医务人员锐器伤调查分析及控制策略

Investigation and analysis of sharp instrument injuries in medical staff and preventive strategies

目的了解医务人员锐器伤的发生人群、时间以及操作环节,探讨有效的控制策略。方法依据医疗锐器伤发生后登记上报的69例案例发生情况,进行监测追踪,对锐器伤的发生原因、锐器种类、操作环节等因素进行分析。结果护士及低年资医务人员锐器伤发生率高,占62.32%、55.07%;周一、五及上午时段锐器伤发生率高;病室内发生锐器伤占37.68%,手术室占33.33%;发生锐器伤的锐器主要是注射器针头,其次是输液器针头及缝合针,分别占26.09%、21.74%、17.39%;处理使用过的锐器(28.99%)、手术(27.54%)、经皮拔针(23.19%)等环节容易发生锐器伤;有63.77%的医务人员发生锐器伤时未戴手套。结论护士、低年资医务人员是锐器伤的高危人群,操作不规范、防护不当是锐器伤发生的主要原因;加强医务人员的职业安全教育,规范安全操作行为,是减少医务人员锐器伤发生的有效控制措施。

OBJECTIVE To investigate the hlgh-risk groups, time, and operational links for medical staff with Sharp instrument injuries and explore the effective prevention strategy. METItODS A total of 69 cases of medical staff suffered from sharp instrument injury from 2007 to 2010 were analyzed with a retrospective study to observe the reasons, types, operational links of sharp instrument iniuries. RESULTS The incidence of sharp instrument injuries in the nurses and medical staff with short service life was 62. 32% and 55. 07%, respectively; the incidence of sharp instrument iniuries that occurred on Monday, Friday and morning sessions was hight the sharp injuries that occurred in ward accounted for 37. 68%, operating room 33. 33% the major sharp instruments causing injuries were the syringe needles （26.09 %）, infusion needles （21.74%）, and suture needles （17.39 %） the sharp injuries frequently occurred in dealing with used sharp instruments （28. 99%）, surgery （27. 54%）, withdrawing needles percutaneously （23. 19%） ; 63.77% of the medical staff did not wear gloves when the injuries occurred. CONCLUSION The nurse and the medical staff with short service life are the population at high risk for sharp injuries; non-standard operation and improper protection are the main causes for sharp injuries; it is an erective way to effectively reduce the sharp injuries by strengthening the training of occupational safety of the medical staff and standardize the safe operation.