陕西省30所医疗机构医务人员锐器伤调查

Sharp injuries among health care workers in 30 medical facilities in Shaanxi province

目的了解陕西省医务人员锐器伤(sharp injuries,SI)发生情况,为制定预防措施,降低SI发生率提供科学依据。方法采用问卷调查方式,对2011年5月1—31日陕西省30所医疗机构SI发生情况进行横断面调查。结果有效调查16 386名调查对象,其中1 489例(9.09%)发生SI 1 901例次,SI平均发生密度为0.12次/(人.月)。护士(10.36%)和工作年限为5～10年的工作人员(10.38%)是SI发生的高危人群;SI发生例次较高的地点为普通病房(37.88%)及手术室(23.25%);注射器针头(33.98%)、静脉输液头皮针(23.25%)及手术缝针(16.73%)是造成医务人员SI的主要医疗器具;手术缝合(14.31%)、将针头放入锐器盒(11.20%)、拔除动(静)脉针(9.89%)和双手回套针帽(9.68%)等操作是造成医务人员SI的主要环节;1 351例次(71.07%)SI可追溯暴露源,781例次(41.08%)为污染SI,其中54例次为血源性疾病暴露,血源性疾病暴露率为4.00%。血源性暴露中,乙型肝炎病毒占74.07%(40/54),梅毒占12.96%(7/54),丙型肝炎病毒占11.11%(6/54),人免疫缺陷病毒占1.85%(1/54)。结论 SI是医疗机构常见的职业损害,应通过减少不必要的锐器接触、推行使用安全器械、执行标准操作规程、实施安全防护等措施,有效降低SI发生率。

Objective To investigate the occurrence of incidence of sharp injuries （SI） among health care workers （HCWs） in Shaanxi province, and provide scientific basis for taking preventive measures to reduce incidence of SI. Methods A cross-sectional investigation on the occurrence of SI in medical facilities at 30 hospitals of Shaanxi prov- ince in May 2011 was carried out through questionnaire. Results Among 16 386 investigated HCWs, 1 489 （9. 09%） occurred 1 901 times of SI, the average frequency was 0. 12 times / person / month; nurses（10. 36%） and HCWs who worked for 5 to 10 years （10. 38%） were the high-risk groups for SI; the locations where SI usually oc- curred were general wards （37. 88%） and operating rooms （23. 25%） ; the major medical devices causing SI were syringe needles （33.98%）, intravenous infusion needles（23. 25%） and surgical needles（16. 73%） ; the major proce- dures involving in SI were surgical suture （ 14. 31 %）, putting needles into sharps containers （ 11.20 %）, removing needles from artery or vein（9. 89%）, and putting needle cap back（9. 68%） ; 1 351 cases （71.07%） of SI can be traced to exposure sources,781 （41.08%） were contaminated SI, 54 were bloodborne disease exposure, the expo- sure rate of bloodborne diseases was 4. 00%. Of bloodborne exposure, hepatitis B virus exposure accounted for 74. 07% （40/54）, syphilis 12. 96% （7/54）, hepatitis C virus 11. 11 % （6/54）, and human immunodeficiency virus 1.85%（1/54）. Conclusion SI is a common occupational injury in medical facilities, incidence of SI can be reduced by reducing unnecessary sharps exposure, promoting the use of safe medical devices, performing the standard opera-tion and taking safe protective measures.