某三级儿童医院10年医务人员血源性职业暴露资料分析  

Ten-year blood-borne occupational exposure among health care workers in a tertiary children’s hospital

作　　者：梁静[1] 尹运冬[1] 孙一楠 李素芳[3] 文飞球[4] LIANG Jing;YIN Yun-dong;SUN Yi-nan;LI Su-fang;WEN Fei-qiu(Department of Preventive Healthcare,Shenzhen Children’s Hospital,Shenzhen 518026,China;Department of Healthcare-associated Infection Management,Shenzhen Children’s Hospital,Shenzhen 518026,China;Nursing Department,Shenzhen Children’s Hospital,Shenzhen 518026,China;Department of Hematological Oncology,Shenzhen Children’s Hospital,Shenzhen 518026,China)

机构地区：[1]深圳市儿童医院预防保健科,广东深圳518026 [2]深圳市儿童医院医院感染管理科,广东深圳518026 [3]深圳市儿童医院护理部,广东深圳518026 [4]深圳市儿童医院血液肿瘤科,广东深圳518026

出　　处：《中国感染控制杂志》2023年第11期1291-1297,共7页Chinese Journal of Infection Control

摘　　要：目的探讨儿科医务人员血源性职业暴露发生特点及相关影响因素,为其职业安全防护提供有效依据。方法采用回顾性调查方法对2013—2022年某三级甲等儿童医院上报的643例儿科医务人员血源性职业暴露事件进行分析,包括职业暴露基本情况、暴露部位、暴露环节、暴露原因、暴露后应急处理及随访情况。结果儿科医务人员职业暴露者以护士为主(86.00%),年龄≤25岁(64.39%)、工龄<5年(77.76%)发生职业暴露占比较高,职业暴露发生最多的科室为急诊科(27.53%),职业暴露全年发生高峰集中在6—8月。通过计划-实施-检查-处理(PDCA)循环法改进血源性职业暴露防护措施的实施,2013—2022年该院血源性职业暴露发生率整体呈逐年下降趋势(χ2=195.79,P<0.001)。暴露方式以锐器伤为主(89.89%),暴露部位以手部为主(91.44%)。暴露环节/操作居前三位的分别是整理或清洗物品/器械(38.41%)、采血(16.95%)、拔针(14.15%)。儿童专科医院职业暴露源以无血源性传播病原体为主(71.38%),操作时因他人意外误伤占一定比率(18.66%)。结论儿科医务人员职业暴露影响因素复杂,应根据其暴露特点进行根因分析,加强对重点人群、重点部位和重点季节的关注,并采取针对性防控措施,预防血源性职业暴露的发生。Objective To evaluate the characteristics and related influencing factors of blood-borne occupational exposure among pediatric health care workers(HCWs),so as to provide effective references for their occupational safety protection.Methods 643 cases of blood-borne occupational exposure among pediatric HCWs in a tertiary first-class children’s hospital from 2013 to 2022 were analyzed retrospectively,including basic information of occupational exposure,exposure sites,exposure occasions,exposure causes,post-exposure emergency treatments and follow-up.Results Nurses were the main occupational exposure group of pediatric HCWs(86.00%),with a relatively high proportion of occupational exposure among those aged≤25 years(64.39%)and those with less than 5 years of service experience(77.76%).The department with the highest incidence of occupational exposure was the emergency department(27.53%),and the peak of occupational exposure throughout the year was from June to August.Through the implementation of the plan-do-check-act(PDCA)cycle projects to improve the implementation of protective measures for blood-borne occupational exposure,the overall incidence of blood-borne occupational exposure in this hospital from 2013 to 2022 showed a decreasing trend year by year(χ2=195.79,P<0.001).The major type of exposure was sharp instrument injuries(89.89%).Hands were the most exposed sites(91.44%).The top three exposure occasions/operations were sorting/cleaning items/instruments(38.41%),blood collection(16.95%)and needle extraction(14.15%).The main sources of occupational exposure in children’s hospital were non-blood-borne pathogens(71.38%),with a certain proportion of accidental injuries by others during operations(18.66%).Conclusion The influencing factors of occupational exposure for pediatric HCWs are complex.Causes should be analyzed based on their exposure characteristics.Attention should be paid to key populations,key sites and key seasons,and targeted prevention and control measures should be taken to prevent the occ

关 键 词：血源性病原体 职业暴露 锐器伤 儿科 医务人员 

分 类 号：R197.323.4[医药卫生—卫生事业管理]