某院医务人员血源性职业暴露调查与防控探讨
Occupational exposures to blood-borne pathogens and its prevention and control in a tertiary specialized hospital
邱月秀 1周明霞 1蔡磊 1黄红玉1
作者信息
- 1. 214062 江苏无锡市,无锡市第九人民医院感染管理科
- 折叠
摘要
目的 了解某院医务人员血源性职业暴露发生现状,分析其发生原因及特点,探讨减少职业暴露的有效措施.方法 回顾性分析某三级甲等专科医院 2019 年 1 月 1 日至 2022 年 12 月 31 日医务人员上报的血源性职业暴露资料,分析其发生的原因、暴露源、发生场所及随访情况等.结果 共发生 114 例血源性职业暴露,2022 年实施干预后血源性职业暴露例次率为 1.45%,低于干预前 2019 年—2021 年的平均值 3.72%,差异有统计学意义(P<0.05).发生血源性职业暴露的工作岗位主要为医师(42.98%),其次为护士(36.84%),男性为主(53.51%),以工龄＜5 年员工最多(62.28%),发生地点以手术室(57.90%)和病区(33.33%)为主.暴露方式主要为针刺或锐器割伤(86.84%).暴露发生环节主要为术中操作(39.47%).引起针刺或锐器割伤的器具主要为手术缝合针及刀片(50.51%).暴露源病原体主要为乙型肝炎病毒(59.41%).乙肝表面抗体阴性或抗体滴度低于 10 mIU/mL的医务人员占 17.54%.所有医务人员经随访无暴露后感染发生.结论 加强教育培训,规范操作规程,可以有效降低医务人员血源性职业暴露发生率.医务人员应加强乙肝免疫接种.发生血源性职业暴露后应规范暴露后处置流程,避免发生感染.
Abstract
Objective To investigate the prevalence,causes,and features of occupational exposures to blood-borne pathogens(BBPs)among medical staff,and develop countermeasures to reduce the occupational exposures.Methods We retrospectively collected the occupational exposure data reported by medical staff in a tertiary specialized hospital from January 1,2019 to December 31,2022 and analyzed the causes,sources,and locations of these exposure events and the follow-up data.Results A total of 114 BBP exposures were recorded.The frequency of exposures was 1.45%in 2022(after interventions),significantly lower than the average value(3.72%)during the period from 2019 to 2021(P<0.05).Doctors were most likely to be exposed(42.98%),followed by nurses(36.84%).Males(53.51%)and staff with a service length of<5 years(62.28%)were at higher risk.The operating room(57.90%)and wards(33.33%)were two leading locations for BBP exposures.Needle-stick and sharp instrument injuries were the main causes(86.84%).The exposures occurred mainly during surgeries(39.47%),and the injury was mainly caused by a suture needle or a surgical blade(50.51%).The vast majority of BBPs was hepatitis B virus(59.41%).A low proportion(17.54%)of medical staff had a negative or<10 mIU/mL hepatitis B surface antibody level.No post-exposure infection was noted.Conclusions Intensified education and training and standardized operating procedures are effective in reducing occupational exposures to BBPs.Hepatitis B vaccination should be promoted among medical staff.Occupational exposures to BBPs should be properly managed to avoid post-exposure infections.
关键词
血源性职业暴露/病原体/感染追踪/医务人员/防控措施Key words
Occupational exposure to blood-borne pathogens/Pathogen/Infection tracking/Medical staff/Prevention and control引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据