实习护士发生针刺伤的原因分析及防范对策

Causes of needle injuries in probationer nurses and preventive countermeasures

目的调查实习护士针刺伤及防护现状,寻找针刺伤发生的规律和原因,提出有针对性的防范对策。方法采用自行设计的调查表,对320名实习护士进行针刺伤问卷调查。结果共发放问卷320份,收回有效问卷316份,回收率98.75%;实习护士防护意识差,接触患者前后洗手占3.16%;在可能接触患者血液、体液操作中每次戴手套的占11.08%;静脉输液、静脉采血每次戴手套的为0;对防护知识完全不知晓的占18.35%;发生针刺伤1～3次的比例最高,占45.89%;在实习的第2个月内发生针刺伤的实习护士最多,占45.89%;针刺伤发生环节中双手回套针帽最高,占18.49%;316人中有213人发生过针刺伤,但上报率较低,占41.78%。结论发生针刺伤的根本原因是护理操作不规范,加强实习护士岗前教育,增强防护意识,强化技能训练,提高带教质量,规范操作,能有效减少针刺伤发生,确保实习护士的健康和职业安全。

OBJECTIVE To investigate the current status of the needle injuries in the probationer nurses and explore the causes of the needle injuries so as to put forward the targeted prevention countermeasures. METHODS A total of 320 probationer nurses in the hospital were investigated by self-designed questionnaires. RESULTS Of totally 320 questionnaires distributed, there were 316 qualified questionnaires with the recovery rate of 98. 75%; the protection awareness of the probationer nurses was poor, the respondents who washed hands before and after touching the patients accounted for 3. 16%; 11. 08% of them wore gloves during the operations that may be exposed to the patients blood or body fluids; and none of them wore gloves in any blood collection or intravenous infusion; 18.35 % of them lacked the protection knowledge. Furthermore, 45.89 % of them were pricked from one time to three times. 45.89% of the probationer nurses encountered the needle injuries in the second month of in-ternship period; 18.49 % of them were pricked while they worn the needle cap by two hands. The needle injuries occurred in 213 of 316 respondents, but the reported rate was relatively low （41. 78%）. CONCLUSION The irregular operation is the main reason leading to the needle injuries. To strengthen the pre-service education, intensify the protection awareness, reinforce the skill training, improve the teaching quality, and standardize the operation can effectively reduce the incidence of needle injuries and ensure the health and occupational safety of the probationer nurses.