广东省39所医院医务人员锐器伤调查  

Survey on sharps injuries among health care workers at 39 hospitals of Guangdong province

作　　者：张友平[1] 侯铁英[1] 白雪皎[1] 陈子龙[1] 

机构地区：[1]广东省人民医院广东省医学科学院,广东广州510080

出　　处：《中国感染控制杂志》2013年第1期19-23,共5页Chinese Journal of Infection Control

摘　　要：目的了解广东省医务人员血源性职业暴露的发生情况,为制定预防措施提供科学的依据。方法采用问卷调查方法,对广东省39所医院医务人员2011年6月锐器伤的发生情况进行横断面调查。结果发放调查表32 617份,回收32 297份,回收率为99.02%;实际有效问卷32 007份,有效率为99.10%。发生锐器伤1 460例,1 909例次,锐器伤发生率为4.56%,例次率为5.96%,平均月发生密度为0.06次/(人月)。发生污染锐器伤1 495例次,污染锐器伤例次发生率为4.67%(1 495/32 007);污染锐器伤占锐器伤总例次的78.31%(1 495/1 909),其中61.67%(922/1 495)能追踪到暴露源,38.33%(573/1 495)不能确定其是否具有传染性。血源性污染器械中,81.71%(67/82)为乙型肝炎暴露源,14.63%(12/82)为梅毒暴露源,3.66%(3/82)为丙型肝炎暴露源,无艾滋病暴露源。锐器伤发生的地点主要为普通病房(47.72%)与手术室(20.27%);频率最高的操作是加药(15.92%),其次为医疗废物处置(12.78%)和拔除动(静)脉针(12.21%);主要医疗器具为一次性注射器(35.99%)、头皮钢针(19.43%)和手术缝针(13.41%)。医务人员职业暴露相关知识培训率为93.25%。结论锐器伤是导致血源性传播疾病感染的主要职业因素,医疗机构应建立健全职业病防治组织机构和规章制度,规范医务人员的血源性职业暴露预防与控制行为,降低血源性职业暴露伤害风险。Objective To investigate occupational exposure to blood among health care workers （HCWs） in Guangdong province, and provide scientific basis for developing preventive measures. Methods A cross-sectional survey on sharps injuries among HCWs at 39 hospitals in Guangdong province in June 2011 was conducted through questionnaires. Results A total of 32 617 questionnaires were distributed, and 32 297 （99. 02%） were responded; and 32 007（99.10%） questionnaires were available for analysis. 1 460 HCWs had suffered 1 909 times of sharps in- juries, and the incidence was 4. 56% , the injury episode rate was 5.96% ; the average number of injury per month was 0. 06/person. 1 495 （4. 67%, 1 495/32 007） injury episodes were caused by contaminated sharps~ contaminated sharps injuries accounted for 78. 31% （1 495/1 909） of total sharps injuries, and 61.67% （922/1 495） of which could trace to the exposure sources, while 38. 33% （573/1 495） couldn＇t determine the infectivity. Among blood- contaminated devices, 81.71% （67/82） were hepatitis B exposure, 14. 63% （12/82） were syphilis exposure; 3. 66% （3/82） were hepatitis C exposure, there was no HIV exposure. The locations where sharps injuries occurred mostly were general wards （47. 72%） and operating rooms （20. 27%） ; the procedures involved in high injury rates were dispensing（15. 92%） , medical waste disposal （12. 78%）, and syringe needle removal（12. 21%）; the main medical devices that caused sharps injuries were disposable syringe needles（35.99%）, scaple needles（19. 43%） andsuturing needles （13. 41%）. HCWs; training rate of knowledge about bloodborne occupational exposure was 93. 25%. Conclusion Sharps injury is the main professional factor that cause bloodborne diseases. In order to re- duce the risk of injuries caused by occupational exposures, medical institutions should establish corresponding or- ganization and rules, and HCWs should standardize preventive and control behavior towards occupational ex

关 键 词：医务人员 职业暴露 锐器伤 职业防护 医院感染 

分 类 号：R136[医药卫生—劳动卫生]