传染病房工作人员锐器伤情况分析与防护措施的探讨

Analysis on sharp injuries among healthcare providers in infectious disease in-patient ward and the relevant protection measures

目的了解传染病房工作人员锐器伤现状及影响因素,探讨有效的防控方法。方法对首都医科大学附属北京佑安医院2007-2010年院内工作人员发生锐器伤的情况进行回顾性分析。结果共发生锐器伤32例,以女性为主(30例,93.75%);平均工龄3.4年;职业人群主要为护士(62.50%);锐器用途依次是皮下注射、静脉输液、缝合/剪断;操作环节主要是在拔针头时、诊疗后整理锐器物和手术时;暴露源的种类为乙肝(21例,65.63%)、艾滋病(6例,18.75%)、丙肝(3例,9.38%)。发生锐器伤的人员无一例感染。锐器伤的暴露源为乙肝的受伤者均曾接种过乙肝疫苗,93.75%的受伤者进行了有针对性药物预防治疗。医院平均支付909.1元/例预防锐器伤的工作人员发生感染。结论通过对新上岗的在传染病病房或者医院工作的人员开展培训,尽量减少锐器使用,推行带有锐器伤防护措施的安全器械,使用合格的锐器收集容器,加强个人防护,提高传染病房工作人员免疫接种率等措施,有效地降低锐器伤的发生和伤后感染。

Objective To study sharp injuries among healthcare providers in infectious diseases in-patient wards and the affecting factors,in order to explore the effective ways to prevent and control these injuries.Methods Data about sharp injuries from 2007 to 2010 were collected and analyzed.Results Sharp injuries occurred in 32 cases,most of them were female health providers and the majority were nurses（62.50%）,and their average ages of work were 3.4 years.Sharp stab injuries happened during subcutaneous injections,intravenous infusions,suture/shear procedures.Most injuries happened when the medical providers were pulling out the infusion needle and processing the sharp objects during and after surgical procedures.They had exposed to HBV,HIV,HCV when they were injuried.However,no case was infected.For those who had exposed to HBV in the injury,HBV vaccination were carried out immediately and specific treatment was initiated in 93.75% of the injuries.An average of 909.1 yuan was needed to be paid by the hospital to set up the measures to prevent sharp injuries among medical providers.Conclusion It＇s necessary for the new health providers,who will work in the infectious disease ward or hospitals,to get an education and training.To implement the safety measures to prevent sharp injuries.Avoiding the use of sharp devices and using qualified sharps collection containers,enhancing personal protection,improving the immunization rate of infectious diseases and other health care measures can effectively reduce the incidence of sharps injuries and secondary infections.