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[目的]了解综合医院医护人员职业感染及管理对策。[方法]采用多阶段分层随机抽样的方法,以湖北省8家综合医院医护人员为调查对象,对797名医护人员的职业感染现状进行现场调查。[结果]医护人员职业感染率为33.25%,以上呼吸道感染、结核、甲肝和乙肝为主;工作中被锐器损伤581人,占72.90%,其中483人曾被污染的锐器刺伤;被锐器刺伤的原因排序为单独操作、配合时、病人躁动和被其他操作者刺伤;手术科室与非手术科室之间(χ2=48.3969,P<0.01),内、外、妇、儿科室之间(χ2=64.0316,P<0.01),医生与护士之间(χ2=10.9625,P=0.0009)锐器刺伤情况存在差异;65.37%医护人员主观认为发生职业损伤的两大主要原因是医护人员自身疏于防范和病人不配合;此外,发生职业暴露后的心理状态亦有不同。[结论]锐器损伤是医护人员常见的职业性损伤;不同职业、科室医护人员锐器损伤存在差异;职业损伤在不同性别、职业和职称的医护人员间存在差异;医护人员自我防护意识淡薄,甚至一些医护人员在工作中未采取防护措施。医院应加强管理,最大限度地减少锐器伤发生,并加大医务人员职业感染防护知识培训。
[Objective] To understand occupational infection and management strategies of medical staff in general hospitals. [Methods] The multi-stage stratified random sampling method was used to investigate the current status of occupational infection in 797 medical staffs from 8 general hospitals in Hubei province. [Results] The occupational infection rate of medical staff was 33.25%, mainly respiratory tract infection, tuberculosis, hepatitis A and hepatitis B; 581 people were injured by sharpening, accounting for 72.90%, of whom 483 were stabbed by contaminated sharps; The causes of stab wounds were classified as separate operation, with the patients being agitated and punctured by other operators; the surgical departments and non-surgical departments (χ2 = 48.3969, P <0.01); the internal and external departments of gynecology and pediatrics (Χ2 = 64.0316, P <0.01), there was a difference in the stab wound between doctors and nurses (χ2 = 10.9625, P = 0.0009); 65.37% of the two main reasons that the medical staffs considered the occupational injury subjectively were the medical care Personnel themselves neglect to prevent and patients do not match; In addition, the psychological state after occupational exposure are also different. [Conclusion] Sharps injury is a common occupational injury of medical staff. There are differences in sharps injuries among medical staff in different occupations and departments. Occupational injury is different among medical staff of different sex, occupational and professional titles. The awareness of self-protection of medical staff is weak, Even some health care workers did not take protective measures in their work. The hospital should strengthen management, minimize the occurrence of sharp injuries, and increase medical knowledge of occupational infection prevention training.