53名血源性职业暴露与风险防范

53 Cases of blood-borne occupational exposure and prevention for risks

目的分析53名血源性职业暴露危险因素,提出防范措施,降低职业暴露风险。方法使用北京市医院感染管理质量控制和改进中心的《医院感染监控管理系统》,对在职医务人员进行职业暴露的培训,使医务人员能及时填写质控中心统一使用的《针头刺伤与锐器损伤统一报告表》,通过监测系统监测医院2008年1月-2009年12月发生的53名血源性职业暴露的医务人员,对其工龄、职业、暴露地点、部位、方式、损伤程度、暴露源、局部处理、预防用药及随访结果进行统计分析。结果血源性职业暴露主要是锐器伤造成,锐器类型以输液器针头占首位,致锐器伤操作环节以输液结束拔针与回套针帽时发生率最高;危险因素为针头处理不正确,标准预防措施落实不到位。结论加强医务人员职业暴露防护教育的培训及防范管理,改善医疗操作环境,规范操作流程,实施标准预防,最大限度地减少职业暴露风险,降低职业暴露发生率。

OBJECTIVE To analyze the risk factors,preventive measures of 53 cases occupational blood-borne exposure proposed to reduce the risk of occupational exposure.METHODS We use the Beijing hospital infection control and improvement of the quality of management of hospital infection surveillance system center,Medical personnel on-the-job training,occupational exposure,The medical staff to promptly complete the quality control of standardized on the unity of needle stick injuries and sharps injury report form.Through the monitoring system in our hospital in Jan 2008 in Dec 2009 53 cases occurred in blood-borne occupational exposure of medical personnel.Their length of service,occupation,exposed location,location,type,degree of injury,exposure source,local treatment,preventive medication and follow-up results were analyzed.RESULTS The sharp instrument injury was the most common type of the occupational blood borne exposure,and commonly appeared in the pinhead of infusion apparatus,and most appeared at the withdrawal of needles after transfusion completed or bare-handed.The risk factors of sharp injury is improper handing of needles and standard precautions may not be implemented.CONCLUSION To reduce the risk and incidence of occupational exposure,we strengthen the training and management of protection of the occupational exposure prevention,improve the health care operating environment,standardize operating procedures and implement standard precautions.