医务人员职业暴露调查分析与预防

目的 了解医务人员职业暴露现况,探讨防范对策.方法 利用北京市医院感染管理质量控制和改进中心“医院感染监控管理系统”开展监测,并对数据进行分析.结果 2005年8月-2011年2月共监测到86名医务人员职业暴露情况,暴露种类以锐器伤为主,占93.02％;血源性暴露源占55.81％;职业分布以护士为主,占60.47％;科室分布外科占29.07％,内科占26.74％;工作年限短的医务人员职业暴露发生率高,占55.81％;伤害发生的地点以病房、手术室居多,分别占48.84％、23.25％;导致伤害的暴露物种类以注射器针头、头皮针居多,分别占27.91％、23.25％;职业暴露的操作环节最多为锐器物用后处置,占25.58％,其次为拔针时,占24.42％.结论 护理人员和低年资医务人员是职业暴露高危人群,应加强对其培训教育,加强对重点部门的管理,建立健全职业暴露规范化管理体系,以降低职业暴露危害.

Prevention of occupational exposure to medical staff

OBJECTIVE To understand the current status of occupational exposure to medical staff,and explore the countermeasures.METHODS The surveillance was carried out by using monitoring and control system of nosocomial infections of Beijing center for quality control and improvement of nosocomial infections,and the data were statistically analyzed.RESULTS From Aug.2005 to Feb.2011,a total of 86 cases of occupational exposures were monitored.The sharp injuries were the major exposure,accounting for 93.02%;blood-borne exposure source accounted for 55.81%;the exposure mostly distributed in the nurse,accounting for 60.47%;the distribution of the exposure in departments were as the following: department of surgery 29.07%,department of medicine 26.74%;the incidence of the occupational exposure to medical personnels with low seniority was 55.81%;the exposure most frequently occurred in the wards and operating rooms,accounting for 48.84% and 23.25%,respectively;the syringe needles and scalp acupuncture were the exposure sources,accounting for 27.91% and 23.25%,respectively;the disposal of the used sharp instruments was the most frequent cause of occupational exposure,accounting for 25.58%,followed by pulling of the needles(24.42%).CONCLUSION Nursing staff and medical personnel with low seniority are the groups at high-risk of occupational exposure;it is necessary to strengthen the training and the management in key departments,establish and make the standardized management system for occupational exposure so as to reduce the hazards of occupational exposures.