手术室医务人员职业暴露分析及干预措施的效果评价

摘要

Objective To analyze the characteristics of the operating room occupational exposure and its reason of the occurrence; to formulate the occupational exposure prevention and control interventions of operating room and have a evaluation the interventions.Methods Based on data from occupational exposure report of the hospital medical staff occupational exposure monitoring system from January 1,2009 to December 31, 2015, occupational exposure was summarized that happened six years in Operating Room, and analyze the characteristics of the operating room occupational exposure, as well as the causes, factors of occupational exposure, the effect of prevention and control interventions of occupational exposure.Results It was a comparison between occupational exposures occurred in the operating room and the total occupational exposure in the hospital that gender has differences(χ2=26.90,P<0.01). Males constitute ratio in the operating room is higher than that of hospital, but exposure type comparison showed that there was no significant difference between the operating room and the hospital(χ2=0.42,P>0.05). The mainly occupational exposure was sharps' injuries. Comparison showed that doctors proportions was significantly higher in operating room than hospital (χ2=46.81,P<0.01). In the operating room, the ratio of occupational exposure in nurses was higher than in doctors, and the same trend presented in the hospital as well. After interventions, the ratio decreased from the occupational exposure during 2009 and 2011 (before intervention) compared with the occupational exposure happening in 2012 to 2014 in operating room (after intervention) (χ2=11.02,P<0.01). After intervention, the exposure constituent rate in the time of 2012 to 2014 decreased as well comparing the rate during 2009 and 2011 (χ2=11.68,P<0.01).Conclusions Operating room is one of the main places of occupational exposure. In operating room, mainly occupational exposure was sharps' injuries and blood, body fluid exposure. The proportion of doctors is higher than nurses who occurs occupational exposure. To formulate intervention measures against operating room occupational exposure features, and supervise in real-time can reduce incidence of surgery-related personnel occupational exposure.%目的 分析手术室职业暴露的特点、发生职业暴露的原因,制订手术室职业暴露预防控制措施并对干预措施进行效果评价.方法 以2009年1月1日—2014年12月31日全院医务人员职业暴露监测系统职业暴露报告数据为基础,汇总6年间发生在手术室的职业暴露情况,分析手术室职业暴露的特点、发生职业暴露的原因,并对手术室职业暴露预防和控制干预措施进行效果评价.结果 发生在手术室的职业暴露和全院总的职业暴露情况比较,男女性别差异有统计学意义(χ2=26.90,P<0.01),手术室的男性构成比高于全院;暴露类型比较,手术室和全院差异无统计学意义(χ2=0.42,P>0.05),职业暴露类型均以锐器伤为主;职业构成比较,手术室比全院的医生构成比增高(χ2=46.81,P<0.01),在手术室职业暴露医生高于护士,而在全院的职业暴露护士构成比高于医生.实施干预措施后的2012—2014年比实施前的2009—2011年手术医务人员职业暴露发生率降低(χ2=11.02,P<0.01).实施干预措施后的2012—2014年比实施前的2009—2011年手术室职业暴露构成比也降低(χ2=11.68,P<0.01).结论 手术室是职业暴露的主要场所之一,手术室职业暴露以锐器伤和血液、体液暴露为主,手术室医生的职业暴露比例高于护士.针对手术室职业暴露特点制定干预措施并实时监督能有效降低手术医务人员职业暴露发生率.