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[目的]了解医务人员的职业环境、职业伤害与感染的发生情况,为医疗卫生事业改革与发展提供参考。[方法]2011年3至5月期间,以自行设计的调查问卷为工具,采用分层随机抽样方法,在上海市18个区(县)抽取13家不同类别和等级医院的医务人员。[结果]共调查442例对象;护士占40.5%,三级医院医务人员占50.7%。个人防护用品的总使用率为86.5%。受到被血污染的锐器刺伤后,59.7%的调查对象对血液来源进行追踪和检测,乙型肝炎病毒的检测阳性率最高(36.2%)。发生伤害最多的岗位是护士(50.8%),三级医院医务人员职业伤害发生率最高(45.1%)。受到伤害后仅有47.3%的医务人员立即报告。[结论]医务人员不安全医疗行为普遍存在,且自我保护能力和意识不强,尤其是三级医院的护士。应采取有效措施降低医务人员的职业感染与伤害发生率。
[Objective] To understand the occupational environment, occupational injuries and infection of medical staff and provide reference for the reform and development of medical and health undertaking. [Methods] From March to May 2011, self-designed questionnaires were used as tools, and stratified random sampling method was used to select medical staff from 13 hospitals of different categories and ranks in 18 districts and counties in Shanghai. [Results] A total of 442 subjects were investigated; nurses accounted for 40.5%, tertiary hospital medical staff accounted for 50.7%. The total use of personal protective equipment was 86.5%. After being stabbed by blood-stained sharp objects, 59.7% of the respondents traced and tested the blood source, and the positive rate of hepatitis B virus was the highest (36.2%). The jobs with the most injuries were nurses (50.8%), and the occupational injuries among medical staff in tertiary hospitals were the highest (45.1%). Only 47.3% of medical staff received immediate reports of injuries. [Conclusion] The unsafe medical behaviors of medical staff are ubiquitous, and the self-protection ability and consciousness are not strong, especially the nurses in tertiary hospitals. Effective measures should be taken to reduce the incidence of occupational infections and injuries among medical staff.