某三甲医院医务人员医疗锐器伤的分析

Analysis of needlestick and sharps injuries among medical staff in upper first-class hospital

目的了解综合医院医务人员医疗锐器伤的发生情况及危险因素，为医院感染控制部门及卫生部门制订预防措施提供参考依据。方法采用统一问卷调查方法，对南京市某三级甲等医院800名医务人员过去一年内医疗锐器伤的发生情况进行调查，其中641人问卷有效完整，医生239人，护士348人，其他工作类别54人。对资料进行χ2检验及多因素Logistic回归分析。结果共调查641名医务人员，373名发生过医疗锐器伤，发生率为58．19％。不同工作类别及不同工作科室的医疗锐器伤发生率的差异有统计学意义（P〈0．01）。注射器针头、玻璃、头皮针输液器针头及缝合针是造成医务人员医疗锐器伤的主要器具，其中医生以缝合针伤害率（48．21％）明显高于护士（6．72％），护士以注射器针头、头皮针输液器针头以及玻璃的伤害率（71．15％、59．68％、49．04％）明显高于医生（46．43％、6．25％和16．96％），差异均有统计学意义（P〈0．01）。医生以抽取体液或组织标本、冲洗伤口、缝合、剪断和切开伤害率明显高于护士，护士以注射、静脉输液、经肝素帽封管、连接静脉输液管路、抽取动脉血或静脉血伤害率明显高于医生，差异均有统计学意义（P〈0．05）。结论医务人员医疗锐器伤的发生较普遍，漏报严重，应加强医护人员的培训和操作规范管理。

Objective To investigate the incidence of ueedlestick and sharps injuries among the medical staff in an upper first-class hospital and its risk factors and to provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection. Methods A questionnaire survey was conducted in 800 healthcare professionals in an upper first-class hospital in Nanjing, China to investigate the incidence of needlestick and sharps injuries in the past year. A total of 641 persons completed the questionnaire, including 239 doctors, 348 nurses, and 54 other healthcare workers. The obtained data were subjected to chi-square test and logistic analysis. Results Needlestick and sharps injuries occurred in 373 of 641 healthcare professionals, with an incidence rate of 58.19%. There were significant differences in the incidence of needlestick and sharps injuries among the medical staff of different types or in different departments （P〈0.01）. The syringe needles, glass, scalp infusion needles, and suture needles were the major medical apparatus that caused needlestick and sharps injuries; the incidence rate of injury caused by suture needles in doctors （48.21%） was significantly higher than that in nurses （6.72%） （P〈0.01）, and the incidence rates of injuries caused by syringe needles, scalp infusion needles, and glass in nurses （71.15%, 59.68%, and 49.04%） were significantly higher than those in doctors （46.43%, 6.25%, and 16.96%） （P〈0.01）; compared with nurses, the doctors had higher incidence rates of injuries due to body fluid or tissue sample collection, wound flushing, suture, and cutting （P〈0.05）; compared with doctors, the nurses had higher incidence rates of injuries due to injection, intravenous infusion, heparin cap sealing, intravenous infusion line connection, and venous or arterial blood collection （P〈0.05）. Conclusion Needlestick and sharps injuries are common in medical staff. The results of the study on risk factors provide a basis for the infection control department of hospital and health administration department to establish the policies for safe iniection.