精神病专科医院441名医护人员职业暴露现状调查及对策

Investigation and countermeasures of occupation exposure status of 441 doctors and nurses in psychiatric hospital

目的:分析精神病专科医院医护人员发生职业暴露的常见危险因素,并提出有效防护措施。方法:对精神病医院医护人员进行职业暴露调查,并对职业暴露者相关资料进行分析。结果:441名医护人员中共有18名工作人员发生职业暴露,全部为护理人员。其中职业暴露地点全部在病房;部位有14例在手指、3例在手臂、1例在眼睛;类别有锐器伤14例(输液针10例、注射针3例、缝针1例),患者咬伤3例,血液喷溅1例;暴露环节为输液过程针刺伤8例,其中因患者兴奋不合作导致的针刺伤4例;清理用物6例;护理过程咬伤3例;输液过程血液喷溅1例。暴露源中有3例乙肝病毒阳性;无丙肝、梅毒和HIV病毒阳性。结论:加强职业暴露防护知识培训,落实标准预防措施和规范操作流程,能有效减少职业暴露的发生。

Objective:To analyze the risk factors of occupational exposure among common psychiatric hospital medical staff,and to propose effective protective measures.Methods:We investigated the occupation exposure status of doctors and nurses in psychiatric hospital,and analyzed the relevant information of occupational exposure.Results:In the 441 doctors and nurses,18workers occurred occupational exposure,and they were all nurses.All of the occupational exposure locations were in the ward.The position of 14 cases was at the fingers,three cases were at the arm,one case was at the eye.14 patients were sharp injury(10 cases of transfusion needle,3 cases of injection needle,1 case of suture needle),3 cases were bite by the patients,1 case was blood splashes.8 cases were exposed on the infusion process with needle stick injuries,including 4 cases of needle stick injuries because of noncooperation and excitement of patients;6 cases occurred on the process of cleaning materials;3 cases with bite occurred on the nursing process;1 case with blood splashing occurred on the infusion process.In the exposure source,3 cases were positive hepatitis B virus,there was no positive hepatitis C,syphilis and HIV virus.Conclusion:Strengthening occupational exposure protection knowledge training and implementation of standard precautions and standard operating procedures,can effectively reduce the incidence of occupational exposure.