穿戴三级防护装备对护士针刺伤安全隐患的调查研究

Investigation And Research On Hidden Safety Hazards Of Needlestick Injuries Of Nurses By Wearing Level Three Protective Equipment

目的了解传染病隔离病区护理人员穿戴三级防护装备进行采血、注射、加药及处理锐器等操作存在的安全隐患,为进一步提高特殊环境下护理工作安全提供依据。方法从护士穿戴三级防护装备舒适度和穿戴防护装备执行穿刺操作的安全隐患两方面设计调查问卷,对81名(女71人,男10人)临时组建隔离病区的护士进行问卷调查和资料分析。结果对穿戴三级防护装备舒适度调查:61.49%护士认为穿戴的防护服尺码不合适;61.73%护士穿戴防护装备后3小时内出现不适症状,81.48%出现鼻梁压痛症状;72.84%出现额头压痛症状;46.91%出现头痛症状;37.04%出现头晕症状,30.86%出现手部皮肤干燥症状。导致不舒适症状主要原因为护目镜占91.36%;医用防护口罩占85.19%和防护服占37.04%。对穿戴三级防护装备执行穿刺操作安全调查:81.48%的护士认为穿戴防护装备后影响穿刺操作;95.06%认为护目镜起雾影响穿刺操作,25.93%认为穿刺操作时光线不足。原因分析表明:61.73%的护士戴护目镜未使用专业防雾液涂抹防雾;59.26%的护士穿刺操作时穿戴三双以上手套;41.98%护士在穿刺操作时无使用安全型针具;34.2%的护士穿刺操作后有针具二次分类行为。结论穿戴三级防护装备给护士工作带来各种身体的不适和操作的不便,增加了针刺伤风险,存在较大安全隐患。通过强化岗前穿戴防护培训,改善医学防护装备穿戴的舒适度,降低穿戴不良反应,并根据特殊环境改进操作流程和操作习惯等科学管理方法对存在问题进行专案改善,最大限度地降低安全隐患,更好地保障护士的安全。

Objective To understand potential safety hazards of nursing staffs in infectious disease isolation wards wearing three-level protective equipment for blood sampling,injection,dosing,and handling of sharps,to provide basis for further improving nursing safety work in special environments.Methods We designed the questionnaire from two aspects:comfort of nurses wearing level three protective equipment and safety hazards of wearing protective equipment during puncture operations.We carried out the questionnaire survey and data analysis for 81 nurses (71 females and 10 males) in temporarily bulit isolated wards.Results Survey on comfort of wearing level three protective equipment:61.49% of nurses believed that protective clothing size was inappropriate;61.73% had symptoms of discomfort within 3 hours after wearing protective equipment,81.48% had symptoms of nasal bridge tenderness;72.84% had symptoms of forehead tenderness;46.91% had headache symptoms;37.04% had dizziness symptoms,and 30.86% had dry hand skin symptoms.Main causes of discomfort symptoms include goggles accounting for 91.36%;medical protective masks for 85.19% and protective clothing for 37.04%.Safety survey of puncture operation when wearing three-level protective equipment:81.48% of nurses believed that wearing protective equipment would affect puncture operation;95.06% believed fogging of goggles affected puncture operation,and 25.93% believed that light was insufficient during puncture operation.Reason analysis showed 61.73% of nurses wore goggles and did not apply professional anti-fog liquid to apply anti-fogging;59.26% of nurses wore more than three pairs of gloves during puncture operations;41.98% of nurses did not use safety needles during puncture operations;34.2% of nurses had secondary classification of needles after puncture operation.Conclusion Wearing level three protective equipment brings various physical discomforts and operational inconveniences to nurses,increases risk of needle stick injuries.Strengthening pre-job wear protection training,can improve comfort of wearing medical protective equipment,reduce adverse effect of wearing,improve existing problems of operation process and operating habits according to special environment and other scientific management methods,minimize potential safety hazards,and guarantee safety of nurses better.