某大型三甲医院手术室工作人员血源性职业暴露及其防护认知现状调查  

Investigation on occupational blood-borne exposure and protection awareness of personnel in operating room of a large tertiary hospital

作　　者：张姗 嵇晴 王鲁娜 张恒东[1,4] ZHANG Shan;JI Qing;WANG Luna;ZHANG Hengdong(School of Public Health of Nanjing Medical University,Nanjing,Jiangsu 211166,China;General Hospital of the PLA Eastern Theater Command,Nanjing,Jiangsu 210002,China;School of Public Health of Suzhou University,Suzhou,Jiangsu 215123,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210028,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]中国人民解放军东部战区总医院,江苏南京210002 [3]苏州大学公共卫生学院,江苏苏州215123 [4]江苏省疾病预防控制中心,江苏南京210028

出　　处：《职业卫生与应急救援》2021年第2期192-196,共5页Occupational Health and Emergency Rescue

基　　金：江苏省自然科学基金(BK20181488);江苏省临床医学科技专项(BL2014082)。

摘　　要：目的了解某三甲医院手术室工作人员血源性职业暴露及其防护认知情况。方法选取南京市某大型三甲医院手术室的工作人员为研究对象,采用发放问卷和现场访谈相结合的方法,了解不同岗位工作人员血源性职业暴露及其防护认知的情况。结果参与调查的295名手术室工作人员中有139人在过去1年发生过血源性职业暴露,暴露发生率为47.12%;其中锐器伤有105人(占52.88%),皮肤黏膜暴露有66人(占22.37%),两者均发生过的有32人(占10.85%)。暴露后上报率为12.23%(17/139),未上报的主要原因是感觉没有必要62人(占50.82%)和不了解上报流程28人(占22.95%)。锐器伤发生率较高的岗位是麻醉护士和卫生员,麻醉后监测治疗室护士发生率最低,以上差异有统计学意义(P<0.05)。对上报流程不了解的人员中卫生员占比最高,手术室护士最低,差异有统计学意义(P<0.05)。暴露人员认为发生血源性职业暴露的主要原因是防不胜防和工作节奏快。不同岗位工作人员的职业防护知识培训率和暴露后处理流程知晓率差异均有统计学意义(P<0.05),不同岗位工作人员锐器伤发生率、皮肤黏膜暴露率与职业防护培训率、暴露后处理流程知晓率之间均存在显著的负相关关系(r=-0.827~-0.529,P均<0.01)。结论该三甲医院手术室血源性职业暴露发生率较高,上报率较低,卫生员职业防护认知能力较医护人员低。医院须针对不同岗位工作人员,在职业防护方面建立正规有效的分层培训制度,全面提升手术室工作人员职业防护技能。Objective To investigate the occupational blood-borne exposure and protection awareness of professionals in the operating room of a tertiary hospital.Methods The medical staff in the operating room of a large-scale tertiary hospital in Nanjing were surveyed with questionnaires(medical staff)or on-site interview(cleaners)on occupational blood-borne exposure and protection awareness.Results Among 295 surveyed staff in operating room,139(47.12%)had blood-borne exposures in the past year,of whom 105(52.88%)were injured by sharps,66(22.37%)were exposed to skin and/or mucous membranes,and 32(10.85%)had both sharp injury and skin and/or mucous membrane exposure.The post-exposure reporting rate was 12.23%(17/139).The major reasons for not reporting were self-conscious unnecessity(62 cases,50.82%)and not-knowing the reporting procedure(28 cases,22.95%).Both the nurses in operating room and the cleaners had the highest incidence of sharp injury,while the nurses in the post-anesthesia monitoring and treatment room had the lowest incidence(P<0.05).Among those who did not understand the reporting process,the proportion of cleaners was the highest,while that of nurses in operating room was the lowest,and the difference was statistically significant(P<0.05).The most of exposed personnel thought that the main reasons for blood-borne exposure were unpredictable and due to the fast-paced task.The differences of the protection-related training and knowing the post-exposure treatment process among these personnel with different job-types were statistically significant(P<0.05).There was a significant negative correlation between the proportion of awareness rate of post-exposure treatment processes(or proportion of protection-related training)and the incidence of sharp injuries(or the occurence of skin and/or mucosal exposure)in different jobtypes(r=-0.827--0.529,P<0.01).Conclusions The overall incidence of blood-borne exposure of medical staff in the operating room of the tertiary hospital was relatively high,and the reporting rate w

关 键 词：手术室 血源性职业暴露 防护认知 医务人员 

分 类 号：R136.2[医药卫生—劳动卫生]