摘要
目的分析医务人员发生血源性职业暴露的风险,制订有效的干预对策。方法回顾某三甲医院2016年1月至2017年12月发生的131例医务人员血源性职业暴露,分析高危人群、发生环节、暴露源种类、穿戴防护用品、应急处理等风险因素。结果131例医务人员血源性职业暴露中,护士发生率最高,占59.54%;其次是医生,占32.82%。护士、护师、住院医生和实习的护生、医学生是发生血源性职业暴露的高危人群,构成比分别是28.24%、16.03%、11.45%、13.74%、16.03%。职业暴露以锐器伤为主,占74.04%,发生锐器伤风险最高的环节是他人之意外扎伤,占19.85%,其次是整理废弃物,占17.56%。暴露源种类分布中,HIV和混合病原体检出率较高,分别占12.98%、7.63%。发生暴露时,医务人员防护用品的使用率低:锐器伤使用率为51.55%,非锐器伤使用率为23.53%。暴露后部分医务人员应急处理不规范,实习学生占53.33%,本院护士和护师占40.00%。结论做好医护人员及学生职业防护教育培训工作,规范操作规程,风险环节的管控,落实标准预防,可以降低医务人员血源性职业暴露的风险。
Objective To analyze the risk factors of bloodborne occupational exposure of medical staff and formulate effective intervention strategies.Methods Data of 131 medical staff suffering from bloodborne occupational exposure from January 2016 to December 2017 were retrospectively studied.Exposure population,occurrence process,exposure source,personal protective equipment,and emergency management were analyzed.Results Among the 131 medical staffs with occupational exposure,nurses had the highest incidence,which accounting for 59.54%,which followed by doctors accounting for 32.82%.Nurses,primary nurse,resident physician,internships,and medical students were high-risk groups with bloodborne occupational exposure,accounting for 28.24%,16.03%,11.45%,13.74%,and 16.03%,respectively.Occupational exposure was dominated by sharp instrument injuries,accounting for 74.04%,of which the highest risk is accidental puncture accounting for 19.85%,followed by disposal of waste accounting for 17.56%.Among the types of exposure sources,the detection rates of HIV and mixed pathogens were relatively high,accounting for 12.98%and 7.63%,respectively.When exposure occurs,the utilization rate of personal protective equipment for medical personnel was low:51.55%in sharp injuries,and 23.53%in non-sharp injuries.After exposure,the emergency management of some medical staffs was not standardized,among whom the internship students accounting for 53.33%,the nurses and primary nurses accouning for 40.00%.Conclusion By strengthening the trainingof occupational protection,standardizing operating procedures,managing the risk control,and implementing standard prevention,the risk of bloodborne occupational exposure can be reduced among medical staffs.
作者
张为华
袁喆
袁巧
ZHANG Weihua;YUAN Zhe;YUAN Qiao(Department of Hospital-Acquired Infection Control,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
CAS
2020年第7期1164-1166,1171,共4页
Chongqing medicine
关键词
职业暴露
风险因素
干预对策
occupational exposure
riskfactors
intervention measures
