医务人员血源性职业暴露调查及其对策  

Investigation and countermeasures of occupational exposure to bloodborne pathogens among health care workers

作　　者：孙晓玲[1] 徐桂强[1] 刘均凤 张红梅[1] 王咏梅[1] 侯桂英[1] SUN Xiao-ling;XU Gui-qiang;LIU Jun-feng;ZHANG Hong-mei;WANG Yong-mei;HOU Gui-ying(The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院,山东青岛266003

出　　处：《中国感染控制杂志》2018年第5期440-443,共4页Chinese Journal of Infection Control

摘　　要：目的了解医务人员职业暴露现状,分析发生原因及危险因素,为采取有效防护措施提供依据。方法采用回顾性调查方法,对某院2013年1月1日—2016年12月31日发生的职业暴露事件进行调查分析。结果该院共发生职业暴露632例次。职业暴露发生以护士为主,共392例次,占62.02%;主要发生于工作年限不满2年的医务人员,共387例次,占61.23%。医务人员发生职业暴露的时机居前三位的分别是在输液完毕拔针、集中处置使用过的锐器物及针头以及手术缝合时,分别占15.19%、14.71%和12.18%。导致锐器伤发生的器械中,头皮钢针所占比例最大,共137例次,占23.42%;其次是缝合针,96例次,占16.41%。职业暴露血源性病原体以乙型肝炎病毒为主,占58.86%,其次是未知暴露源导致的职业暴露,占18.04%;职业暴露地点主要发生在普通病房(38.61%)。结论应加强职业安全防护教育,提高医务人员预防职业危害的能力,规范具有潜在危险的操作行为,加强医疗废物分类与管理,从而降低医务人员职业暴露所带来的危害。Objective To understand status of occupational exposure of health care workers(HCWs),analyze the causes and risk factors,and provide basis for effective precaution measures.Methods Retrospective analysis was performed to investigate and analyze the occupational exposure occurred in a hospital from January 1,2013 to December 31,2016.Results A total of 632 cases of occupational exposure occurred in this hospital,62.02%(n=392 cases)occurred among nurses,61.23%(n=387 cases)occurred among HCWs who worked for less than 2 years.The top three occupational exposure opportunities were needle withdrawal after transfusion,centralized disposal of used sharp objects(including needles),and surgical suturing,accounting for 15.19%,14.71%,and 12.18%respectively.Among devices causing sharp injury,scalp steel needle accounted for the largest proportion(n=137,23.42%),the next was suture needle(n=96,16.41%).Hepatitis B virus was the major bloodborne pathogen causing occupational exposure,accounting for 58.86%,followed by unknown exposure sources(18.04%);general ward was the main location of occupational exposure(38.61%).Conclusion It is necessary to strengthen occupational safety precaution education,improve HCWs’ability of preventing occupational hazard,correct potentially dangerous operation,strengthen classification and management of medical waste,so as to reduce hazard to HCWs induced by occupational exposure.

关 键 词：医务人员 职业暴露 职业防护 血源性 调查 

分 类 号：R136[医药卫生—劳动卫生]