211例医务人员锐器伤监测结果分析

摘要

目的 分析医务人员锐器伤发生情况,为持续改进锐器伤安全管理工作提出建议.方法 回顾性分析某院2006年8月—2015年7月上报的《锐器伤登记表》,分析统计相关资料.结果 共上报211例锐器伤,主要人群为护士(118例,55.92%)和医生(83例,39.34%);工龄主要为5年及以下者(117例,55.45%);发生地点主要为外科病房(67例,31.75%)、内科病房(65例,30.81%)及门急诊(33例,15.64%);致伤物主要为注射器针头(91例,43.13%)、缝合针(34例,16.11%)和头皮针/输液器针头(27例,12.80%);主要致伤操作为各种注射(40例,18.95%)、静脉输液(38例,18.00%)、手术缝合/剪断(36例,17.06%).主要致伤环节为操作中(治疗、检查、手术),共109例(51.66%).血源性病原体污染的器械中,HBV污染95例(76.61%),HCV污染25例(20.16%),HIV污染4例(3.23%).无血源性病原体感染病例发生.211例医务人员接种乙肝疫苗者155例(73.46%).结论 应重点针对工作时间≤5年的护士和医生,外科病房、内科病房及门急诊的医务人员,注射、静脉输液、缝合/剪断等操作时做好锐器伤防护工作.医院相关部门完善上报流程,加强追踪.%Objective To analyze the occurrence of sharp injuries among health care workers(HCWs),and put forward suggestions for safety management of sharp inj uries.Methods Recorded form of sharp inj uries reported in a hospital in August 2006-July 2015 were analyzed retrospectively,relevant data were analyzed statistically.Results A total of 211 sharp injuries occurred among HCWs were reported,sharp injuries mainly occurred among nurses(n=118,55.92%)and doctors(n=83,39.34%);117(55.45%)sharp injuries occurred in HCWS whose length of service was≤5 years;the main occurrence locations of sharp injuries were surgical ward(n=67,31.75%),internal medicine ward(n=65,30.81%),and outpatient as well as emergency departments(n=33,15.64%);the main de-vices causing sharp injuries were syringe needle(n=91,43.13%),suture needle(n=34,16.11%),and scalp nee-dle/transfusion needle(n=27,12.80%);the main injury-related manipulations were all types of injection(n=40, 18.95%),intravenous transfusion (n=38,18.00%),and surgical suturing/cutting (n=36,17.06%).The main opportunities of injuries was during manipulation(treatment,examination,operation,n=109,51.66%).Among bloodborne pathogens contaminated devices,contaminated by HBV,HCV,and HIV were 95 (76.61%),25 (20.16%),and 4 cases(3.23%)respectively.There was no bloodborne pathogen infection occurred.155(73.46%) of 211 HCWs were inoculated hepatitis B vaccine.Conclusion Prevention of sharp injuries should be focused on nurses and doctors who work for≤5 years,HCWs in surgical ward,internal medicine ward,and outpatient as well as emergency departments.Prevention of sharp inj uries during manipulations such as inj ection,intravenous transfu-sion,suturing/cutting should be intensified.Related hospital departments should improve the reporting process and intensify follow-up.