226名护士发生职业暴露的监测分析及防护管理

Monitoring analysis and the protection management of 226 nurses with occupational exposure

目的探讨传染病医院护士职业暴露的发生情况、原因及预后,提出防护管理对策和暴露发生后的处理措施。以降低职业暴露的发生率及其影响。方法回顾性分析本院2009年4月至2012年12月226名护士职业暴露发生的情况,对护士职业暴露的科室分布、暴露方式、受伤部位、暴露地点,暴露源种类、暴露后处理情况及随访结局进行分析,所有资料均采用Excel软件进行数据录入和SPSS 16.0软件进行统计学分析。本研究主要采用描述性统计分析方法,计量资料以x±s描述,计数资料采用构成比描述。结果护士发生职业暴露共226人次,其中针刺伤183人次(81.0%),体液溅入37人次(16.3%),被患者抓咬伤6人次(2.7%)。发生频率最高的科室为妇科、中西一科、ICU和手术室。暴露源以HBV最为常见,其次为HCV和HIV。职业暴露后伤口均及时得到正确处理,暴露者均未感染。结论通过提高意识、加强管理、规范操作、及时处理等,严格执行标准预防,正确使用个人防护用品,规范伤口处理及发生暴露后的上报及随访体系,就能有效地防止职业暴露的发生。

Objective To explore the occurrence, causes and prognosis of occupational exposure situation of nurses in infectious disease hospital, and put forward countermeasures for protection management and treatment measures after the exposure, and reduce the incidence of occupational exposure and their effects. Methods From April 2009 to December 2012, total of 226 nurses were collected in our study. The occupational exposure rate of nurses occupational exposure, exposure mode, the injured area, exposed places, exposure source types, damage the post-processing and follow-up outcome were analyzed, retrospectively. Results Among the 226 nurses with occupational exposure, there were 183（81%） persontime with needle stick injuries, 37（16.3%） persontime with patient＇s body fluids entering and 6（2.7%） persontime with patients bitten. The departments with highest frequency occupational exposure were Gynaecology, the First Department of Chinese and Western, ICU and Operating room. HBV is the most common expose source, followed by HCV and HIV. After occupational exposure, the wound were all treated correctly on time, all nurses had not been exposed to the infection. Conclusions By raising awareness, strengthen management, standardized operation and timely disposal, strict implementation of standard precautions, proper use of personal protective equipment, standardized wound treatment and after exposure reporting and follow-up system, could effectively prevent the occurrence of occupational exposure.