职业安全培训对护士血源性职业暴露风险的影响

Effect of occupational safety training on nurse blood-borne occupational exposure risks

目的观察职业安全培训是否可有效降低护士血源性职业暴露的风险。方法选取我院180名临床护士(肾内科、消化内科、心内科、骨科、手术室及ICU)为研究对象。首先采取回顾性问卷调查方式,调查过去一年内护士与血源性职业暴露相关的因素如针刺伤的发生情况(发生频率,发生密度),针刺伤发生后正确处理伤口的知晓率及上报率,不良操作习惯(回套针帽,分离针头及不戴手套)的发生情况等。然后对受调查护士进行职业安全培训。职业安全培训包括全面性防护的概念、防护措施、有关针刺伤的危害、安全操作技能以及发生刺伤后的处理流程等。经过安全培训后再次采用问卷调查护士培训后一年内以上指标的发生情况。结果培训前针刺伤的发生率为84%,针刺伤发生密度为5.2次/人,污染针头刺伤的发生率为68%。而职业安全培训后针刺伤的发生率为47%,针刺伤发生密度为2.3次/人,污染针头刺伤的发生率为22%,与培训前比较差异有统计学意义(P<0.05)。职业安全培训前护士自我防护情况,正确处理伤口知晓率为23%,及时登记上报率为15%,培训后正确处理伤口知晓率为86%,及时登记上报率为85%,差异有统计学意义(P<0.05)。操作中不良习惯的情况,培训前回套针帽发生率为76%,分离针头发生率为82%,不戴手套发生率为68%,而培训后回套针帽发生率为31%,分离针头发生率为24%,不戴手套发生率为35%,差异有统计学意义(P<0.05)。结论临床护士经过系统职业培训后,操作中不良习惯改善,针刺伤发生率下降,自我防护意识增强,血源性职业暴露的风险降低。

Objective： To study the effect of occupational safety training on nurse blood - borne occupational exposure risks. Methods： 180 clinical nurses from Department of Nephrology, gastroenterology, cardiology, orthopedics, operating room and ICU in our hospital were selected as research objectives. First, with a retrospective questionnaire, it is surneyed for these relevant factors of occupational exposure to bloodborne, such as the occurrence of needle stick injuries （ frequen- cy, incidence density）, the awareness rate of correctly handlig the wound and timely reporting rate, poor operating prac- tices （ recapping the needle cap, isolating needles and not - wearing gloves） in the past year . Then the nurses surneyed were given occupational safety training. Occupational safety training includes comprehensive protection concept, protective measures, needle stick injuries related hazards, safety skills and stabbing occurred after treatment processes. After occupa- tional safety training, occurrence of the above indicators were surneyed again. Results： Incidence of needle stick injuries before training was 84%, the needle stick injuries occurance density 5.2 times / person, incidence of contaminated needles stabbed 68%. After the occupational safety training, the incidence of needle stick injuries was 47% , the needle stick inju- ries occurance density 2.3 times / person, contaminated needles stabbed incidence 22%. The difference is significant（ P 〈 0.05）. Before traning, the awareness rate of correctly handlig the wound was 23%, the rate of reportig timely 15%, while through occupational safety training the rate of correctly handlig the wound was 86% and the rate of repertig timely was 85%, the difference was statistically significant （P 〈0.05）. Before training, the rate of recapping the needle cap was 76%, the rate of separation needles was 82%, occurrence rate of not - wearing gloves 68%, but after training, the rate of recapping needle cap was 31% , incidence rate of separation needles 24% , incidence of not -wearing gloves 35% , the difference was statistically significant （ P 〈 0.05 ）. Conclusions ： Through the vocational training systematically, the bad op- erational habits of clinical nurse is improved, the incidence of needle stick injuries decreased signifcanfly, the serf- protec- tion awareness is reinforced, the risks of blood - borne occupational exposure reduced.