护士对职业危害及防护的认知研究

Study on Nurses' Cognition of Occupational Hazards and Protection

目的了解临床护士对职业危害及防护管理的理解,探讨通过加强医院管理,提升职业卫生管理水平的可行性。方法对临床护士(包括护理管理者和普通护士)进行问卷调查,采用SPSS17.0软件进行统计分析。结果本次调查共回收合格问卷965份,锐器伤(97.7%)和职业接触所致的感染性疾病(90.2%)在护理管理者和普通护士中的认知度均较高;肿瘤化疗药物、电离辐射、消毒剂因素在护理管理者中的认知度更高;护理人员比较关注超负荷劳动导致的生理(76.9%)、心理问题(78.7%)和长时间站立(74.2%)带来的危害。以医疗质量和安全对医疗机构的重要性为10分为标准参考分进行评价,调查对象评价职业卫生管理重要性的分数为10分者573人(59.4%),8-9分者249人(25.8%)。医疗机构职业卫生管理存在问题集中在法律法规可执行性不足、职业防护宣教不足、外聘人员管理和防护用品可及性不足。管理难点集中在职业防护的成本效益、评价困难和医院领导层重视不足。结论临床护士尤其是护理管理者还应更加重视如肿瘤药物配置和输注、消毒供应等岗位可能发生的职业危害。医院管理者应加强对职业卫生管理重视,增加医院对职业卫生管理的投入。

Objective To learn nurses＇ understanding of occupational hazards and protective management and discuss the feasibility of enhancing hospital management and improving occupational health management level. Methods Questionnaire survey was conducted among hospital nurses and SPSS17.0 was applied to complete statistical analysis. Results In 965 copies of qualified questionnaires, sharp instrument injuries（97.7%）, infectious diseases caused by occupational exposure（90.2%） ranked the top two factors that nurses were aware of. Nursing managers thought more about contacting cancer chemotherapy drugs and disinfectants, exposure to radiation. Nurses were more concerned about physiological（76.9%） and psychological problems（78.7%） as well as prolonged standing harm（74.2%） caused by work overload. 573（59.4%） nurses scored the significance of occupational health management as 10 points while 249（25.8%） scored it as 8-9 points when considering the significance of occupational health management as 10 point. Occupational health management problems concentrated in insufficient executability of laws and regulations, inadequate occupational protection education, insufficient management on external personnel and narrow access to protective equipment. Management difficulties focused on the cost-effectiveness of occupational protection, difficulties in evaluation and the lack of attention from hospital managers. Conclusion Clinical nurses, especially nursing managers should pay more attention to occupational hazards such as contacting cancer chemotherapy drugs, infusion and disinfectants. Hospital managers should pay more attention to occupational health management and increase relevant investment.