锐器伤专项微型培训在职业暴露风险中的应用  

Application of special mini-training for sharp injury in risk of occupation exposure

作　　者：李彦[1] 李岩[1] 陈同利 张建勇[1] 时利民[1] 

机构地区：[1]解放军第88医院感染控制科,山东泰安271000

出　　处：《中华医院感染学杂志》2017年第9期2148-2151,共4页Chinese Journal of Nosocomiology

基　　金：全军后勤科研计划面上基金资助项目(CJN14L002)

摘　　要：目的探讨锐器伤专项微型培训方法的效果,以提高职业防护的执行力、降低锐器伤的发生。方法 2015年6月对481名医务人员进行锐器伤基线调查,确定针剂开启、针头处理、锐器传递、锐器盒的使用为专项微型培训内容,采取制定锐器使用标准操作规程、骨干培训、现场培训、固化培训的流程组织实施,对比培训前与培训后第一个月和第六个月锐器使用标准操作正确率和培训后1年锐器伤发生率。结果发放调查问卷501份,回收481份,应答率96.01%;基线调查锐器伤的发生率为53.85%,发生密度为0.11次/人·月;不同类别医务人员中护士锐器伤发生率最高,发生率为59.83%;针头和玻璃是造成医务人员锐器伤的主要刺伤器具;锐器伤发生时机排前3位的分别是掰安瓿时、回套针头帽时和分离针头与注射器时;其中污染锐器伤218例次,占41.60%,血源性疾病暴露55例次,血源性疾病暴露率为11.07%;锐器伤专项微型培训后针剂开启、针头处理、锐器传递、锐器盒的使用操作正确率分别由20.13%、61.93%、69.15%、75.93%提高到72.43%、88.84%、90.81%、93.87%,差异有统计学意义(P<0.05);与培训前相比,培训后一年内医师、护士锐器伤的发生率显著降低(P<0.001)。结论锐器伤专项微型培训有效弥补了大课培训的不足,培训灵活机动,医务人员参与性强,锐器使用操作更加规范、高效,可有效降低职业暴露的发生。OBJECTIVE To explore the effect of special mini-training for sharp injury so as to improve execution power of occupational protection and reduce the incidence of sharp injury.METHODS The baseline survey was conducted for sharp injuries among 481 health care workers in Jun,2015.The contents of the special mini-training involved the needle injection opening,disposal of needles,delivery of sharp instruments,and use of sharp injury boxes;the standard procedures for use of sharp instruments,training of backbones,onsite training,and curing training were carried out.The rate of standard use of sharp instruments was compared before the trainings and after the trainings for one and six months,and the incidence of sharp injuries was observed after the trainings for one year.RESULTS Totally 501 questionnaires were issued,and 481 questionnaires were recycled,with the response rate 96.01%.The baseline survey showed that the incidence of sharp injuries was 53.85%,the density of occurrence was 0.11 per person/month.Among the health care workers,the incidence of sharp injuries was the highest（59.83%）in nurses;the needles and glass were the major sharp instruments that resulted in the sharp injuries among the health care workers.The top 3timing of occurrence of the sharp injuries were as the following：the timing of breaking ampoules,timing of recapping the needle cap,timing of separating needles from injection syringes.There were 218（41.60%）case times of contaminated sharp instruments injuries and 55 case times of blood-borne diseases exposure,and the rate of exposure of blood-borne diseases was 11.07%.The rates of correct opening of needle injection,disposal of needles,delivery of sharp instruments,and use of sharp instrument boxes were respectively increased from 20.13%,61.93%,69.15%,and 75.93%to 72.43%,88.84%,90.81%,and 93.87%after the special mini-training for sharp injury（P〈0.05）.The incidence of sharp injuries was remarkably reduced in doctors and nurses within one year after the training（P〈0.001）.CONC

关 键 词：锐器伤 培训 职业暴露 

分 类 号：R192[医药卫生—卫生事业管理]