论文部分内容阅读
目的调查某骨科医院医务人员锐器伤发生情况,探讨其职业防护措施。方法选取2010年1月至2016年10月某骨科医院登记备案的职业暴露医务人员796例,其中发生锐器伤594例,调查其年龄、性别、职业类型等基本信息,同时调查锐器伤发生原因、频次、操作环节、受伤部位、受伤时使用锐器种类、暴露源病原体、锐器伤发生后采取的相关保护措施等情况。结果护士发生锐器的比例明显高于医生、医技和勤杂人员,差异有统计学意义(P<0.05);随着医务人员工作年限的增加,锐器伤的发生率逐渐降低,不同工作年限医务人员锐器伤发生率之间差异有统计学意义(P<0.05)。注射操作环节中发生锐器伤的比例明显高于术中操作、临床穿刺及废物处理,差异有统计学意义(P<0.05)。导致锐器伤的物种主要为注射针头,其次为废弃锐器;受伤部位主要为双手,其次为腿部;手部受伤原因主要为未佩戴手套操作。锐器伤中血液污染占69.02%、废物区污染占25.76%、未受污染占5.22%;对其病原体进行追溯发现,暴露源病原学明确为阳性的占30.47%。不同职称医务人员锐器伤后采取积极防护措施的比例差异有统计学意义(P<0.05),其中无职称和中级职称的医务人员受锐器伤后采取防护措施的比例均>40%,但初级职称医务人员采取防护措施的比例较低。不同污染程度锐器伤后采取保护措施的比例差异有统计学意义(P<0.05),其中被血源污染的锐器刺伤后采取保护措施的医务人员比例较高。结论中低年资骨科医务人员锐器伤发生率偏高;发生锐器伤的操作环境主要为注射治疗和术中操作;应加强对职业暴露特别是血源性污染的防护知识培训,保障医务人员职业安全。
Objective To investigate the occurrence of sharp injuries among medical staffs in an orthopedic hospital and to explore their occupational protective measures. Methods From January 2010 to October 2016, a total of 796 cases of occupational exposure were recorded and registered in a orthopedic hospital. Among them, 594 cases of sharp injuries occurred, and basic information such as age, sex and occupation type were investigated. At the same time, Reasons, frequency, operation, the injured site, the type of sharps used when injured, the source pathogen exposed, and the relevant protective measures taken after the sharp injury occurred. Results The proportion of sharp objects in nurses was significantly higher than that of doctors, technicians and diligent workers (P <0.05). With the increase of working life of medical staff, the incidence of sharp injuries decreased gradually, and different working years There was a significant difference in the incidence of sharp injuries among medical staff (P <0.05). The incidence of sharp injuries during the injection procedure was significantly higher than that during operation, clinical puncture and waste treatment (P <0.05). The main species causing sharp injuries were injection needles, followed by abandoned sharps. The injured parts were mainly hands, followed by the legs. The main causes of hand injuries were unopened gloves. Blood contamination of sharp wounds accounted for 69.02%, waste area pollution accounted for 25.76%, uncontaminated accounted for 5.22%; the pathogen was retrospectively found that exposure to the source of etiology was positive for 30.47%. There were significant differences in the proportion of active protective measures taken by medical staff of different titles after sharps injuries (P <0.05). Among them, medical personnel without professional titles and intermediate professional titles received> 40% protective measures after sharps injuries Junior professional medical staff to take a lower percentage of protective measures. There were significant differences in the proportion of protective measures taken after sharp injury with different degree of pollution (P <0.05), among which there was a high proportion of medical staff who took protective measures after stab wounds contaminated by blood. Conclusions The incidence of sharps injuries in orthopedic and orthopedic medical staff is relatively high. The operating environment for sharp injuries is mainly injection treatment and intraoperative operation. Training on protection of occupational exposure, especially blood-borne contamination, should be strengthened to ensure medical care Occupational safety of personnel.