Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
目的 了解临床医务人员锐器伤发生状况及上报时间，从而有针对性地加强职业暴露防护措施。 方法 采用回顾性调查方式，对医院2009年1月－2011年12月报告的76例锐器伤医务人员的备案资料,如人员分类、操作环节、科室、上报时间进行统计分析。 结果 从人员构成看护理人员最多，占46.05%（35例），其次为实习同学/规范化培训医生，占23.68%（18例）；手术、整理或清洗器械是造成医务人员锐器伤的主要环节，分别占30.26%、26.32%；妇产科是最易发生锐器伤的科室，其发生率达25.75%，其次为急诊科为25.00%，门诊系统为13.79%；发生锐器伤后的上报时间24 h内、48 h、72 h、72 h以上分别占51.32%、19.74%、10.52%、18.42%。 结论 医院应进一步完善各项规章制度及操作规范，加强医务人员特别是新近的实习医生及规范化培训医生的职业防护培训及教育，规范锐器伤上报管理工作，对不及时上报及易发生锐器伤的主要操作环节等进行针对性培训，以便于加强锐器伤的防护及对职业暴露者采取及时的预防控制措施。
目的 探讨实习护士锐器伤发生情况及影响因素，为制订降低实习护士锐器伤政策提供依据。 方法 2012年3月，针对333名临床实习护士进行问卷调查；采用SPSS软件对锐器伤年发生率进行单因素和多因素logistic回归分析。 结果 共322名实习护士完成调查，锐器伤年发生率50.0%，发生频率为1.3次/人年。最近一次发生锐器伤时，仅6.5%上报登记。单因素分析显示，本科生、学校课程未针对预防锐器伤进行培训，临床实习带教老师未进行预防锐器伤培训的实习护士，其锐器伤发生率更高。在临床实习可能接触患者血液和体液的操作中，带手套的频率越高，锐器伤发生率越低；注射完成后，回套针帽的频率越高，锐器伤发生率越高。多因素分析表明，本科实习护士发生锐器伤的风险高于中专或大专实习护士[OR=4.603，95%CI（2.241，9.443）]；注射完成后，回套针帽频率增加，发生锐器伤的风险增加[OR=1.672，95%CI（1.032，2.729）]。 结论 在教学和临床实践过程中，针对实习护士，尤其是本科实习护士，应进一步加强培训，杜绝回套针帽现象；并进一步健全现有锐器伤上报登记制度。
目的 探讨凉山州第一人民医院医务人员锐器伤职业暴露的危险因素及应对措施。 方法 对医务人员在2011年8月1日－31日期间里的锐器伤发生情况进行问卷式和面对面提问式相结合的方式进行调查，共调查医务人员1 112名，包括医生288名，护士589名，医技人员180名，其他55名；采用《医务人员锐器伤调查问卷》进行筛查，筛查后与发生锐器伤的人员面对面交谈，并填写《医务人员锐器伤危险因素调查表》。用医务人员职业暴露监测系统（EPINeT）进行统计分析。 结果 发生锐器伤45例，发生率为4.05%，护士发生锐器伤的比例较高，达到了5.3%，医生为4.5%，医技人员较低为0.56%，其他人员发生锐器伤的可能性较小，经四格表的χ2检验，医生与护士锐器伤的发生率差异无统计学意义（χ2=0.010，P＞0.05）。锐器伤发生的主要时机以抽血（占16%）、拔出动静脉针（占14%）、双手回套针帽（占14%）、手术缝针（占12%）以及将针头放入锐器盒（占10%）为主；发生的场所以普通病房（占60%）和手术室（占22%）为主；锐器伤发生的器械以一次性注射器（占32%）、静脉留置针（占18%）、真空采血针（占16%）和手术缝针（占14%）为主。 结论 医生和护士是锐器伤发生的高危人群，应采取一系列措施降低其发生职业暴露的风险，包括增加医护人员数量、加强职业培训、禁止双手回套针帽、采用安全留置针和使用皮肤粘合剂以及采用腹腔镜、阴道镜进行手术等措施，尽量降低医护人员的职业暴露风险。
【摘要】 目的 探讨肿瘤科护士锐器伤发生原因及预防管理对策。 方法 2006年6月-2008年5月，采用医疗锐器伤登记表收集护士锐器伤情况，并对相关数据资料进行统计分析。 结果 24名护士（5.71人次/100张床）发生锐器伤，主要发生于护龄≤1年的护士（66.67%）；发生时间多集中在上午8:30～11:00之间（41.67%）；地点多为病房床旁（70.83%）；锐器伤集中发生在操作后处理废弃物过程中（50.00%）；而伤害发生率最高的器具为输液器头皮针（59.26%）；通过追踪调查，发现所有锐器伤人员经处理后均未发生血源性感染。 结论 加强防范知训培训，提高护士自我防护意识；规范护理操作行为和废弃锐器的处理等是预防或降低护士工作时段被感染的重要措施与方法。【Abstract】 Objective To discuss the causes and preventive measures of sharp instrument injuries among oncology nurses. Methods Sharp Instrument injuries were collected with the guide of Roll Call of Sharp Instrument Injuries in Medicine from June 2006 to May 2008. Related data were statistically analyzed. Results Sharp instrument injuries occurred to 24 nurses (5.71 per 100 beds), most of whom had just been in the post for less than one year (66.67%). Most injuries happened at 8:30 am-11:00 am during the morning (41.67%) and at, the bed side (70.83%). A half of the injuries occurred during medical waste disposal and most injuries were caused by scalp acupuncture (59.26%). No hematogenous infection occurred after proper treatment of the injuries. Conclusion Strengthening the knowledge of self-protection, stipulating and monitoring procedures of operating and disposing of sharp instruments are the most important measures to prevent the nurses from being injured during their working.
ObjectiveTo know the status and risk factors of occupational exposure in a top-class hospital in Sichuan, and provide the basis for occupational safety and protective measures. Methods"Hospital Medical Staff Occupational Exposure Registration Form" was used in this retrospective study. Statistical analysis was performed on medical workers' exposure data between January 2011 and June 2014 in a top-class hospital in Sichuan Province. ResultsA total of 139 cases of occupational exposures were recorded in some of the medical staff. There were more females than males. Nurses had the most exposures (70.5%), and the exposure sources were mainly human immunodeficiency virus and hepatitis B virus (27.9% and 21.0%, respectively). The exposure type was mainly sharp injury (84.2%). Exposure occurred mainly in surgery (47.5%), and different job or places had different exposure types with significant differences (χ2=12.683, 20.897, P<0.05). Sharp injury was mainly caused by the scalp needle and syringe, and the injured sites were mainly upper limbs (98.3%). However, exposure to blood and body fluids occurred mainly on upper limbs (54.5%) or face (45.5%). ConclusionOccupational exposures are mainly sharp injuries, especially in surgeries. Women, nurses or medical staff with low qualifications had the highest exposure risk. Thus, occupational safety and protection training should be strengthened.
ObjectiveTo explore the risk factors for hematogenous occupational exposure by analyzing hematogenous occupational exposure in medical workers, and discuss countermeasures in order to reduce the occurrence of hematogenous occupational exposure in medical workers. MethodsWe summarized and analyzed the hematogenous occupational exposure reported by registered medical personnel in the First People's Hospital of Yibin City from January 2012 to December 2014. ResultsThere were 129 cases of hematogenous occupational exposure, and nurses were at high risk of such exposure (65.12%).The exposure occurrence focused in medical personnel with working time shorter than 5 years.The top three high-risk operational procedures were needle injection, puncture, and medical waste disposal; sharp instrument injuries (109 cases, 84.50%) were the main factor leading to hematogenous occupational exposure in medical workers.Sources of exposure were detected and confirmed in 92 cases (71.32%); after testing, 79 cases (61.24%) of infections were confirmed in the source patients with one or more blood-borne pathogens.Through scientific treatment, no infection after hematogenous occupational exposure was detected in the medical workers. ConclusionMonitoring and analysis of hematogenous occupational exposure can facilitate identification of key departments, target population and risk factors, which is important for taking appropriate interventions.
Objective To investigate the occurrence of sharp instrument injuries among healthcare workers in a comprehensive teaching hospital and explore the risk factors, so as to provide scientific basis for the prevention approaches. Methods A total of 1 180 healthcare workers with sharp instrument injuries between 2011 and 2014 were included in the study. Occupational hematogenous exposure monitoring and protecting system for health workers was established and optimized. The report and treatment process was standardized. Targeted monitoring system of sharp instrument injuries was developed. Sharp instrument injuries between 2011 and 2014 were systematically collected and analyzed. Results Between 2011 and 2014, there were 1 180 health workers who had sharp instrument injuries. Health workers had the highest rate of exposure to hepatitis B virus(41.06%), followed by syphilis (13.35%). Syringe needles (27.54%), suture needles (24.15%) and scalp needles (19.58%) were the instruments that caused most of the injuries. We constructed occupational exposure records for all those with sharp instrument injuries, and performed regular follow-up. No hematogenous infections were found because of sharp instrument injuries. Conclusions Sharp instrument injuries are common in healthcare institutions. It is important to establish and perfect the occupational exposure monitoring and protecting system, so as to reduce the risk of occupational exposure for health workers in hospitals.