医务人员锐器伤发生情况调查与防护对策

Investigation and countermeasures of sharp instrument injuries in medical staff

目的了解医务人员锐器伤发生现状,为制定预防措施提供科学依据。方法 2016年4月20日—4月22日采用自行设计的《医务人员锐器伤情况调查表》对全院医务人员进行锐器伤现状问卷调查。结果参加调查的481名,医务人员中259名过去1个月曾经发生过锐器伤,发生率为53.85%。不同医务人员锐器伤的发生率不同,差异具有统计学意义(P=0.001),其中护士锐器伤发生率最高,发生率为59.83%。工作年限<2年的医务人员锐器伤发生率高于其他组别,但差异无统计学意义(P=0.707)。针头和玻璃为造成医务人员锐器伤的主要刺伤器具,分别占47.60%和40.12%。受伤原因排在前三位的分别是掰安瓿时、回套针头帽时和分离针头与注射器时。发生锐器伤后有55.69%的医务人员未上报,未上报原因最主要的是认为扎伤器具为清洁器具,不需要上报,占45.35%,发生锐器伤后95.63%的医务人员都能正确及时的处理伤口。结论医务人员锐器伤暴露普遍存在,亟须提高医务人员职业防护意识,制定实施针对性职业防护措施,建议加强重点人群、高危环节的培训,掌握锐器安全操作方法,避免和减少锐器伤发生。

Objective To understand the situation of sharp instrument injuries in medical staff,so as to provide scientific basis for making preventive measures. Methods Using a self-designed Medical Personnel Injury Questionnaire the hospital medical staff were surveied on sharp instrument injuries from April 20 to 22,2016. Results Of the 481 staff investigated,at least one time of sharp instrument injuries occurred in 259 medical staffs,incidence rate was 53.85%. The incidence of sharp injuries of different medical personnel was different,the difference was statistically significant （P=0.001）,the nurses sharp injury had the highest incidence （59.83%）. In medical staff less than 2 years of work experience of sharp injuries was higher than that of other groups,but the difference was not statistically significant （P=0.707）. The needles and glasses were major medical instruments that lead to sharp injuries of medical personnel,accounted for 47.60% and 40.12% respectively. The causes of injuries in the top three were breaking the ampoule,back needle cap and separation of needles and syringes. After the sharp instrument injuries,55.69% medical staffs did not reported. The main reason was that injuried by clean appliances did not need to report,accounted for 45.35%. 95.63% of the medical staffs can timely and correctly treat sharp injuries. Conclusion Medical personnel injuries exposure exists generally. The occupation protection consciousness of medical staff need to be improved and implement targeted occupation protection measures. Strengthen the focus groups,high-risk areas of training and master the sharps safe operation method to avoid and reduce the occurrence of sharp injury.