中专临床实习护生锐器伤发生情况调查分析及对策

摘要

Objective To investigate medical sharp instrument injuries among the nursing trainees of two-year course training schools and come up with preventive strategies.Methods One hundred and twenty-one nursing trainees of Grade 2010 involved in the survey to investigate the medical sharp instrument injuries by a self-designed questionnaire.The questionnaire covered occurrence of sharp instrument injury,links for the sharp nursing students injuries,the time for sharp instrument injuries and the distribution of damage equipment.Results One hundred and five cases among the subjects were wound by medical sharp instruments,taking up 86.8%.During nursing operation,46.1%of them were injuried from dispensing medicine,18.1%of them from withdrawing the needle after transfusion.After nursing operation,7.3%were injuried from withdrawing the needles into the transfusion bag and 5.6%from recapturing the needle with both hand.The rate of sharp instrument injuries reached its highest(60.8%)3 months before starting nursing internship.The main sharp instruments included ampule(47.8%),scalp acupuncture(24.1%),and syringe needle(15.1%), Conclusions Sharp instrument injuries in nursing students during clinical internship frequently occurred.The high prevalence of glass ampoule injury is the largest for the reasons of inexperience in nursing operation and unprofessional operation. The schools should enhance education on preventive knowledge to improve their sense of protection and safety.The hospitals should strengthen the training and guidance by the clinical teachers in practice to correct improper operations to lower the incidence of sharp instrument injuries among nursing trainees.%　　目的 调查中专临床实习护生锐器伤发生情况，以便为预防及减少护生锐器伤提出针对性的对策。方法 采用自行设计调查问卷对2012届121名中专实习护生进行调查，了解护生实习期间发生锐器伤的情况以及护生锐器伤发生的环节、锐器伤发生时间段和伤害器具分布情况。结果 121名护生发生锐器伤105名，发生率为86.8%。在操作过程，配药发生锐器伤占46.1%，其次为注射后拔出针头/针芯，占18.1%；操作后，重新将针头插回输液袋发生锐器伤占7.3%，双手回套针帽和整理锐器时各占5.6%；护生锐器伤发生率最高时间段为实习前3个月，占60.8%；伤害器具主要为玻璃安瓿，占47.8%，其次为头皮针，占24.1%，注射器针头，占15.1%。结论 中专临床实习护生锐器伤发生普遍，配药时玻璃安瓿划伤发生率最高，操作不熟练和不规范是发生锐器伤的主要原因。学校应增加防护知识教育，提高护生的安全防护意识；医院应加强操作培训，并要求临床带教老师在实践中跟踪指导，反复纠正护生不正确的操作习惯，减少护生锐器伤的发生。