手术室医护人员血源性职业暴露特征分析

doi:10.12183/j.scjpm.2022.0347

摘要/Abstract

摘要： 目的分析手术室医护人员血源性职业暴露特征,为预防医护人员血源性职业暴露提供科学依据。方法分析来源于医院院感中心质管部的2015—2019年手术室医护人员血源性职业暴露资料,采用回顾性分析方法对发生血源性暴露的手术室医护人员特征进行分析。结果 2015—2019年北京市某医院共报告手术室血源性职业暴露的医护人员126例,各年依次为32、28、29、23、14例,发生血源性职业暴露的手术室医护人员例数逐年减少。发生血源性职业暴露的手术室医护人员以女性为主,占66.67%。年龄20~53岁,以20~39岁为主,占57.94%。以医师为主,占70.63%。大专学历的医护人员所占比例最大,为43.65%,只有32.54%的医护人员有参加过血源性传播疾病职业暴露培训,病原体以乙肝病毒为主,占53.97%,其次为丙肝病毒,占31.75%,苍白密螺旋体占5.56%。暴露发生环节以术中缝合、传递手术器械以及协助操作为主,共占总暴露病例的71.43%。结论北京市某医院手术室血源性职业暴露发生情况逐年减少,但仍有发生,院感防控任务仍较重,标准预防需要加强,需健全手术室安全教育培训,增强预防职业暴露能力,以降低手术室医护人员职业暴露风险。

关键词: 医护人员, 血液传播疾病, 血源性病原体, 职业暴露, 医院感染, 职业防护

中图分类号:

R187

陈晓敏, 王菲. 手术室医护人员血源性职业暴露特征分析[J]. 华南预防医学, 2022, 48(3): 347-350.

参考文献

[1] 王斌华,李琳,刘娟,等.血源性病原体职业暴露特点及防控费用研究[J].中国感染控制杂志,2018,17(11):979-982.
[2] 陈建伟,孙吉花,支红敏,等.应用失效模式与效应分析防范手术中血源性职业暴露[J].中国感染控制杂志,2019,18(8):776-782.
[3] 徐敏,熊薇,赖晓全,等.PDCA降低医务人员血源性职业暴露发生率的效果研究[J].中华医院感染学杂志,2018,28(18):2861-2864.
[4] 医院感染预防与控制评价规范WS/T 592—2018[J].中国感染控制杂志,2018,17(8):746-752.
[5] Sahiledengle B, Tekalegn Y, Woldeyohannes D, et al.Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: A systematic review and meta-analysis[J]. Environ Health Prev Med,2020,25(1):58.
[6] Abere G, Yenealem DG, Wami SD.Occupational exposure to blood and body fluids among health care workers in Gondar Town, Northwest Ethiopia: A result from cross-sectional study[J]. J Environ Public Health,2020,2020:3640247.
[7] 程文琴,武涧松,李婧,等.医务人员血源性职业暴露相关因素调查分析[J].中华医院感染学杂志,2018,28(18):2865-2867.
[8] 邱燕燕,陈少华,陈小翠.医务人员HIV职业暴露后的应对方式与心理体验[J].中国艾滋病性病,2019,25(12):1265-1269,1279.
[9] 黄伟丽,李奇峰,秦文,等.医务人员锐器伤发生相关因素分析及防护对策[J].中华医院感染学杂志,2018,28(18):2872-2875.
[10] 陈建伟,孙吉花,支红敏,等.手术人员血源性职业暴露现状调查[J].中国职业医学,2018,45(2):256-258,261.
[11] Ngwa CH, Ngoh EA, Cumber SN.Assessment of the knowledge, attitude and practice of health care workers in Fako Division on post exposure prophylaxis to blood borne viruses:A hospital based cross-sectional study[J]. Pan Afr Med J,2018,31:108.
[12] Rapisarda V, Loreto C, Vitale E, et al.Incidence of sharp and needle-stick injuries and mucocutaneous blood exposure among healthcare workers[J]. Future Microbiol,2019,14:27-31.
[13] Lin H, Wang X, Luo X, et al.A management program for preventing occupational blood-borne infectious exposure among operating room nurses: An application of the PRECEDE-PROCEED model[J]. J Int Med Res,2020,48(1):300060519895670.
[14] Ahmed AM, Kabbash IA, Hassan NM, et al.Assessing of policies and practices for occupational exposure to blood-borne viral infections in Tanta University Hospitals, Egypt[J]. Environ Sci Pollut Res Int,2018,25(31):30747-30754.
[15] Hebo HJ, Gemeda DH, Abdusemed KA.Hepatitis B and C viral infection:Prevalence, knowledge, attitude, practice, and occupational exposure among healthcare workers of Jimma university medical center, Southwest Ethiopia[J]. Scientific World J,2019,2019:9482607.
[16] Kane P, Marley R, Daney B, et al.Safety and communication in the operating room: A Safety questionnaire after the implementation of a blood-borne pathogen exposure checkpoint in the surgical safety checklist preprocedure time-Out[J]. Jt Comm J Qual Patient Saf,2019,45(10):662-668.
[17] 孙晓玲,徐桂强,刘均凤,等.医务人员血源性职业暴露调查及其对策[J].中国感染控制杂志,2018,17(5):440-443.
[18] 杨金燕,杨育卉,施施,等.某综合医院医务人员血源性职业暴露流行病学特点研究[J].中华医院感染学杂志,2018,28(5):780-782.
[19] 周国清,尹丹萍,何多多,等.临床针刺伤的相关因素及防治措施[J].中华医院感染学杂志,2018,28(4):628-630.
[20] 张鸿,陈炜,刘玉馥,等.某综合医院684例医务人员职业暴露案例的回顾分析[J].第三军医大学学报,2018,40(3):264-269.
[21] Jahic R, Piljic D, Porobic-Jahic H, et al.Epidemiological characteristics of the accidental exposures to blood-borne pathogens among workers in the hospital[J]. Med Arch,2018,72(3):187-191.