浙江省2011年犬伤门诊规范化建设现况调查分析

Investigation of standardized development of dog bite injury clinics in Zhejiang province, China in 2011

目的了解《浙江省犬伤门诊评审标准(试行)》(浙卫发〔2010〕50号)实施以来各地犬伤门诊建设进度及遇到的困难和问题,进一步完善相关标准,更好地开展犬伤门诊规范化建设。方法制定调查方案、设计调查表,由统一培训的调查员对全省范围内所有犬伤门诊开展现场调查,采用EpiData 3.0软件建立数据库,Excel软件进行数据分析。结果2011年全省共有703家犬伤门诊,其中79.23%设在乡镇卫生院,26.46%为独立设置,68.71%具有完整五大功能分区,9.39%的门诊面积<15 m2,39.12%的门诊无冷热双相供水,8.96%的门诊甚至无伤口冲洗设备,3.27%的门诊无急救药品配备,平均每家犬伤门诊医护人员7人,5.85%的门诊在节假日和夜间无医护人员配备。结论与2008年相比,浙江省犬伤门诊的整体规范化有所提高,但各地规范化建设进展不平衡,需加强人群犬伤暴露后卫生服务可及性研究,重新考量犬伤门诊的分布、数量和配置。

Objective To assess the progress and issues of the development of dog bite injury clinics since the Zhejiang Accreditation Standards for Dog Bite Injury Clinics （Tentative） （Zhejiang provincial Department of Public Health [2010] No. 50） was inaugurated, and to further improve the relevant standards for the development of dog bite injury clinics. Methods The assessment plan and questionnaire were developed, and trained staff conducted field survey of all dog bite injury clinics in Zhejiang province. A database was established using EpiData 3.0, and data analysis was performed using Excel. Results In 2011, there were 703 dog bite injury clinics in Zhejiang province; of these dog bite injury clinics, 79.23% were located in township health centers, 26.46% were operated independently, 68.71% provided full services, 9.39% had a facility smaller than 15 m2, 39.12% had no cold and hot water supplies, 8.96% had no wound irrigation devices, and 3.27% had no availability of first- aid supplies. There were 7 medical workers on average in each dog bite injury clinic, and 5.85% of all clinics had no medical staff on holidays and during night. Conclusion Compared with the situation in 2008, the standardized development of dog bite injury clinics in Zhejiang province was improved overall in 2011, but with great variations among different regions. Further study is warranted to improve the access to health services after dog bite injury, and the location, number, and configuration of dog bite injury facilities should be reconsidered.