手术室护士锐器伤及标准预防执行现状的调查

Investigation on Sharp Injuries and Implementation of Standard Precautions by Operating Room Nurse

目的探讨手术室护士发生锐器损伤的状态、防护水平及影响因素,为提高护士自我防护意识和能力提供参考依据。方法采用便利抽样的方法选择439名手术室护士进行锐器伤经历及标准预防(standard precautions,SP)执行情况的问卷调查。结果在过去1年内,仅15.9%的护士未被手术刀、缝针等手术相关锐器刺伤,64.9%的护士在担任器械护士时被刺伤过;锐器使用中,有80.4%的护士丢弃注射器前用手将针头与注射器分离,仅36.4%的护士术中用专用容器传递锐利器械。68.6%的护士能将所有患者的血液、体液、分泌物、排泄物都视为有传染性,不同工龄、学历、职称和医院级别的护士对SP的认知有统计学差异(P<0.05);80.2%的手术室护士对已知患者有血源性传播疾病时,能做到严格按标准隔离方式进行隔离,但对于未检出和未做血源性传播疾病检查的患者,分别有45.6%(200/439)和55.6%(244/439)的护士能够把他们当作血源性传播疾病的患者来进行防护,而且防护的执行情况与SP的认知有明显相关(P<0.05)。结论手术室护士锐器伤普遍发生,部分护士仍然按传统的隔离模式进行隔离,标准预防的认知和执行有待提高。

Objective To investigate sharp injuries,protection level of operating room nurses and its influential factors, and to provide theoretical basis and practice guidance for improving self-protective abilites of nurses. Methods Questionnaire was used to survey 439 operatin room nurses on experiences of sharp injuries and cognition of standard precautions. Results In the past one year, only 15.9% nurses had not the experience of suffering from sharp injuries by related operating instruments,such as surgical knives,suture needle and so on. 64.9 % surveyed had punctured injuries when working as instrument nurses. 80.4% nurses used to detach needle from syringe before discarding it. 68.6% nurses could identify patient＇s blood,body fluids,secretions and excreta as contagious waste. There was significant difference in cognition of standard preeausions among nurses with different work years, academic background and levelof hosptial whey worked in. 80.2% of the operating room nurses could follow the standard precausions to practice isolation when they were informed that patient had blood transmitted diseases. 45.6% and 55.6% of the surveyed could protect themsevles even patients were not detected or tested for blood transmitted diseases. There was significant correlation between implementation of standard precautions of operating room nurses and their cognition of related knowledge（ P 〈0.05）. Conclusion Sharp injuries are quite common among operating room nurses. Part of nurses still practice isolatoin based on traditional model and their cognition of standard precausions needs improving.