首页|某三级甲等中医医院2014-2023年血源性职业暴露监测与防护策略研究

某三级甲等中医医院2014-2023年血源性职业暴露监测与防护策略研究

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目的 分析某三级甲等中医医院医务人员血源性职业暴露的流行病学特征、原因与处置情况,为降低暴露风险提供参考。方法 采用回顾性研究方法,收集2014年1月-2023年12月某中医医院血源性职业暴露上报资料,并进行描述性分析。结果 2014-2023年医务人员血源性职业暴露报告发生率为3。08%(527/17 098)。其中破损皮肤或黏膜暴露55例次,发生率为0。32%;锐器伤472例次,发生率为2。76%,两者比较差异有统计学意义(x2=335。125,P<0。001)。血源性职业暴露中主要为锐器伤(89。56%)、女性(83。49%)、工龄<5年(42。69%)、中级职称(67。93%)的医务人员。破损皮肤或黏膜暴露以医生为主(58。18%),锐器伤以护士为主(73。73%)。内科锐器伤暴露最高(42。80%),手术室破损皮肤或黏膜暴露最高(47。27%)。锐器伤发生环节主要为拔针(21。82%)、处置使用过的锐器物与随意放置锐器(20。34%)和注射、穿刺、针灸、封管或采血(19。49%)。71。73%的暴露来源明确,检出经血传播病原体前三位分别为乙型肝炎病毒(70。86%)、丙型肝炎病毒(11。92%)和梅毒螺旋体(9。27%),暴露后正确处置率为88。05%。结论 2014-2023年该中医医院血源性职业暴露以锐器伤为主,护士在拔针、处置使用过的锐器物等过程中发生较多,破损皮肤或黏膜暴露主要为医生在手术过程中患者血液喷溅至眼睛。
Monitoring and protection strategies for blood-borne occupational exposure in a tertiary traditional Chinese medicine hospital from 2014 to 2023
Objective To analyze the epidemiological characteristics,causes and disposal of blood-borne occupa-tional exposure of health care workers(HCWs)in a tertiary traditional Chinese medicine hospital,and provide ref-erence for reducing exposure risks.Methods Data on blood-borne occupational exposure reported by a traditional Chinese medicine hospital from January 2014 to December 2023 were collected retrospectively,and analyzed descrip-tively.Results The reported incidence of blood-borne occupational exposure among HCWs from 2014 to 2023 was 3.08%(527/17 098).Among them,55 cases had damaged skin or mucous membrane exposure,with an incidence of 0.32%;472 cases had sharp device injuries,with an incidence of 2.76%.Difference between the two was statis-tically significant(x2=335.125,P<0.001).The main characteristcs of blood-borne occupational exposures were sharp device injuries(89.56%),female(83.49%),HCWs with less than 5 years of service(42.69%)and inter-mediate professional titles(67.93%).Damaged skin or mucous membrane exposure mainly occurred in doctors(58.18%),while sharp device injury occurred mainly in nurses(73.73%).Department of internal medicine had the highest exposure to sharp device injuries(42.80%),and operating room had the highest damaged skin or mucous membranes exposure(47.27%).The main occurrence timing of sharp device injuries were needle pulling(21.82%),disposal of used sharp devices and randomly placed sharp devices(20.34%),as well as injection,puncture,acu-puncture,tube sealing or blood collection(19.49%).71.73%exposure sources were clear,and the top three detec-ted blood-borne pathogens were hepatitis B virus(70.86%),hepatitis C virus(11.92%),and Treponema pallidum(9.27%).The correct disposal rate after exposure was 88.05%.Conclusion From 2014 to 2023,blood-borne oc-cupational exposure in this traditional Chinese medicine hospital was mainly caused by sharp device injuries.Nurses experienced more incidents during needle pulling and sharp device handling.Damaged skin or mucous membrane ex-posure was mainly due to splashing patient's blood into the eyes of doctors during surgery.

occupational exposuresharp device injurydamaged skinmucosal exposureretrospective analysistraditional Chinese medicine hospital

杨文沁、韩琳、张强、李海涛、杨致霈、张志刚

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陕西中医药大学公共卫生学院,陕西 咸阳 712046

陕西中医药大学附属医院感染管理科,陕西 咸阳 712000

职业暴露 锐器伤 破损皮肤 黏膜暴露 回顾性分析 中医医院

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(12)