某军队中心医院医务人员职业暴露危险因素分析及干预

Analysis on the risk factors in occupational exposure of medical staff,and the countermeasures on them

目的分析医务人员发生职业暴露的危险因素,制定有效的防护措施。方法回顾调查2014年1月—2015年1月发生职业暴露的45名医务人员,对暴露工作者的人员结构、暴露地点、暴露源病种、暴露方式、锐器伤伤器种类和发生职业暴露操作环节进行统计分析。结果发生职业暴露的45名医务人员中,护士比例最高,占66.67%,其次为医师,占24.44%;病房内发生职业暴露最多,占48.89%,其次是手术室,占35.56%;暴露源病种主要以乙型肝炎病毒为主,占55.56%,其次是丙型肝炎病毒,占22.22%;暴露方式以锐器伤为主,占99.11%;锐器伤伤器主要是注射器,占31.70%,其次是输液器和缝合针,分别占29.57%和24.39%;职业暴露发生的操作环节主要以手术中操作和护理技术操作居多,分别占31.11%和22.22%。结论加强医务人员培训,通过规范医疗护理技术操作、改变惯性错误行为、落实职业安全防护措施,提高医务人员的职业技能,增强医务人员的风险感知,加强职业防范能力,落实各项防范措施等能有效降低职业性暴露。

Objective To analyze the risk factors in occupational exposure of medical staff so as to develop effective protective measures. Methods A retrospective survey was carried out among 45 medical staff suffered from occupational exposure from January 2014 to January 2015. including personnel structure of the exposed workers,exposed locations,exposing source of diseases,exposure types,injury types and occupation exposure injury for operation which were analyzed statistically. Results Among the occupation exposure of 45 medical staff, nursing staff aceunted the highest proportion （66.67%）,followed by the physician （accounted for 24.44%）. Ward occupation exposure was highest（accounted for 48.89%）,followed by the operation room（accounted for 35.56%）. Exposure source disease were mainly composed by hepatitis B virus （HBV）（accounted for 55.56%）, followed by the hepatitis C virus （HCV）（accounted for 22.22%）. The most common exposure mode was sharp injury（accounted for 99.11%）;The mainly sharp injury indicator was syringes（accounted for 31.70%）,followed by infusion and suture needle （29.57% and 24.39%,respectively）;The occupational exposure occurred when operation were mainly in operation and nursing technical manipolution,accounted for 31.11% and 22.22% ,respectively. Conclusion To strengthen the training of medical personnel,to standardize the operation of medical care,to change the inertia error,to implement the occupational safety and protection measures,to improve the medical staff＇s professional skills,to enhance awareness of the risk perception of medical personnel,and to strengthen the ability of occupational prevention measures could reduce the occupational exposure effectively.