临床护士锐器伤的分析与防护措施

Sharp Instrument Injuries:Analysis of 76 Clinical Nurses and Protective Measures

目的探讨临床护士锐器伤的发生情况与防范对策。方法采用"医疗锐器伤登记表"上报的76名临床护士锐器伤进行相关资料的分析。结果76名临床护士发生锐器伤中锐器物种类依次为头皮针(43.4%)、各种注射器针头(28.9%)、玻璃(14.5%)、缝合针(5.3%)、其他(7.9%);发生锐器伤的操作环节主要是操作后处理锐器(34.2%)、掰安瓿(14.5%)、回套针帽(13.1%)、拔针(9.2%)等;44名(57.9%)锐器伤是被血污染针头所刺伤,其中23名(30.3%)锐器伤证实患者患有乙型肝炎、丙型肝炎等血源性传染病;89.5%的锐器伤发生者操作时未戴手套;已证实的22名乙型肝炎感染的锐器伤仅10名受伤护士注射了乙型肝炎免疫球蛋白。结论强化"标准预防"理念、提高职业防护意识、规范操作行为、加强锐器伤的监控管理是减少临床护士锐器伤害的重要措施。

OBJECTIVE To investigate the status and countermeasures of the clinical nurse injuries caused by sharp instruments. METHODS The related data of the 76 cases reported for clinical nurses stab injury by applying our hospital ＂ Medical Sharp Instruments Injury Registration Form＂ were analyzed. RESULTS The kinds of sharp instruments inducing sharps instrument injured in 76 cases were scalp puncture （43.4%）, various syringe needles （28.9%）, glass （14.5%）, suture needles （5.3%） and others （7.9%） ; the main causes of sharp injuries were the post-operation processing （34.2%）, opening the ampoules with the fingers and thumb（14.5%）, capping needles （13.1%） and withdrawal of the needles （9.2%） ; 57.9% of the sharp instrument injuries were stabbed by blood contaminated needles. Among them, 23 cases （30.3%） stabbed due to the patients with the blood borne infectous diseases such as hepatitis B and hepatitis C. And 89. 5% among them were without wearing gloves. Only 10 injured nurses of the 22 cases were injected hepatitis B immunoglobulin. CONCLUSIONS The important measures to reduce the clinical sharp instrument injuries are.. to strengthen the ＂standard precautions＂ idea, raise awareness of occupational protection and performance standards, and strengthen the monitoring and management of the sharp injuries.