2018-2023年山东省某医院不同岗位医务人员锐器伤职业暴露状况
Occupational exposure to sharps injuries among medical personnel in different positions at a hospital in Shandong province, China, 2018-2023
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摘要:目的 剖析某三级医院不同岗位医务人员锐器伤职业暴露状况。方法 回顾性收集某综合医院2018-2023年上报的所有锐器伤案例, 分析锐器伤的基本特征、涉及器械、暴露后的应急处理及随访情况, 并分类探讨不同岗位医务人员的锐器伤特征。结果 六年累计发生锐器伤340例, 实习人员发生率最高(2.70例/100 FTE·年), 后勤人员最低(1.05例/100 FTE·年)。6月为高发月份, 平均7.33例; 高发环节包括器械操作中、将器械放入锐器收集器和从橡皮或其他阻体中拔出针头, 占76.47%。护士锐器伤多发生于普通病房, 与头皮针相关; 医生集中于手术室, 多由手术器械引起; 实习人员以采血针为主; 药师与医技人员与安瓿操作相关, 后勤人员多来自废物处理环节的空心针和玻璃碎片。护士和医生为主要受伤人群, 分别高发于女性(25~ < 35岁)和男性(工龄 < 5年), 暴露源以乙型肝炎病毒(HBV)感染为主。暴露后处理以标准化应急处理为主, 但后勤人员的非标准化处理比例较高。随访报告显示, 实习人员和后勤人员提交率较低, 且培训覆盖率偏低。结论 不同岗位医务人员锐器伤特点存在显著差异, 应关注岗位特异性高风险环节及器械, 加强针对性培训和职业健康管理, 有效预防职业暴露。Abstract:OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different positions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics, high-risk links, involved instruments, post-exposure emergency treatment and follow-up situations were analyzed, while sharps injury characteristics of medical staff in different positions were classified and discussed.RESULTS Over six years, 340 sharps injuries occurred with the highest incidence among interns (2.70 cases/100 FTE·year) and the lowest among logistics staff (1.05 cases/100 FTE·year).Jun.was the month with the highest incidence, averaging 7.33 cases.High-risk links included instruments handling, placing instruments into sharp containers and removing needles from rubber or other barriers, accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles; doctors mostly occurred in operating rooms and were due to surgical instruments; interns were primarily injured by blood collection needles; pharmacists and medical technicians were related to ampoule handling; while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups, with a higher incidence among females (25- < 35 years) and males (less than five years of work experience).The exposure source was mainly hepatitis B virus (HBV) infection.Post-exposure treatment was primarily standardized emergency treatment, but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury characteristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.
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