江苏省某三甲综合医院医务人员血源性职业暴露特征分析及防控策略

Analysis of Blood-borne Occupational Exposure Characteristics and Prevention and Control Strategy for Medical Personnel in a Third-class A General Hospital in Jiangsu Province

目的分析医务工作人员发生血源性职业暴露的特点,并据此提出有效的控制策略。方法回顾性选取2019年1月—2023年12月江苏省某三甲等综合医院发生的369例医务人员血源性职业暴露事件,分析内容包括血源性职业暴露的一般资料、暴露科室、位置、方式等。结果5个年度的职业暴露中,以2020年发生职业暴露最多,2020—2023年度职业暴露发生例次整体呈递减趋势,以2023年职业暴露最少。医务人员中发生血源性职业暴露最多的群体为护理人员,工龄<5年的医务人员职业暴露占比最高。血源性职业暴露的科室分布:外科34.15%(126/369)、内科27.10%(100/369)、手术室14.63%(54/369)等。主要暴露方式依次为锐器伤、操作中的整理诊疗用物/医疗废物、拔除动(静)脉针、穿刺/缝合。乙肝病原体是主要暴露源。结论根据分析结果,建议加强对医务人员血源性职业暴露的关注,特别关注重点人群和操作环节,并采取针对性地防控措施,以有效遏制血源性职业暴露的发生。

Objective To analyze the characteristics of blood-borne occupational exposure of medical staff,and put forward effective control strategies accordingly.Methods From January 2019 to December 2023,369 cases of bloodborne occupational exposure of medical staff in a tertiary general hospital in Jiangsu Province were retrospectively selected.The analysis included general information,exposure department,location and mode of blood-borne occupational exposure.Results Among the five years of occupational exposure,occupational exposure occurred most in 2020,and the number of occupational exposure cases in 2020-2023 showed a decreasing trend as a whole,with the least occupational exposure in 2023.The group with the most blood-borne occupational exposure among medical staff was nursing staff,and the proportion of occupational exposure of medical staff with working age<5 years was the highest.The distribution of departments of blood-borne occupational exposure:surgery 34.15%(126/369),internal medicine 27.10%(100/369),operating room 14.63%(54/369),etc.The main exposure methods were sharp instrument injury,sorting medical supplies/medical waste during operation,removal of arteriovenous needle,puncture/suture.Hepatitis B pathogens are the main source of exposure.Conclusion According to the analysis results,it is suggested to strengthen the attention to the blood-borne occupational exposure of medical staff,pay special attention to the key population and operation links,and take targeted prevention and control measures to effectively curb the occurrence of blood-borne occupational exposure.