁卫萍. 2005-2009年医务人员锐器伤调查分析[J]. 中华医院感染学杂志, 2010, 20(17): 2612-2613.
5. 　Smith DR, Mihashi M, Adachi Y, et al. Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital[J]. J Hosp Infect, 2006, 64(1): 44-49.
6. 　Clarke SP, Rockett JL, Sloane DM, et al. Organizational climate, staffing, and safety equipment as predictors of needlestick injuries and near-misses in hospital nurses[J]. Am J Infect Control, 2002, 30(4): 207-216.
7. 　Mc Cormick RD, Maki DG. Epidemiology of needlestick injuries in hospital personnel[J]. Am J Med, 1981, 70(4): 928-932.
8. 　崔艳, 王彦. 国内外医务人员锐器伤研究进展[J]. 实用心脑肺血管病杂志, 2011, 19(9): 1623-1625.
9. 　Bryce EA, Ford J, Chase L, et al. Sharps injuries: defining prevention priorities[J]. Am J Infect Control, 1999, 27(5): 447-452.
10. 　Beekmann SE, Vlahov D, Koziol DE, et al. Temporal association between implementation of Universal precautions and a sustained, progressive decrease in percutaneous exposures to blood[J]. Clin Infect Dis, 1994, 18(4): 562-569.
11. 　Mercier C. Reducing the incidence of sharps injuries[J]. Br J Nurs, 1994, 3(6): 897-901.
12. 　Dobie DK, Worthington T, Faroqui M, et al. Avoiding the point[J]. Lancet, 2002, 359(9313): 1254.
13. 　Aziz AM. Subcutaneous injections: preventing needlestick injuries in the community[J]. Br J Community Nurs, 2012, 17(6): 258, 260-264.
14. 　Ippolito G, Puro V, Petrosillo N, et al. Surveillance of occupational exposure to bloodborne pathogens in health care workers: the Italian National programme[J]. Euro Surveill, 1999, 4(3): 33-36.
15. 　Whitby RM, Mclaws ML. Hollow-bore needlestick injuries in a tertiary teaching hospital: epidemiology, education and engineering[J]. Med J Aust, 2002, 177(8): 418-422.
16. 　Algie BA, Arnold L, Fowler CL. Needlestick injuries and subsequent disease: first-person accounts from 3 nurses[J]. J Emerg Nurs, 1999, 25(2): 93-101.
17. 　Pournaras S, Tsakris A, Mandraveli K, et al. Reported needlestick and sharp injures among health care work in a Greek general[J]. Occup Med (Lond), 1999, 49(7): 423-426.
18. 　郑洁芳, 姜建新, 贾骏. 医务人员锐器伤监测分析及其对策[J]. 中华医院感染学杂志, 2012, 22(14): 3120-3122.
19. 　王佩萍, 黄俊音. 护理人员锐器伤危险因素的分析及对策[J]. 中国实用医药, 2010, 5(20): 266-267.
20. 　杨广清, 赖兰萍, 张翠云. 医疗行为中锐器伤调查分析[J]. 护理研究, 2008, 22(6): 1527-1528.
21. 　戴青梅, 王立英, 刘素美, 等. 医护人员职业性损伤的危险因素及防护对策[J]. 中华护理杂志, 2002, 37(7): 532-534.
22. 　高菲. 护生在静脉输液中发生锐器伤的原因及对策[J]. 现代医药卫生, 2011, 27(7): 1072-1073.
23. 　孙花子, 刘颖. 临床护士发生锐器伤的危险因素及预防对策[J]. 中华医院感染学杂志, 2011, 21(7): 1398-1399.
24. 　吴俊琪, 马拥军, 徐瑞龙. 临床实验室锐器伤的危害性与控制对策[J]. 中华医院感染学杂志, 2010, 20(3): 376-377.
25. 　Khuri-Bulos NA, Toukan A, Mahafzh A, et al. Epidemiology of needlestick and sharp injuries at a university hospital in a developing country: a 3-year prospective study at the Jordan University Hospital, 1993 through 1995[J]. Am J Infect Control, 1997, 25(4):322-329.
26. 　龚光明. 临床护士发生锐器伤的调查分析及预防对策[J]. 中华医院感染学杂志, 2010, 20(5): 680-682.
27. 　Takagi H, Uehara M, Kakizaki S, et al. Accidental transmission of HCV and treatment with interferon[J]. J Gastroenterol Hepatol, 1998, 13(3): 238-243.
28. 　黄雄招, 孙波. SHEL模式在手术室护士锐器伤防范中的应用[J]. 护理学杂志, 2009, 24(10): 56-57.
29. 　Smith DR, Mihashi M, Adachi Y, et al. Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses[J]. Am J Infect Control, 2009, 37(7): 545-550.
30. 　钟翠坤. 临床护士发生锐器伤的原因分析及防护对策[J]. 吉林医学, 2011, 32(12): 2481-2482.
31. 　CDC. U.S. Public Health Service. Updated U.S. public health service guidelines for the management of occupationl exposures to HBV, HCV and HIV recommendations for postexposure prophylaxis[S]. MMWK Recomm Rep, 2001, 50(RR-11): 1-52.
32. 　李映兰. 美国护士预防经血液传播疾病的意识和措施[J]. 中华护理杂志, 2002, 37(8): 633-634.
33. 　杨丹, 王定壁. 临床护理人员医疗锐器伤的调查与干预措施[J]. 西部医学, 2010, 22(2): 372-374.
34. 　张镇静, 周丽荣, 林征, 等. 综合性医院护士医疗锐器伤调查分析[J]. 中国护理管理, 2008, 8(10): 57-59.

West China Medical Journal

临床护理人员锐器伤现状和防治措施研究进展

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