内镜室护士医院感染的危险因素分析及防护措施

Risk factors of nosocomial infection and protection measures of nurses in endoscopy rooms

目的分析内镜室护士医院感染的危险因素,提出针对性的防护措施。方法对本市3家三级医院内镜室护士11名,发放自行设计的医院感染调查问卷、自我防护调查问卷进行调查,统计医院感染的危险因素,包括体液污染、排泄物污染、血液污染、锐器损伤发生频次,自我防护情况,包括自我防护等级和个人防护意义等。结果本市3家医院内镜室2013年1月共进行胃镜、结肠镜、十二指肠镜和支气管镜1 110例次,随机抽查436例,不同级别防护职业暴露发生率比较差异具有统计学意义(F=5.2614、4.2615、4.6251、4.0123,P均<0.05)。6名主管护师职称体液污染、排泄物污染、血液污染和锐器损伤分别为0.92、0.69、0.00和0.23例次,显著低于护师及护士,不同职称职业暴露例次比较差异具有统计学意义(P均<0.05)。11名护士防护不当后果知晓率为90.90%,职业暴露处理方法知晓率为63.63%,高危操作防护知晓率为72.73%,标准预防内容知晓率为54.55%,主管护师职称各项知晓率显著高于护师及护士,两组比较差异具有统计学意义(χ2=6.2053、21.5647、12.4851、15.0314,P均<0.05)。结论内镜室护士职业暴露发生率较高,部分护师和护士防护意识较差,因此,提高认识、强化内镜室护士防护管理,对降低医院感染具有重要意义。

Objective To analyze the risk factors of nosocomial infection of nurses in endoscopy rooms, and put forward some pertinent protection measures. Methods Total of 11 nurses were collected from three tertiary hospitals, issued nosocomial infection questionnaires, self-protection questionnaires which designed by their own hospitals. The risk factors of nosocomial infection, included fluid contamination, excreta contamination, blood contamination, number of sharp instrument injury, self-protection conditions, including self-protection levels and self protection meanings were analyzed, respectively. Results Three tertiary hospitals＇ endoscopy rooms totally conducted gastroscopies, duodenoscope, bronchoscopy about 1 110 cases, 436 cases were checked randomly, different levels of protection professionals had different incidence of exposure, with significant differences（F = 5.2614, 4.2615, 4.6251 and 4.0123; P all 0.05）. There were 6 lead nurses＇ fluid contamination, excreta contamination, blood contamination, number of sharp instrument injury were 0.92, 0.69, 0.00 and 0.23 persontime, respectively, significantly lower than nurses and nurse practitioners, the cases of exposure in different professional titles were significantly different（P〈0.05）. There were 90.90% of 11 nurses knew their improper protection behavior, occupational exposure processing method awareness rate was 63.63%, high risk operations awareness rate was 72.73%, normal prevention knowledge awareness rate was 54.55%, the awareness rate in lead nurses was significantly higher than nurses and nurse practitioners（χ^2 = 6.2053, 21.5647, 12.4851 and 15.0314, P〈0.05）. Conclusions Endoscopy room＇s occupational exposure rate is high, some nurses and nurse practitioners＇ protection awareness is poor, thus, deepen the understanding and strengthen endoscopy room nurses＇ protection management are important for decreasing nosocomial infection.