某三级甲等综合性医院医务人员血源性职业暴露现状调查分析及干预措施评价  

Current status of bloodborne occupational exposures among health care workers in a three-A hospital and intervention measures

作　　者：花静[1] 李家斌[2] 王进[1] 王文阳[1] 汤红芳[1] 

机构地区：[1]安徽医科大学附属巢湖医院感染管理科,安徽巢湖238000 [2]安徽医科大学第一附属医院感染疾病科,安徽巢湖230032

出　　处：《中华医院感染学杂志》2017年第18期4286-4289,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81172737)

摘　　要：目的分析本院医务人员血源性职业暴露的危险因素,为制定规章制度和防控措施提供依据。方法对2014年1月-2015年12月31名血源性职业暴露医务人员的基本信息资料进行汇总、统计分析。结果职业暴露的主要高危人群是护士和实习护士,占74.2%;年龄在30岁以下的医务人员占80.6%;工作年限在1年以内的人员占35.5%;工作年限在5年以内的人员占74.2%;暴露地点主要涉及到为检验或治疗场所占64.5%;病区以内科病区为主;暴露源以乙型肝炎为主,占83.9%;暴露类型主要是针刺伤,占93.5%;注射后回套针帽、输液后拨针、分离针头、采血后拨针为高危环节,占67.7%。结论建立健全职业暴露防护体系是降低职业暴露风险和规范管理的重要手段。加强重点人群、重点科室的职业安全教育;使用安全、有效防护功能的护理产品;规范注射和输液、拔针操作规程;制定切实可行的应急措施和防护策略,能有效预防职业暴露的发生,保障医务人员的职业安全。OBJECTIVE To investigate the risk factors for bloodborne occupational exposures among health care workers so as to provide guidance for development of regulations and prevention measures. METHODS From Jan 2014 to Dec 2015, a total of 31 health care workers with bloodborne occupational exposures were enrolled in the study, the basic information data was collected and Statistically analyzed. RESULTS The nurses and intern nurses were the major high-risk population with occupation exposure, accounting for 74. 2%; the health care workers who were less than 30 years old accounted for 80.6 %, the health care workers whose working experience was less than 1 year accounted for 35.5%, the health care workers whose working experience was no more than 5 years accounted for 74.2%. The clinical examination and treatment sites were the major exposure sites, accounting for 64.5%, the internal medicine department wards were dominant. Hepatitis B was the predominant exposure source, accounting for 83.9%, and the needle-stick injury was the maior exposure type. The capping back the needle cap after injection, withdrawing the needle after infusion, separating the syringe needle and withdrawing the needle after blood collection were the high-risk links, accounting for 67.7%. CONCLUSION The establishment of the occupational exposure protection system is an important mean to reduce the risk of occupational exposure and standardize the management. It is an effective way to strengthen occupational safety education for key populations and departments, use safe and effective protective care products, standardize the operation specifications for injection, transfusion and withdrawal of needles and formulate feasible emergency measures and protective strategies so as to prevent the occupational exposures and ensure the occupational safety of the health care workers.

关 键 词：血源性 职业暴露 危险因素 干预措施 

分 类 号：R181.31[医药卫生—流行病学]