2011年–2014年某大型综合性教学医院工作人员锐器伤情况分析

Analysis of sharp instrument injuries among healthcare staff in a comprehensive teaching hospital from 2011 to 2014

目的了解某大型综合性教学医院的工作人员血源性职业暴露中锐器伤发生的情况,分析原因,为预防锐器伤的发生提供科学依据。方法选择2011年—2014年所有发生锐器伤的一线工作人员,共计1 180人。建立和完善医院工作人员血源性病原体职业暴露的监控体系和防护体系,规范医院工作人员职业暴露的报告、处置流程,开展锐器伤的目标性监测,系统收集并分析2011年—2014年发生锐器伤的情况。结果 2011年—2014年,全院共有1 180名医院工作人员发生锐器伤,其中乙型肝炎的职业暴露比例最高(41.06%),其次为梅毒(13.35%)。注射器针头(27.54%)、缝合针(24.15%)和头皮针(19.58%)是造成伤害最多的锐器,所有发生锐器伤的人员均建立了职业暴露健康档案,定期随访,未发现因锐器伤感染血源传播性疾病的情况。结论医疗机构中锐器伤的发生仍很常见,应建立和完善职业暴露的监控体系和防护体系,及时规范地处置暴露者,以降低医院工作人员职业暴露的危险性。

Objective To investigate the occurrence of sharp instrument injuries among healthcare workers in a comprehensive teaching hospital and explore the risk factors, so as to provide scientific basis for the prevention approaches. Methods A total of 1 180 healthcare workers with sharp instrument injuries between 2011 and 2014 were included in the study. Occupational hematogenous exposure monitoring and protecting system for health workers was established and optimized. The report and treatment process was standardized. Targeted monitoring system of sharp instrument injuries was developed. Sharp instrument injuries between 2011 and 2014 were systematically collected and analyzed. Results Between 2011 and 2014, there were 1 180 health workers who had sharp instrument injuries. Health workers had the highest rate of exposure to hepatitis B virus（41.06%）, followed by syphilis （13.35%）. Syringe needles （27.54%）, suture needles （24.15%） and scalp needles （19.58%） were the instruments that caused most of the injuries. We constructed occupational exposure records for all those with sharp instrument injuries, and performed regular follow-up. No hematogenous infections were found because of sharp instrument injuries. Conclusions Sharp instrument injuries are common in healthcare institutions. It is important to establish and perfect the occupational exposure monitoring and protecting system, so as to reduce the risk of occupational exposure for health workers in hospitals.