甘肃省医务人员锐器伤现状调查

Investigation of sharp injury of medical staff in Gansu Province

目的调查甘肃省医务人员锐器伤的现状情况,为我省医务人员的职业防护提供依据。方法本研究采用回顾性调查的方法,使用分层随机抽样的方法,对甘肃省331所三级医疗机构进行了锐器伤电子问卷调查。结果调查显示甘肃省锐器伤的发生率为33.01%,例次发生率为47.88%,报告率为49.34%,已知感染源的锐器伤中,血源性疾病污染率占13.36%;一级医疗机构的锐器伤发生率最低为29.68%,二级医院次之为33.12%,三级医院最高为35.46%;护士锐器伤的发生率为37.29%,高于医生及其他人员;发生锐器伤的主要器具为针具类,占81.32%,主要为一次性注射器、头皮针、手术缝针等;发生锐器伤的主要地点为治疗室、普通病房、手术室、换药室等;发生锐器伤的主要环节为双手回套针帽、配药、将针头放入锐器盒、手术缝针、拔出动(静)脉针等;甘肃省各地区间锐器伤的主要器具、环节、暴露地点总体趋势相同,但因地区和经济差异,具体略有不同;发生锐器伤的主要传染病为乙肝、丙肝、梅毒和艾滋病等。结论甘肃省锐器伤的发生率较高、需加强医护人员的培训,制定安全注射制度,提高职业防护意识,提供安全医疗器具等相关措施减少锐器伤的发生。

OBJECTIVE To investigate the current situation of sharp injury of medical staff in Gansu province,and to provide basis for occupational protection of medical staff in Gansu province.METHODS An electronic questionnaire survey was conducted on sharp injuries in 331 medical institutions in Gansu Province by means of retrospective investigation and stratified random sampling.RESULTS The incidence of sharp instrument injuries in Gansu province was 33.01%,the incidence of cases was 47.88%,and the reporting rate was 49.34%.Among the sharp instrument injuries with known infection sources,the contamination rate of blood-borne diseases accounted for 13.36%.The incidence of sharp injury was the lowest in primary medical institutions(29.68%),followed by secondary hospitals(33.12%)and tertiary hospitals(35.46%).The incidence of sharp injury occurred in nurses was 37.29%,which was significantly higher than that in doctors and other medical staff.The main instrument of sharp injury was needle,accounting for 81.32%,mainly disposable syringes,scalp needles,surgical stitches,etc.The main places of sharp injuries were treatment room,general ward,operating room,dressing room,etc.The main behaviors that had high risk of sharp injuries were recapping needles with both hands,dispensing medicine,putting the needle into the sharps disposal units,surgical stitches,pulling out artery(intravenous)needle,etc.The main types,behaviors and exposure sites of sharp injuries in different regions of Gansu province had the same general trend,but the details are slightly different due to regional and economic differences.The main potential risks of infection of sharp injury were hepatitis B,hepatitis C,syphilis and AIDS.CONCLUSION The incidence of sharp injury is high in Gansu Province.It is necessary to strengthen the training of medical staff,adopt safe injection system,improve occupational protection awareness,provide safe medical equipment and other measures to reduce the occurrence of sharp injury.