摘要
目的分析医务人员血源性职业暴露的特征,为完善职业防护措施提供科学依据。方法采用回顾性调查方法,对某三甲综合性教学医院2018年1月至2023年12月上报的血源性职业暴露数据进行分析。结果2018—2023年该院医务人员共报告血源性职业暴露330例,发生率在1.63%~2.06%之间,年均发生率为1.91%,职业暴露全年发生高峰集中在7~9月。发生血源性职业暴露的医务人员以女性为主(66.97%),年龄主要分布在≤25岁(59.70%),工作年限≤1年(74.24%),职业类别以实习进修和规培人员为主(60.91%);发生科室以内科(37.88%)和外科(35.76%)为主,暴露方式以锐器伤为主(90.30%),暴露部位以手部为主(90.00%),暴露源以乙型肝炎病毒(56.36%)为主,其次为梅毒螺旋体(16.36%);暴露环节居前三位的依次为拔针(23.94%)、处理锐器(18.18%)、手术(10.91%),暴露发生场所主要在病房内(55.76%)和手术室(26.97%);暴露原因居前三位的依次是个人操作不慎(64.55%)、违规操作导致(13.64%)、意外或紧急情况(12.12%)。不同职业类别医务人员暴露方式、暴露环节、暴露场所和暴露源间比较,差异有统计学意义(P<0.05)。结论医院应结合实际情况,加强对职业暴露重点科室、重点环节和重点人群的防控,开展针对性职业防护培训,规范操作流程,完善职业安全防控体系,降低血源性职业暴露的发生。
Objective To analyze the characteristics of bloodborne occupational exposure(BOE)among healthcare workers and provide a scientific basis for improving occupational protection measures.Methods A retrospective study was conducted to analyze the data of bloodborne occupational exposure reported in a tertiary grade-A comprehensive teaching hospital from January 2018 to December 2023.Results A total of 330 cases of BOE were reported among the healthcare workers from 2018 to 2023,with an incidence rate ranging from 1.63%to 2.06%and an annual average incidence rate of 1.91%.The peak period of occupational exposure occurred from July to September.The majority of exposed healthcare workers were female(66.97%),aged≤25 years(59.70%),and had≤1 year of work experience(74.24%).The main occupational categories were interns,trainees,and residents(60.91%).The departments with the highest exposure rates were internal medicine(37.88%)and surgery(35.76%).The major type of exposure was sharp injuries(90.30%),and hands were the most exposed sites(90.00%),and the main exposure source was the hepatitis B virus(56.36%),followed by Treponema pallidum(16.36%).The top three exposure links were needle removal(23.94%),sharp instrument handling(18.18%),and surgery(10.91%).The primary locations of exposure were wards(55.76%)and operating rooms(26.97%).The top three reasons for exposure were personal operational negligence(64.55%),violation of operating procedures(13.64%),and accidental or emergency situations(12.12%).Significant differences were observed in exposure modes,links,locations,and sources among healthcare workers of different occupational categories(P<0.05).Conclusion It is necessary for the hospital to strengthen the prevention and control of occupational exposure of key departments,links and populations based on the actual situation,carry out targeted occupational protection training,standardize operating procedures,and improve the occupational safety prevention and control system to reduce the occurrence of BOE.
作者
张培金
蔡东珍
秦丹
李燕
吴群
张晓娟
尹慧
钟芳
雷健
谢贝贝
ZHANG Peijin;CAI Dongzhen;QIN Dan;LI Yan;WU Qun;ZHANG Xiaojuan;YIN Hui;ZHONG Fang;LEI Jian;XIE Beibei(Department of Infection Management,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)
出处
《右江民族医学院学报》
2025年第1期132-137,共6页
Journal of Youjiang Medical University for Nationalities
基金
芜湖市创新环境建设(软科学)项目(2023rkx23)
皖南医学院中青年科研基金项目(WK2023ZQNS23)。
关键词
医务人员
职业暴露
血源性病原体
锐器伤
healthcare workers
occupational exposure
bloodborne pathogen
sharp injuries
作者简介
第一作者:张培金,主管医师,研究方向:医院感染防控,E-mail:20181088@wnmc.edu.cn;通讯作者:秦丹,副主任护师,研究方向:医院感染防控,E-mail:2743965622@qq.com。
