骨科护士职业暴露原因分析及应对措施  

Cause analysis and countermeasures of occupational exposure of orthopaedic nurses

作　　者：杨静怡 YangJingyi(Department of Hospital infection management,Tianjin Beichen hospital,Tianjin 300400,China)

机构地区：[1]天津市北辰医院,天津300400

出　　处：《首都食品与医药》2024年第6期93-95,共3页Capital Food Medicine

摘　　要：目的探讨骨科护士职业暴露原因及相关危险因素.方法采用天津市北辰医院感染管理科设计的锐器损伤登记表,对该院骨科2018年6月在编护理人员工作期间发生的医疗锐器损伤情况进行分析,探讨骨科护理人员锐器损伤等职业暴露发生率、暴露原因.同时根据入职时是否接受骨科护理人员职业暴露培训分为接受培训组(培训组)和未接受培训组(未培训组),分析比较两组职业暴露情况是否存在差异.结果骨科被调查护理人员共34人,收回31份有效问卷,有效问卷收回率为91.18%.31份有效调查中报告锐器损伤67例次,平均每位被调查护士发生(2.21±0.23)例次.锐器损伤原因分析提示,空针或输液穿刺针损伤22例次(32.8%),手术刀划伤11例次(16.4%),剪刀刺伤12例次(17.9%),骨科其他锐性器械损伤4例次(6.0%),其他18例次(26.9%).67例次锐器损伤中有9例次为传染性疾病暴露,其中HBV暴露8次,梅毒暴露1次.31份有效调查报告中11人未接受职业暴露培训(未培训组),20人接受培训(培训组).未培训组发生锐器致伤30例次,平均发生率为(2.7±1.3)例次/人;接受培训组发生锐器致伤37例次,平均发生率为(1.9±0.9)例次/人,培训组显著低于未培训组(P<0.05);培训组中骨科护士培训后到发生执业暴露的平均时间为(26.2±11.3)个月,而未培训组平均暴露时间为(18.7±8.6)个月,差异有统计学意义(HR=2.99,95%CI:2.07-4.33,P<0.05).结论骨科护士锐器致伤发生率较高,部分锐器致伤会导致相关传染性疾病职业暴露发生,职业培训有助于减少传染性疾病暴露风险.Objective To explore the causes of occupational exposure and related risk factors of orthopaedic nurses.Methods In June 2018,the incidence of injury and infection of nursing staff in the Department of orthopedics of Beichen hospital were analyzed by using the injury registration method of Ruichen hospital.At the same time,according to whether the orthopaedic nursing staff received occupational exposure training at the time of entry,they were divided into the trained group and the untrained group.Whether there were differences in occupational exposure between the two groups was analyzed and compared.Results There were 34 nursing staff in orthopedics department,and 31 valid questionnaires.The effective questionnaire rate was 91.18%.Among the 31 valid investigations,67 cases of sharp instrument injury were reported,with an average of(2.21±0.23)cases per investigated nurse.The analysis of the causes of sharp instrument injury showed that 22 cases(32.8%)were injured by empty needle or infusion puncture needle,11 cases(16.4%)were scratched by scalpel,12 cases(17.9%)were stabbed by scissors,4 cases(6.0%)were injured by other sharp instruments in orthopedics,and 18 cases(26.9%)were injured by other sharp instruments.Among the 67 times of sharp instrument injury,9 times were exposed to infectious diseases,including 8 times of HBV exposure and 1 time of syphilis exposure.Among the 31 valid survey reports,11 did not receive occupational exposure training(untrained group)and 20 received training(training group).In the untrained group,30 cases were injured by sharp instruments,with an average incidence of(2.7±1.3)cases/person;there were 37 cases of sharp instrument injury in the training group,with an average incidence of(1.9±0.9)cases/person,which was significantly lower in the training group than that in the untrained group(P<0.05);in the training group,the average time from training to practice exposure of orthopaedic nurses was(26.2±11.3)months,while the average time of exposure in the untrained group was(18.7±8.6)mo

关 键 词：护士 锐器损伤 职业暴露 骨科 

分 类 号：R135[医药卫生—劳动卫生]