医务人员锐器伤职业暴露基线调查与分析

Baseline investigation and analysis of occupational exposure to sharp instrument injury in medical personnel

目的了解医务人员锐器伤职业暴露的真实情况与特点,为完善职业防护措施提供科学依据。方法对医院内有机会接触锐器的所有医务人员采用浙江省医院感染管理质控中心统一设计的调查问卷,调查2011年5月1-31日锐器伤职业暴露发生情况。结果调查的1257名医务人员共发生锐器伤128人,锐器伤发生率10.18%,发生182人次,人均0.14次;护士发生最高,有106人次,占58.24%,其次为医师54人次,占29.67%;锐器伤发生地点主要在普通病房和手术室;导致锐器伤的锐器以注射器针头最多见,其次为真空采血针;发生锐器伤危险因素在医疗废物处置中最多,其次为抽血和补液配制;发生锐器损伤后报告医院感染管理科有3例。结论医院感染管理部门应加强医务人员职业暴露相关知识培训,提高医务人员职业防护意识,针对高危人群、科室、环节等采取切实可行的预防措施,改进职业暴露报告监控系统,提高职业暴露后的上报率,降低职业暴露的发生。

OBJECTIVE To observe the real situation and characteristics of the occupational exposures to sharp instrument injuries in the medical personnel in the hospital so as to provide the scientific basis for perfecting the protective measures.METHODS The unified design questionnaire by the infection control center of Zhejiang province was employed to investigate all the medical sharp instrument injuries in the hospital,the occupational exposure to the sharp instrument injuries was investigated from May 1st to May 31,2011.RESULTS There were 128 individuals with the sharp instrument injuries,with the incidence rate of 10.18%,182 case-times,and 0.14 times per capita.The incidence was highest in the nurses,there were 106 case-times（58.24%）,followed by the doctors（54 case-times,29.67%）.The sharp injuries mainly occurred in the general ward and the operating room,and the syringe needles injuries were the most common sharp injuries,the next was the vacuum picks needle.The disposal of the medical waster was the most common risk factor for the sharp injuries,the next was the haemospasia and rehydration preparation.There were 3 cases who reported to the infection control department after the sharp injuries.CONCLUSION The hospital infection management department should strengthen the related knowledge training of occupational exposures to the medical personnel,improve the consciousness of occupational protection in the medical staff.In response to the high-risk groups,high-risk department,and high-risk links,it is necessary to adopt the feasible preventive measures,improving the occupational exposures report monitoring system,improving their professional report rate after the exposure,so as to reduce the rate of occupational exposure.