护生针刺伤职业暴露危险因素分析及防范策略

Analysis on the Risk Factors of Occupational Exposure to Needle-pricking Injuries of Nursing Students and Their Preventive Strategies

目的:分析护生针刺伤职业暴露的危险因素,进一步探讨防范策略,以保障护生职业健康。方法:回顾性调查某三级甲等综合医院2011-2016年护生针刺伤职业暴露情况,统计分析护生发生针刺伤职业暴露的学历、年龄、实习阶段、科室、工作时段、部位、操作环节、血源性职业暴露及暴露源种类等情况。结果:88例护生针刺伤职业暴露大专生占64.77%、专生占30.68%、本科生占4.55%,年龄≤22岁占89.77%,实习阶段≤2个月占55.68%,外科占53.41%,白班占78.41%,手指暴露占86.36%,操作环节主要是静脉输液拔针处置针头不规范占69.32%,其次是注射拔针回套针帽占17.04%,血源性职业暴露占34.09%,暴露源种类主要是HBV占17.05%。结论:大、中专,年龄≤22岁及实习阶段≤2个月的护生是发生针刺伤职业暴露的高危人群,外科、白班、手指、静脉输液和注射拔针处置针头操作行为不规范是发生针刺伤职业暴露的高危因素。加强护生职业安全防护教育与操作行为规范训练,加强护生职业安全管理,保障护生职业健康。

Objective：To analyze the risk factors of occupational exposure of nursing students with needle puncture,then to explore the preventive strategies to ensure the occupational health of nursing students.Method：A retrospective study was conducted to investigate the occupational exposure of nursing students during the period from 2011 to 2016 in a Grade 3 comprehensive hospital,and the degree of education,age,internship period,department,working time,location,operation link,bloodborne occupational exposure and the type of exposure source were analyzed.Result：In the 88 cases of occupational exposure with needle puncture injury,the junior college student accounted for 64.77%,the secondary school students accounted for 30.68%,the undergraduate students accounted for 4.55%,the nursing students who are 22 years old or those less than 22 years old accounted for 89.77%,and the nursing students who are in practice stage of two months or those less than two months accounted for 55.68%,surgery accounted for 53.41%,day shift accounted for 78.41%,finger exposure accounted for 86.36%,the main operation link was nonstandard needle removal for intravenous infusion accounted for 69.32%,the next place was injection needle pulling back needle accounted cap for 17.04%,and blood occupation exposure accounted for 34.09%.HBV accounted for 17.05% of the exposed sources.Conclusion：The nursing students who are 22 years old or those less than 22 years old in technical secondary school and junior college and the nursing students who are in practice stage of two months or those less than two months are the high risk group of occupational exposure of needle puncture injury The high risk factors of occupational exposure of needle puncture injury are surgery,day shift,finger,intravenous infusion and nonstandard operation behavior of needle extraction.Strengthen occupational safety protection education and operation behavior standard training of nursing students and strengthen occupational safety management of nursing students to protect the occupational health.