手术室医务人员职业暴露现状及认知情况分析

Occupational exposure and cognition of medical staff in operating room

目的探讨手术室医务人员职业暴露现状及认知情况。方法以本院手术室发生职业暴露的医务人员84例为研究对象,收集职业暴露环节、暴露部位、职业暴露时检出患者病原体类型、职业暴露的原因。参考卫计委颁布的医务人员职业暴露防护管理办法设计调查问卷,对职业暴露相关认知情况进行调查分析。结果发生职业暴露的手术室医务人员中,护士占50.00%(42/84),明显高于医生[33.33%(28/84)]和麻醉师[16.67%(14/84)],差异均有统计学意义(均P<0.05)。医生、护士、麻醉师职业暴露各环节分布情况比较差异均有统计学意义(均P<0.05)。84例职业暴露的手术室医务人员中,存在病原体暴露的46例(54.76%),其中医生17例、护士22例、麻醉师7例。医生、护士、麻醉师职业暴露的原因主要为操作不规范和防范意识不足,所占比例明显高于工作疲乏和意外,差异均有统计学意义(均P<0.05)。手术室医务人员中对患者体液、血液等感染源的认知率为82.14%(69/84),对血源性暴露防护标准的认知率为67.86%(57/84),对隔离措施的认知率为86.90%(73/84),对潜在血源性感染疾病的认知率为80.95%(68/84)。结论手术室医务人员中护士职业暴露发生率最高,病原菌暴露以乙肝病毒为主;职业暴露主要原因为操作不规范和防范意识不足.应加强对医护人员血源性暴露防护标准的培训。

Objective To explore the status quo and cognition of occupational exposure of medical staff in operating room. Methods 84 medical staff with occupational exposure in the operating room of our hospital were selected as the research objects. The types of pathogens and the causes of occupational exposure were collected from the occupational exposure links, exposed sites and occupational exposure. Referring to the management measures of occupational exposure protection issued by the Health Planning Commission, a questionnaire was developed to investigate and analyze the cognitive status of occupational exposure.Results The incidence of occupational exposure of nurses in operation room was 50.00%(42/84), which was significantly higher than that of doctors 33.33%(28/84) and anesthesiologists 16.67%( 14/84), with significant difference (P<0.05). There were significant differences in the distribution of occupational exposure among doctors, nurses and anesthesiologists (P<0.05). Surgical suture was the main method for doctors, instrument delivery and injection were the main methods for nurses, and injection was the main method for anesthesiologists. The occupational exposure sites of doctors, nurses and anesthesiologists were mainly hands, and the incidence was significantly higher than that of eyes (P<0.05). Among 84 occupational exposure medical staff, 46 cases (54.76%) were exposed to pathogens, mainly hepatitis B virus, followed by hepatitis C virus and syphilis, and no HIV was found. The main causes of occupational exposure of doctors , nurses and anesthesiologists were irregular operation and insufficient awareness of prevention. The proportion of occupational exposure was significantly higher than that of fatigue and accidents ( P<0.05).In the operating ,the recognition rate of pationts' body fluid, blood and other infection sources was 82.14%(69/84);blood exposure protection was 67.86 (57/84), isolation measures was 86.90( 73/84);potential blood source was 80.95(68/84).Conclusion The occupational exposure rate of nurses in operating room is the highest, and the main cause of occupational exposure is hepatitis B virus. The main causes of occupational exposure are nonstandard operation and insufficient awareness of prevention.