不同年资护理人员掰启安瓿引起手损伤原因分析及管理措施

Analysis and management measures of hand injuries caused by breaking apart the ampoules in nursing staffs of different curing duration

目的探讨不同年资护理人员掰启安瓿造成手损害的因素及防范措施。方法随机抽查江苏省徐州市3所医院于2009年1月～2012年12月因掰启安瓿而造成手损害的护理人员,从心理紧张、急救急用、方法错误、操作不熟练、用力不均等方面进行统计和分析。结果调查的1176人中有1011人发生手损伤,发生率为85.92%。实习护士组(护龄≤1年)经常发生率(37.84%)明显高于其他组(护龄>1～5年、>5～10年和>10年组分别为30.75%、22.03%和19.59%)(P<0.01)。心理紧张是造成手割伤的主要原因,实习护士组为75.29%,护龄>1～5年组次之为56.19%,明显高于护龄>10年组(20.61%),差异有统计学意义(P<0.01)。操作不熟练和操作方法错误致手损伤与护理人员的护龄直接相关,实习护士组和护龄>1～5年组因操作不熟悉致手损伤率分别为49.40%和32.30%,而护龄>5～10年和护龄>10年组仅为11.86%和7.77%(P<0.01)。掰启安瓿用力不均和急救急用时致手损伤在各类人员中均有发生,差异无统计学意义(P>0.05)。结论掰安瓿致手损伤可造成护理人员的生理伤害和心理恐惧,是医疗工作中职业暴露的高危群体,应加强培训,提高护士的防范意识,规避高危险行为,减少手损伤的发生。

Objective To study the risk factors and preventive measures of hand injuries causeu by breaking apart the ampoule in nursing staffs of different curing duration.Methods Nursing staffs from the local 3 hospitals who had hand injuries caused by breaking apart the ampoules from January 2009 to December 2012 randomly selected.The data were statistically analyzed in the respects of the psychological stress,first aid,error method,operating unskilled and unequal force.Results There were 1101 nursing staffs had hand injuries among the 1176 surveyed people.The total incidence was 85.9％.The incidence rate of the intern group （curing duration：≤ 1 year,37.84％） was significantly higher than the other groups （curing duration：＞1-5 years,30.75％; ＞5-10 years,22.03％; ＞10 years,19.59％） （P ＜ 0.01）.Psychological stress was the major cause of hand injury,which incidence in the intern group was 75.29％,in curing duration ＞1-5 years group was 56.19％,which was significantly higher than curing duration ＞10 years group （20.61％）,with significant difference （P ＜ 0.01）.Operating unskilled and operation errors caused hand injuries in nurses were directly related with curing duration,the incidence of hand injury caused by operating unskilled in the intern group and curing duration ＞1-5 years group were 49.40％ and 32.30％,while the incidence in the curing duration ＞5-10 years group and curing duration ＞10 years group were 11.86％ and 7.77％ （P ＜0.01）.Breaking apart ampoule with unequal force and first aid might cause hand injuries in nursing staffs,and the difference was not significant （P ＞ 0.05）.Conclusion Breaking apart the ampoules can cause physical harm and psychological fear to nurses,they were the high-risk groups of occupational exposure in medical work.The training of nursing staffs should be strengthened,enhance their precaution consciousness,avoid risky behavior,reduce the occurrence of hand injury.