某大型综合医院医护人员针刺及其他锐器损伤情况

Study on status of nee die-stick and other sharps injuries among healthcare workers in a general hospital

目的了解医院医护人员针刺及其他锐器损伤情况，为进一步开展干预研究提供线索，并为干预措施效果评价提供基线数据。方法采用自填式调查问卷对某大型综合医院1201名临床一线医护人员在2009年1月1日至2009年12月31日期间所发生的针刺及其他锐器损伤状况进行回顾性调查。结果医护人员在过去1年中发生针刺及其他锐器损伤共4302人次，针刺及其他锐器损伤年人均发生次数为3．58人次，损伤发生率为78．85％。发生针刺及其他锐器损伤的高风险人群为妇产科、外科、重症监护室和急诊科医护人员，其接触发生率和年人均发生次数分别为94．67％和4．51人次、93．09％和4．46人次、85．44％和3．08人次、76．62％和4．55人次，引起医护人员针刺及其他锐器损伤的主要医疗操作是掰安瓿、输液结束拔针、整理用毕的锐器和手术中（缝合或切开），其接触发生率分别为46．96％、30．97％、25．73％和14．49％。医护人员针刺及其他锐器损伤主要是由安瓿瓶、头皮针、皮下注射针、缝合针和手术刀片引起，其损伤发生率分别为47．04％、37．22％、31．31％、17．65％和7．08％。结论医护人员仍然面临较大的针刺及其他锐器损伤风险，不同工种、不同科室医护人员在不同医疗操作及医疗操作的不同阶段、使用不同医疗锐器、使用锐器的用途不同发生职业接触的风险不同，应积极采取有针对性的综合性预防控制措施，全面贯彻落实GBZ／T213—2008《血源性病原体职业接触防护导则》。

Objective To understand the prevalence of hospital healthcare workers （HCWs） with needle-stick and other sharps injuries, and to provide the basic data for intervention study. Methods A retrospective investigation was conducted with questionnaires for needle-stick and other sharps injuries from January 1 to December 31 of 2009 among 1201 healthcare workers in a general hospital. Results The total number of needle-stick and other sharps injuries among 1201 heahhcare workers in 2009 was 4320, the number of needle-stick and other sharps injuries for each person was 3.58 and the incidence of needle-stick and other sharps injuries was 78.85 %. The subjects with the high risk of needle-stick and other sharps injuries were from the department of gynecology and obstetrics, surgical department, intensive care unit and emergency room, the incidences and the average numbers of episodes were 94.67% and 4.51 per person, 93.09% and 4.46 per person, 85.44% and 3.08 per person, 76.62 % and 4.55 per person in 2009, respectively. The operations resulting in the needle-stick and other sharps injuries were the breaking glass preparation （ampoule or vial）, withdrawing needles, preparing sharp devices and performing an operation, the incidences were 46.96%, 30.97%, 25.73% and 14.49%, respectively. Needle-stick and other sharps injuries were mainly caused by ampoules, winged steel needle, disposable syringes, suture needles and scalpels, the incidences were 47.04%, 37.22%, 31.31%, 17.65% and 7.08%, respectively. Conclusion Healthcare worker are still at risk of needle- stick and other sharps injuries, which was related to the profession, department, medical manipulation and medical apparatus and instruments. Special and comprehensive measurements for preventing the needle-stick and other sharps injuries should be taken actively.