医务人员血源性职业暴露分析与对策

Analysis and strategies for blood-borne occupational exposure of medical staff

目的了解医务人员血源性职业暴露,探讨有效防范措施,以减少职业暴露的发生。方法回顾性调查2010年1月-2011年12月血源性职业暴露医务人员,对其职业、科室分布、暴露方式、暴露源病原体、暴露后的处理等进行分析。结果共发生职业暴露109人,其中护士占41.28%,医师占29.36%;发生频率最高的科室是手术室43人;暴露方式主要是锐器伤,占82.57%,多发生于术中缝合、穿刺及注射操作时;有明确血源性传播疾病的职业暴露占77.98%;87.16%暴露者局部处理正确,未发现因职业暴露而感染血源性疾病。结论加强培训、提高防护意识、规范操作流程、严格实施标准预防、暴露后及时正确地处理与干预是保护医务人员职业安全的有效措施。

OBJECTIVE To know the situation of blood-borne occupational exposure of medical staff, and to discuss the effective precautionary measures, so as to reduce the incidence of occupational exposure. METHODS A retro-spective survey for blood-borne occupational exposure of medical staff was held from Jan. 2010 to Dec. 2011. The occupation, department distribution, exposure mode, pathogen exposure, and post-processing of exposure were analyzed. RESULTS A total of 109 people had the blood-borne occupational exposure, of which 41.28% were nurses and 29.36% were doctors. The highest frequency of staff getting blood borne occupational exposure was in the operating room. The main exposure mode was sharp instrument injury, which was 82.57%. The blood-borne exposure mainly occurred in the process of suture, puncture and injection during surgery. The staff who have a definite blood-borne transmitted disease accounted for 77.98 % of occupational exposures. 87.16 % of the exposure was handled correctly and no infection of blood-borne diseases occurred due to occupational exposure. CONCLUSION Improving training and protection consciousness, execution of standard operating procedures, implementing standard prevention strictly, and correct handling and intervention of exposure in time are effective measures which can protect medical staff from blood-borne occupational exposure.