医务人员职业暴露风险分析与防控对策?  

Analysis on risk prevention and control countermeasures for occupation exposure of medical staff

作　　者：朱晓栋[1,2] 李琳[1,3] 李学军[1,4] 王桂明[1,3] 姜梅杰[1,5] 

机构地区：[1]泰山医学院附属泰山医院,泰安市271000 [2]泰山医学院人口与计生学院,泰安市2011级3班271000 [3]泰安市中心医院医院感染管理科,泰安市271000 [4]泰安市中心医院医院审计科,泰安市271000 [5]泰安市中心医院医院检验科,泰安市271000

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第1期25-29,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：山东省自然科学基金项目(No.ZR2013HM009)

摘　　要：目的监测临床工作中发生职业暴露的高危人群和危险因素,以提高医务人员的职业防护能力,为医务人员降低职业暴露的风险提供参考依据。方法采用自行设计的《职业暴露者个案登记表》和职业暴露者所在科室《职业暴露原因分析与持续改进表》,监测2011年1月至2014年6月医务人员发生的共计286例次职业暴露者,分别从发生职业暴露者的一般情况、职业类别、暴露地点、暴露部位、职业暴露发生的风险环节、暴露方式、理措施、预防用药及随访结果等进行监测分析,所得数据进行统计学处理。结果在286例次职业暴露者中,女性多于男性、分别占77.97%(223/286)和22.03%(63/286);职业类别主要是护士和医师,分别占52.10%(149/286)和27.97%(80/286);职业暴露发生地点主要是病房、手术室和注射(治疗)室,分别占51.39%(147/286)、19.58%(56/286)和11.55%(56/286);风险环节与暴露方式以整理废物时、拔针时、丢弃锐器入利器盒时、手术过程中以及各种穿刺时的锐器伤为主,分别占22.38%(64/286)、19.59%(56/286)、14.34%(41/286)、12.93%(37/286)和11.19%(32/286);职业暴露者的应急处理、立即上报、专家评估、医嘱执行率均达100%(286/286),跟踪随访职业暴露者未发现因职业暴露导致的感染性疾病发生。结论职业暴露损伤的风险不容忽视,完善职业暴露的监控体系,强化标准化预防,加强培训与考核,是减少医务人员职业暴露风险的关键。Objective To improve the occupational protection ability of medical personnel by monitoring the high-risk groups and risk factors of the occurrence of occupational exposure in clinical work, and to provide a reference to reduce the risk of occupational exposure. Methods The form designed by own hospital were applied,＂the occupational exposures case registration form＂were iflled out by the cases of occupational exposure and ＂the analysis of occupational exposure cause and continued improvement form＂were iflled out by departments occurring occupational exposure. Total of 286 cases of occupational exposure among medical staff from 2011 January to 2014 June were collected. The information of surveillance included identiifcation, occupational category, exposed location, exposed part, the risk step of occupational exposure occurring, exposure mode and treatment measure, prophylaxis and follow-up results were analyzed, respectively. Results Among the 286 cases with occupational exposure, the female were more than male, accounting for 77.97%（223/286） and 22.03%（63/286）, respectively. The main categories of exposures were nurse and physician, occupying 52.10% （149/286） and 27.97% （80/286）. The exposed location mainly occurred at ward, operation room and injection （treatment） room, accounting for 51.39%（147/286）, 19.58%（56/286） and 11.55%（33/286）, respectively. The risk occasion and exposed way were based on sharp instrument injury, generally occurred at the time of clearing up medical waste, pulling out the needle, discarding sharps into the sharp-box, processing operation and puncture, accounted for 22.38%（64/286）, 19.59%（56/286）, 14.34%（41/286）, 12.93%（37/286） and 11.19%（32/286）, respectively. The rates of emergency treatment, immediately reported, expert evaluation, and implementation of doctor order of the occupational exposure were all reached 100%（286/286）. According to the followed-up information, all the occupational exposure were not with infection c

关 键 词：医务人员 职业暴露 风险分析 防控对策 

分 类 号：R192[医药卫生—卫生事业管理]