2016-2017年上海市101所医院医务人员锐器伤网上直报分析  

Analysis of direct online report of the hospital medical personnel sharp injuries in 101 hospitals of Shanghai from 2016 to 2017

作　　者：崔扬文[1] 高晓东[1] 胡必杰[1,2] 林佳冰 CUI Yang-wen;GAO Xiao-dong;HU Bi-jie;LIN Jia-bing(Zhongshan Hospital, Fudan University, Shanghai 200032, Chin)

机构地区：[1]复旦大学附属中山医院医院感染管理科,上海200032 [2]复旦大学附属中山医院医院感染病科,上海200032

出　　处：《中华医院感染学杂志》2018年第11期1747-1749,1760,共4页Chinese Journal of Nosocomiology

基　　金：上海市卫生计生委基金资助项目(201640313)

摘　　要：目的了解2016-2017年上海市医务人员对锐器伤管理的现状。方法选择上海市2016年1月-2017年12月101所医院,通过上海市院内感染网络直报监测系统,要求监测医院的医务人员的锐器伤须在24h内登记上报,统计医务人员锐器伤情况。结果调查期间共计101所医院3815例医务人员发生锐器伤,二级和三级综合医院分别占比为42.07%(1 605/3 815)、41.31%(1 576/3 815);按工作年限中以≤5、6~10、11~20、>21年占比分别为72.03%(2 748/3 815)、10.83%(413/3 815)、12.58%(480/3 815)、4.56%(174/3 815);工作类别和职称中以护士和医生为主;暴露地点以普通病房最多为41.34%(1 577/3 815),其次为手术室18.06%(689/3 815);2016年与2017年不同器械类型引起锐器伤的分布情况不同,其中以针头最多(P<0.001)。损伤多发生于多步骤使用过程中各步骤之间及器械使用后处理前,分别为43.41%(1 656/3 815)和38.11%(1 454/3 815);75.47%(2 879/3 815)锐器伤能识别患者源、77.46%(2 955/3 815)的锐器伤的器械为污染器械、69.96%(2 669/3 815)为血液可见;证实暴露源中患有艾滋7例、梅毒11例、乙肝31例等血源性传染病;发生锐器伤后75.62%(2 885/3 815)向防保科报告,58.87%(2 246/3 815)的锐器伤未佩戴手套防护。结论加强职业防护意识、规范操作行为、强化标准预防理念是监管锐器伤管理的重要措施。OBJECTIVE To understand the current status of the hospital medical personnel sharp injury management in Shanghai from 2016 to 2017.METHODS A total of 101 hospitals were selected from Jan.2016 to Dec.2017 in Shanghai.The sharp injuries of the medical personnel in the monitoring hospitals should be registered within 24 hours through Shanghai＇s Intra-hospital Infection Direct Online Monitoring System as required.The hospital medical personnel sharp injuries were statistically analyzed.RESULTS A total of 3 815 medical personnel with sharp injuries in 101 hospitals were included in this study.The sharp injuries in secondary and tertiary general hospitals were 42.07%（1 605/3 815）and 41.31%（1 576/3 815）respectively.According to the different working years,the sharp injuries were divided into 72.03%（2 748/3 815）,10.83%（413/3 815）,12.58%（480/3 815）,and4.56%（174/381）for≤5,6-10,11-20,and21 working years.Among the job categories and titles,the nurses and doctors accounted the highest proportions.The maximum number of exposure sites was general wards accounting for 41.34%（1 577/3 815）,followed by operating rooms with 18.06%（689/3 815）.The distribution of sharp instrument injuries caused by different device types in 2016 and 2017 was different,with the most of needles,and the difference was significant（P〈0.001）.Injuries occurred mostly between steps in the multi-step use process and before the device was used for post-treatment,which accounted for 43.41%（1 656/3 815）and 38.11%（1 454/3 815）respectively.Totally 75.47%（2 879/3 815）of sharp injuries could identify the source of the patients,77.46%（2 955/3 815）of sharp-injured instruments were contaminated instruments,and 69.96%（2669/3 815）were visible of the blood.There were 7 cases of AIDS,11 cases of syphilis,and 31 cases of hepatitis B in confirmed exposure source.Totally 75.62%（2 885/3 815）of the medical personnel were reported to the Department of Preventive Medicine after a sharp injury,and 58.87%（2 246/3 81

关 键 词：医务人员锐器伤 职业性伤害 血源性传染病 标准预防 

分 类 号：R184[医药卫生—流行病学]