应用信息化技术调查护生针刺伤现状

Application of information technology to investigate current status of needlestick injuries among nursing students

目的了解护生针刺伤发生现状,探讨有效的职业暴露应对策略。方法回顾性调查某院2016-2018年临床实习护生针刺伤发生情况。护生在进入临床实习前,统一登记基本资料,并对其进行感染预防及控制相关知识培训,告知护生发生针刺伤后应经蓝蜻蜓医院感染实时监控管理系统上报。通过蓝蜻蜓系统导出护生针刺伤相关数据进行统计、分析。结果共调查2 099名护生,其中男生256名,女生1 843名;大专生1 117名,本科生921名,国内硕士研究生34名,外籍硕士研究生27名。发生针刺伤232例次,针刺伤发生率为11.05%。不同性别、学历、实习阶段、科室护生针刺伤发生率比较差异有统计学意义(均P<0.05)。在操作环节分布上,分离针头、拔针和回套针帽时针刺伤所占比率分别为28.88%、21.55%和18.10%。在暴露源的分布上,HBV和梅毒分别占21.12%、6.90%。在暴露场所分布上,发生在病房的针刺伤占32.33%。结论该院护生针刺伤发生率较低,但女性实习生、学历较低者、实习第一阶段、分离针头时、回套针帽时针刺伤发生率较高。应加强安全注射规范化培训,制定个性化培训方案等。

Objective To investigate the current status of nursing interns’needlestick injuries,and explore effective countermeasures against occupational exposure.Methods Occurrence of needlestick injuries among nursing interns in a hospital from 2016 to 2018 was investigated retrospectively.Before clinical internship,nursing students registered the basic data uniformly,received training on infection prevention and control knowledge,and were informed that they should report to the real-time healthcare-associated infection surveillance management blue-dra-gonfly system after the occurrence of needlestick injuries,relevant data of needlestick injuries were exported and analyzed through the blue-dragonfly system.Results A total of 2099 nursing students were investigated,256 were male students and 1843 were female students;1117 were junior college students and 921 were undergraduate students,34 were domestic master students and 27 were foreign master students.There were 232 cases of needlestick injuries,incidence was 11.05%.There were significant differences in the incidence of needlestick injuries among nursing students of different genders,education background,internship stage and department(all P<0.05).In terms of distribution of manipulation links,28.88%,21.55%,and 18.10%of needlestick injuries occurred during separation of needles,pulling out of needles,and recapping of needles respectively.In the distribution of exposure sources,HBV and syphilis TP accounted for 21.12%and 6.90%respectively.In the distribution of exposure locations,32.33%of needlestick injuries occurred in the wards.Conclusion Incidence of needlestick injuries is lower among nursing students,but higher in the female interns,those with lower education,the first stage of internship,separation of needles,and recapping of needles,it is necessary to strengthen standardized trai-ning on safe injection and develop individual training programs.