医院工作人员锐器伤流行病学特点分析与对策

Epidemiological Characteristics Analysis and Preventability of Sharps Injuries in Hospital

目的分析医院工作人员锐器伤发生环节、场所、器械类型和防护等流行病学特点,为制定锐器伤防治策略提供依据。方法按照上海质量控制中心发布的《锐器伤登记表》统一标准,对2012年1月至2016年12月上海市第六人民医院工作人员发生的锐器伤情况进行分析。结果 2012-2016年发生锐器伤共计274例次。2012-2016年发生锐器伤实际人次有逐年升高趋势,占医院总人数的比例也呈逐年提升趋势。锐器伤的发生涉及34个科室,在医院所有临床医技和后勤部门均有锐器伤发生;高发锐器伤的前3位科室是骨科、手术室、普外科;高发锐器伤的前3位地点是手术室、普通病房、治疗室。共有126名年龄≤25岁的医护人员发生锐器伤,从职业分布来看,在发生锐器伤的人群中,护士、实习医生、实习护士占前3位。90%的锐器伤存在感染的风险。医生发生锐器伤的器械和场所主要为缝合针(51.5%)和手术室(60.9%),89.8%的医生在操作过程中受伤,多为中度损伤。护士发生锐器伤的器械和场所主要是头皮钢针(56.3%)和普通病房(61.9%),主要发生环节是为患者拔除针头(38.9%),以轻度损伤为主。发生损伤的主要防护措施是佩戴手套。发生锐器伤人群一半以上没有接受过专业针刺伤预防的培训。结论锐器伤多发生在低年资医护人员,医生护士锐器伤发生和防护存在差异,对不同群体应针对性培训,提高医护人员职业安全意识。

Objective To analyze the epidemiological characteristics of sharps injuries in links,locations,equipment types and protection,so as to provide the reference for preventive measures.Methods According to the‘sharp injuries registration form＇issued by the hospital infection quality control center,the reported healthcare workers with sharp injuries from January 2012 to December 2016 were monitored and analyzed.Results There were 274 cases of sharp injuries between 2012 to 2016,and the number of cases increased each year,so as the proportion of the injured workers among total staffs increased gradually.There were 34 departments had reported sharp injuries,as well as the clinical education department and logistic department;the orthopedics department,operation room and general surgery department ranked the highest among all departments;the operation room,general ward and treatment room had the highest incidence of sharp injuries among all locations;nurses,doctor interns and nursing interns ranked the top three among the sharp injured population.The infection risks existed in 90% of the sharp injuries.The sharp injuries happened in doctors were mostly during needling（51.5%）and in the operation room（60.9%）.89.8% of the doctors were injured during operations with moderate injury.Nurses were mostly injured by scalp needle（56.3%）and happened in general ward（61.9%）,and it often happened during needle withdrawal（38.9%）with mild injury.The main protection method was wearing gloves.More than half of the injured people had no previous sharp injury prevention training.Conclusions Young health care workers tend to have the sharp injuries.The occurrence and prevention measures of sharp injuries are different between doctors and nurses.Hospitals should provide targeted training,thus to improve the safety awareness of healthcare workers.