某中医院血源性职业暴露危险因素调查分析

Investigation of Blood-Borne Occupational Exposure, Risk Factors and Measures in a TCM Hospital

目的分析中医院血源性职业暴露、危险因素,寻找预防措施。方法参考卫生部制定的《血源性病原体职业接触防护导则》及《医务人员艾滋病病毒职业暴露防护工作指导原则》制定中医院血源性职业暴露处理流程处理,医务人员发生职业暴露后立即按规范处理伤口(挤、冲、消),然后上报院感办并按照《杏林医院感染实时监控系统软件》新职业防护的相关规定填写职业暴露个案登记表,发生职业暴露暴的医护人员凭院感办的职业暴露个案登记表自己去检验科抽血检查感染情况,检验科将检查结果上报《杏林医院感染实时监控系统软件》登记。结果暴露率由高到低依次是护士、医生、卫生员、实习生。中医院医护人员职业暴露方式以锐器刺伤为主,占83.53%,其次是黏膜暴露,占16.47%。85 例职业暴露中暴露源HBV 8 例,比例9.41%;HCV 7 例,比例8.24%;梅毒4 例,比例4.71%。结论中医院职业暴露主要危险群体是护士及医生,主要暴露方式为针刺伤及黏膜暴露,输液完毕拔针是最主要危险因素,HBV、HCV 是常见暴露血源性病原体。医院需强化管理,增加医护人员职业防护意识,规范操作,减少职业暴露。

Objective To investigate blood-borne occupational exposure, risk factors and measures in a TCM hospital. Methods The treatment process of blood-borne occupational exposure in the hospital of traditional Chinese medicine was formulated by referring to the Protection Guideline for Occupational Exposure to Blood-Borne Pathogens and National Guidance on Health-Care Worker Exposure to HIV" formulated by Ministry of Health. Immediately after occupational exposure, medical staff should deal with the wounds. Results Occupational exposure rate from high to low is nurses, doctors, health workers, interns.The occupational exposure mode of medical staff in TCM hospital was mainly sharp instrument stabbing injury (83.53%), followed by mucosal exposure (16.47%). Among 85 cases of occupational exposure, there were 8 cases (9.41%) of HBV, 7 cases (8.24%) of HCV and 4 cases (4.71%) of syphilis. Conclusion The main risk groups for occupational exposure in TCM hospitals are nurses and doctors. The main exposure methods are needle injury and mucosal exposure. Needle extraction after infusion is the most important risk factor. HBV and HCV are common blood-borne pathogens. Hospital should strengthen management, increase the awareness of occupational protection of medical staff, standardize operation and reduce occupational exposure.