新型冠状病毒肺炎医务人员职业暴露现状分析与防范对策

Analysis of occupational exposure of medical staff with new coronavirus pneumonia and its countermeasures

目的分析抗击新型冠状病毒肺炎期间,黑龙江省医疗队医务人员发生职业暴露的现状及危险因素,制定有效的防范对策。方法回顾黑龙江省第一、二、四批援助湖北医疗队2020年1月28日~2月29日发生的9例医务人员职业暴露,应用鱼骨图分析原因。结果在新型冠状病毒肺炎诊治的隔离病房,护理工作任务重,护理人员是最易发生职业暴露的人群。在职业暴露事件中,针刺伤发生率最高,为55.6%。发生的原因主要为患者焦虑、躁动,护士心理压力大,护士未规范进行护理操作,临床护理用具配备不足,未使用安全型静脉留置针,护目镜起雾影响视线,护理人员职业防护培训不够,隔离病房工作量大、处置集中,用物放置不合理。结论应加强高风险人群、重点环节的感染监控,监督护理人员合理使用防护用品,做好职业暴露的监督管控,减低护理人员感染的风险。

Objective To analyze the current status and risk factors of occupational exposure of medical staff in Heilongjiang medical team during the fight against new coronavirus pneumonia,and to formulate effective preventive measures.Methods Nine cases of occupational exposure of medical staff,during January 28 to February 29,2020,of the first,second,and fourth batches of assistance from Heilongjiang Province were reviewed,and the causes were analyzed by fishbone diagrams.Results In the isolation ward for the diagnosis and treatment of new coronavirus pneumonia,the nursing work was heavy,and the nursing staff was the most prone to occupational exposure.Among occupational exposure incidents,the highest incidence of acupuncture injuries was 55.6%.The main reasons were anxiety and restlessness of patients,great psychological pressure of nurses,nonstandard nursing operation of nurses,insufficient clinical nursing equipment,no use of safe venous indwelling needle,fogging of goggles,insufficient occupational protection training of nursing staff,large workload of isolation ward,centralized disposal,and unreasonable material placement.Conclusion It is necessary to strengthen the infection monitoring of high-risk groups and key links,supervise the nursing staff to use protective equipment reasonably,do a good job of supervision and control of occupational exposure,and reduce the risk of nursing staff infection.