医务人员血源性职业暴露分析及对策  

Blood-borne occupational exposure among health care workers and countermeasures

作　　者：曹鸿静 米军香 王钧[3] 何敬芳[1] 刘兴乾 李洋[1] 

机构地区：[1]天津市泰达医院消毒供应中心,天津300457 [2]天津医院五官科,天津300211 [3]天津市人民医院,天津300191

出　　处：《中华医院感染学杂志》2016年第14期3348-3350,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生计生委天津市医药卫生2014年度重点攻关项目(14KG137)

摘　　要：目的分析医务人员血源性职业暴露的原因,探讨防范措施,以减少职业暴露的发生。方法收集2008年1月-2013年12月101名职业暴露医务工作者的人员结构、科室归属、暴露发生的类型及暴露源病种、发生职业暴露的工作环节进行调查,采用Excel 2003统计分析。结果 101名职业暴露者中,护士发生率最高占46.54%,其次为医师和保洁员,分别占34.65%和8.91%;其中神经外科和骨科医务人员发生率居首位,均为18.81%;暴露源病种主要以乙型肝炎为主,占46.30%;暴露发生的类型以锐器伤为主占82.18%,锐器伤发生的工作环节主要以手术操作和护理技术操作居多,分别占25.74%和20.79%。结论该院职业暴露医务工作者以护士为主,主要的暴露类型是锐器伤,可通过规范医疗及护理技术操作、改变惯性错误行为、落实职业安全防护措施、开发和使用安全型医疗护理用品等进行改进。OBJECTIVE To explore the causes of blood-borne occupational exposure among health care workers and put forward the prevention measures so as to reduce the incidence of occupational exposure.METHODS From Jan2008 to Dec 2013,totally 101 occupational exposure health care workers were enrolled in the study,then the staff structure,department attribution,types of exposure,types of exposure sources,and links of occupational exposure were investigated,and the statistical analysis was performed with the use of Excel 2003 software.RESULTS Among the 101 health care workers who had occupational exposure,the incidence was the highest in the nurses（46.54%）,followed by the doctors（34.65%）and the cleaning staff（8.91%）.The incidence of occupational exposure ranked the first place（18.81%）among the health care workers of neurosurgery department and orthopedics department.The hepatitis B was dominant among the exposure sources,accounting for 46.30%.The sharp instrument injuries accounted for 82.18% among the types of exposure.The surgical procedure and nursing technique were the major working links in which the sharp injuries occurred,accounting for 25.74% and 20.79%,respectively.CONCLUSIONThe nurses are dominant among the health care workers who have the occupational exposure,and the sharp instrument injury is the major type of exposure.It is necessary to standardize the medical and nursing technical procedures,alter the inertia inappropriate behaviors,implement the protective measures for occupational safety,and develop and utilize the safe medical and nursing articles.

关 键 词：医务人员 血源性 职业暴露 分析 对策 

分 类 号：R181.32[医药卫生—流行病学]