医务人员针刺伤预防策略的最佳证据总结

摘要

Objective To retrieve and analyze the available evidence on prevention of needlestick injuries among healthcare workers and summarize the best available evidence.Methods We searched the BMJ best practice,Uptodata,Cochrane Library(2014),Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,and complementally searched the PubMed,EM-base,CNKI and Centers for Disease Control to collect literatures including guideline,evidence summary,best practice information sheet,recommended practice and systematic review.Results Nine references were selected including a clinical decision support system,3 evidence summaries,2 recommended practices and 3 systematic review.Finally,7 items of best evidence were summarized,including:wearing double gloves,never recapping needles,using blunt-tip suture,using a neutral zone for passing sharp device,adopting the safety features of sharps,using sharp disposal containers,and continuous education for needlestick injuries.Conclusion Healthcare workers should regulate their behaviors of using sharp instruments during clinical practice and guarantee personal safety by consulting high level evidence.%目的 检索和分析医务人员预防针刺伤的相关证据,并对最佳证据进行总结.方法 首先通过计算机检索BMJ最佳临床实践(British Medical Journal best practice)、Uptodata,Cochrane Library (2014)、Joanna Briggs循证卫生保健国际合作中心图书馆、加拿大安大略注册护士协会、苏格兰学院间指南网、美国指南网等循证资源数据库;其次,补充检索了综合数据库:Pubmed(1966～ 2014)、荷兰医学文摘数据库(1989～2014)、中国知识资源总库和美国疾病预防控制中心网站中的所有证据,包括指南、证据总结、最佳实践信息册、推荐实践及系统评价.结果 共筛选证据9篇,包括:临床决策1篇、证据总结3篇、推荐实践2篇和系统评价3篇.最终总结了7条最佳证据,分别为:操作时戴双层手套、不回套针帽、使用钝针、通过中立区传递锐器、使用具有安全特征的锐器、使用锐器收集容器和对医务人员进行有关锐器伤的培训.结论 医务人员应该按照相关级别的循证医学证据,规范使用锐器的临床实践行为,保证个人安全.