2017—2018年北京市某区1993名医务人员针刺伤及抑郁状况分析

Analysis on needlestick injury and depression among 1993 medical workers in a district of Beijing from 2017 to 2018

目的了解北京市1993名医务人员针刺伤和抑郁状况,为保障医护人员的职业安全,选择和改进防治针刺伤管理办法提供科学依据。方法采用分层整群抽样方法对1993名医务人员进行调查,数据采集时间范围为2017年7月1日—2018年6月30日。采用Excel和SPSS 17.0统计软件对调查数据进行统计分析。结果1993名医务人员中发生针刺伤162人,发生率为8.13%;不同医院级别、工龄、文化程度及夜班天数医务人员针刺伤发生率比较,差异均有统计学意义(均P<0.05);造成针刺伤的主要器具为穿刺针(14.06%),主要发生场所为外科(19.49%),主要发生病区为住院病房(36.71%),主要发生岗位为其他岗位(22.74%),主要发生原因为意外(49.54%)。携带病原体调查发现,没有携带病原体的比例最高(39.61%)。一、二、三级医院调查对象重度抑郁得分率分别为0.95%、0.65%和7.78%,差异有统计学意义(P<0.05)。休假天数≤10和>10天的无抑郁得分率分别为35.32%和9.43%,差异有统计学意义(P<0.05)。近1年平均每月上夜班≤5和>5天的无抑郁得分率分别为27.94%和16.81%,差异有统计学意义(P<0.01);中度抑郁得分率分别为6.62%和6.47%,差异有统计学意义(P<0.05),重度抑郁得分率分别为4.26%、5.12%,差异有统计学意义(P<0.01)。近1年未受过或受过针刺伤调查对象无抑郁得分率分别为8.08%和2.91%,差异有统计学意义(P<0.05);重度得分率分别为2.56%和1.25%,差异有统计学意义(P<0.01)。从业以来未受过针刺伤、受过针刺伤、不清楚无抑郁得分率分别为25.89%、11.04%和7.83%,差异有统计学意义(P<0.01);中度抑郁得分率分别为15.35%、10.18%和7.23%,差异有统计学意义(P<0.05);重度抑郁得分率分别为3.76%、4.06%和2.06%,差异有统计学意义(P<0.01)。结论北京市1993名医务人员针刺伤发生状况及抑郁状况不容乐观,应继续加强防护知识的培训,规范操作流程,配备防护用品,完善报告流程,进一步降低针刺伤发生风险。

Objective To understand the status of needlestick injury and depression among 1993 medical workers in Beijing,provide scientific basis for ensuring the occupational safety of medical staff and selecting and improving the management methods of prevention and treatment of needlestick injury.Methods 1993 medical workers were investigated by stratified cluster sampling.The data collection period is from July 1,2017 to June 30,2018.The data were analyzed by Excel and SPSS 17.0.Results Among 1993 medical workers,162 had needlestick injury with the incidence of 8.13%.There were statistically significant differences in the incidence of needlestick injury among different groups in hospital level,working age,education level and night shift days(all P<0.05).The main instrument causing needlestick injury was puncture needle(14.06%),the main place of occurrence was surgery department(19.49%),the main area of occurrence was inpatient ward(36.71%),the main post of occurrence was other post(22.74%),and the main cause was accidents(49.54%).The investigation on carrying pathogens showed that the proportion of carrying no pathogen was the highest(39.61%).The scores of severe depression in the basic hospitals,secondary hospitals and tertiary hospitals was 0.95%,0.65%and 7.78%,respectively,and the difference was statistically significant(P<0.05).The score rate of no depression in medical workers with leave days≤10 and>10 days was 35.32%and 9.43%respectively,and the difference was statistically significant(P<0.05).The score rate of no depression in medical workers with average night shift per month≤5 and>5 days in the past year was 27.94%and 16.81%respectively,and the difference was statistically significant(P<0.01),the score rate of moderate depression was 6.62%and 6.47%respectively,and the difference was statistically significant(P<0.05),while the score rate of severe depression was 4.26%and 5.12%respectively,and the difference was statistically significant(P<0.01).The score rate of no depression in medical workers with and without needlestick injury in the past year was 8.08%and 2.91%respectively,and the difference was statistically significant(P<0.05),while the score rate of severe depression was 2.56%and 1.25%respectively,and the difference was statistically significant(P<0.01).The score rate of no depression in medical workers who had no needlestick injury since working,had needlestick injury,and had unknown history of needlestick injury was respectively 25.89%,11.04%and 7.83%,and the difference was statistically significant(P<0.01),the score rate of moderate depression was respectively 15.35%,10.18%and 7.23%,and the difference was statistically significant(P<0.05),while the score rate of severe depression was respectively 3.76%,4.06%and 2.06%,and the difference was statistically significant(P<0.01).Conclusion The status of needlestick injury and depression among 1993 medical workers in Beijing is not optimistic,so it is necessary to continue to strengthen the training of protection knowledge,standardize the operation process,equip with protective equipment,improve the reporting process,and further reduce the risk of needlestick injury.