外科系统职业暴露原因Logistic回归分析及处理对策  

Logistic regression analysis and management strategies for occupational exposure in the surgical system

作　　者：刘晓 Liu Xiao(Department of Preventive Health,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11期96-99,共4页Capital Food Medicine

摘　　要：目的探讨外科系统护理人员发生锐利器械致伤及职业暴露的危险关因素。方法采用横断面研究,选取天津市北辰医院2023年10月在职的外科系统护理人员为研究对象,采用“锐利器械损伤及职业暴露调查表”对132位外科系统护理人员进行问卷调查,以明确在过去的1年中是否发生锐器损伤。依据是否发生锐利器械损伤分为损伤组和无损伤组。采用Logistic回归分析方法探讨锐器致伤原因及独立相关危险因素。结果共调查132人,其中121份问卷符合要求,符合率为91.7%。121例符合要求的问卷中共发生锐器损伤59人(损伤组),未发生损伤62人(无损伤组)。损伤组59例共报告锐器致伤78例次,平均每位被调查护理人员发生1.3例次;导致损伤的因素分别为输液或采血穿刺针刺伤22例次(28.2%),碎裂玻璃药瓶割伤8例次(10.3%),锐利医疗废弃物投放时损伤9例次(11.5%),术中缝针刺伤15例次(19.2%),术中手术刀划伤6例次(7.7%),剪刀刺伤5例次(6.4%),其他手术器械损伤8例次(10.3%),其他5例次(6.4%)。多因素Logistic回归分析显示,工作时间小于2年(OR=2.27,95%CI:1.72-7.11)、工作岗位为器械护士(OR=2.06,95%CI:1.50-8.35)和未进行职业暴露学习(OR=2.61,95%CI:1.98-9.62)是发生锐器损伤的独立危险因素(P<0.05)。78例次损伤中已知或潜在的传染性疾病职业暴露16例次,占比为20.5%。其中乙肝职业暴露14例次(87.5%),梅毒职业暴露2例次(12.5%)。121例被调查者中有64人未接受过职业暴露防护学习,发生锐器致伤42例次,平均发生率为(0.71±0.32)例次/人,57例接受过职业暴露学习护理人员发生锐器致伤17例次,平均发生率为(0.30±0.21)例次/人,接受过职业暴露学习的护理人员锐器致伤发生率显著低于未学习过的护理人员(P<0.05)。16例次传染性疾病暴露中7例次(43.8%)上报医院质量控制部门备案,并获得相应处理,包括抗感染干预、注射免疫球蛋白等,其�Objective To analyze and explore the risk factors for sharp instrument injuries and occupational exposure among nursing staff in the surgical system.Method Adopted a cross-sectional study,selecting surgical system nursing staff who were employed in Beichen Hospital in Tianjin in October 2023 as the research subjects.A questionnaire survey was conducted on 132 surgical system nursing staff using the"Sharp Air Injury and Occupational Exposure Survey Form"to investigate whether they had experienced sharp instrument injuries in the past year.Divide into injury group and non-injury group based on whether sharp instrument damage has occurred.Using logistic regression analysis to explore the causes of sharp instrument injuries and independent related risk factors.Results A total of 132 people were surveyed,and 121 questionnaires during the period met the requirements,with a compliance rate of 91.7%.Among the 121 questionnaires that met the requirements,a total of 59 people(injury group)had sharp instrument injuries,while 62 people(no injury group)did not have injuries.A total of 59 cases in the injury group reported 78 incidents of sharp instrument injuries,with an average of 1.3 incidents per surveyed caregiver;the factors leading to injuries were 22 cases(28.2%)of puncture wounds caused by infusion or blood collection needles,8 cases(10.3%)of incisions caused by broken glass bottles,9 cases(11.5%)of injuries caused by sharp medical waste disposal,15 cases(19.2%)of intraoperative suture needle injuries,6 cases(7.7%)of intraoperative surgical knife injuries,5 cases(6.4%)of scissors injuries,8 cases(10.3%)of injuries caused by other surgical instruments,and 5 cases(6.4%)of injuries caused by surgical knives.Multivariate Logistic regression analysis showed that working for less than 2 years(OR=2.27,95%CI:1.72-7.11),working as an instrument nurse(OR=2.06,95%CI:1.50-8.35),and not having undergone occupational exposure learning(OR=2.61,95%CI:1.98-9.62)were independent risk factors for sharp instrument injury(P<0.05).Out of 7

关 键 词：护理人员 锐器损伤 职业暴露 危险因素 

分 类 号：R197.323[医药卫生—卫生事业管理]