供应室护理管理人员职业危害知识和防护行为的调查研究

目的：研究并探讨调研供应室护理管理人员所面对的职业危害因素有哪些,从而可以了解防护的知识、行为,以增强供应室护理管理人员的职业安全意识,提高防护能力。方法：在2011年6月对100名供应室护理管理学习班人员进行抽样问卷调查,方式是不记名,并加以分析。结果：100名供应室护理人员中,45%能够掌握消毒剂的正确使用方法;掌握正确洗手的仅占18%;正确掌握被利器刺伤后处理伤口的占70%;管理人员较少应用防护措施的原因为认为思想上不够重视、防护用品供应不上的原因占79%;高达82%的人员觉得有必要进行职业防护知识的培训。结论：供应室护理人员处于职业危害的环境中,根据调研结果应制订严格的管理制度,严抓防护措施落实;重点针对薄弱环节,制订合理培训计划;加强安全宣教培训,提高防护监督力度。     

消毒供应室医务人员的职业暴露与防护

目的探讨消毒供应室医务人员职业暴露防护的危险因素及对策。方法根据消毒供应室医务人员职业暴露的危险因素,制定并落实规范化的防护措施。结果提高了医务人员职业暴露防护意识,加强了职业安全管理,有效地防止职业感染的发生,确保了工作人员身心健康。结论重视医务人员的职业暴露教育,构建消毒供应室医务人员职业暴露防护的措施与方案,以最大限度地防止医院感染的发生。     

3家基层医院医务人员职业感染防护实施情况调查与分析

目的了解基层医院医务人员职业感染防护知识掌握及实施情况,提高医务人员职业感染防护能力。方法自行设计问卷,对广东省3家县级医院300名医务人员进行有关职业接触防护知识及防护措施执行情况问卷调查。结果医务人员职业感染防护知识掌握率以血源性职业接触的危害掌握率最高(58.3%),标准预防知识掌握率最低(31.7%);防护措施正确执行率最低的是使用工具掰安瓿(0%),其次依次为有被血液、体液泼溅时戴防护镜(1.7%),工作中洗手按七步洗手法(9.7%),脱手套后及时洗手(12.0%);影响医务人员防护措施正确执行的主要因素是掌握职业感染防护知识不全面,自我防护意识不强,医院感染预防监督机制及防护设施不完善。结论加强职业安全教育,提高个人防护意识,完善监督机制,保障防护用品质量,是促进医务人员职业感染防护实施的积极因素。     

军队医院供应室合同工人职业防护调查分析

目的 了解目前军队医院消毒供应室合同工人职业防护现状,提出合理化建议和改进措施.方法 采用自行设计的调查表,以问卷和访谈相结合的方法进行调雀分析.结果 目前军队医院供应室合同工人职业暴露发生率为95%,职业防护措施落实不到位,对职业暴露及职业防护认识不足,发生职业暴露后缺乏正确有效的处理措施.结论 加强职业防护宣传教育,制定严格、正规、系统的岗前培训制度,提高合同工人自我防护意识,实施正确职业防护,更好地控制医院感染的发生.     

新护士职业防护知识认知状态调查与分析

目的 了解新毕业临床护士对职业防护知识掌握情况,结合现状提出增强职业安全防护意识和能力的可行性措施.方法 采用问卷调查了解新毕业临床护士的职业防护知识掌握情况及相关内容.结果 59.2%的新护士不知道医院中护士最常见的职业危险因素,知道安全注射的仅有41.2%,91.0%的人不知道什么是标准预防,可见新毕业临床护士对职业防护知识掌握不全面;25.0%的人不知道受到伤害后如何处理及上报程序,说明面对职业危害时缺乏有效,完善的应对措施.结论 应加强职业防护知识的教育,定期组织职业防护知识培训,医院管理者要加大职业安全防护管理的力度,加强相关措施和制度保障.     

医务人员职业暴露防护知识调查

目的 了解医务人员对职业暴露防护知识掌握情况,为今后开展医务人员培训提供科学依据. 方法 采取普查方法,对农五师医院205名医务人员现场问卷. 结果 职业暴露防护知识正确应答率为69.84%;职业暴露自我防护意识行为应答率为58.78%;愿为艾滋病人服务应答率为38.05%,治疗艾滋病有经验应答率为20.49%,接受职业暴露培训应答率为76.59%,对职业暴露知识培训需求应答率为61.95%. 结论 农五师医院医务人员普遍缺乏对职业暴露防治知识、自身预防行为和艾滋病服务意识与态度,应加强这方面有关知识的培训.     

口腔科医务人员职业暴露的监测分析及防护对策

目的 探讨口腔科医务人员发生职业暴露的原因及防护措施.方法 通过咨询、查询医院感染上报登记资料的方式,分析2010年1-12月口腔科医务人员发生职业暴露的原因、方式、暴露后处理措施及防护措施.结果 口腔科医务人员共计36人,发生职业暴露26人,发生率为72.22％;其中护士5人占19.23％,医师4人占15.38％,实习学生10人占38.46,技工6人占23.08％,保洁员1人占3.85％;工作年限＜2年的医务人员发生职业暴露的人数最多,占69.23％;26人中有23人(88.46％)为针刺伤和锐器伤,3人(11.54％)为黏膜接触;所有人暴露后均能够正确处理伤口,医院感染管理科均进行跟踪随访,无1例感染发生.结论 应制定并健全医务人员的职业安全管理制度,按照标准预防的原则,采取有效的防护措施,加强对医务人员职业暴露防护知识的培训,增强安全防护的意识,保障医务人员的自身安全.     

医务人员职业感染防护实施调查与分析

目的了解医务人员对职业感染防护知识的了解和实施,以提高医务人员职业感染防护的能力,保护医务人员的生命健康。方法自行设计调查问卷,并对湖北省6所县级医院600名医务人员进行职业接触防护知识和防护措施执行的问卷调查。结果医务人员职业感染防护知识的掌握率以血源性职业接触危害掌握率最高,为58.3%,以标准预防知识掌握率最低,为31.7%;防护措施的正确执行率最低的是掰安瓿,为0,其次依次为有被血液、体液泼溅时戴防护镜,占1.7%,工作中洗手按照七步洗手法,占9.7%,脱手套后及时洗手,占12.0%;影响医务人员实施保护措施的主要因素:其对职业感染防护知识了解的不全面,自我保护意识不够强,医院感染的预防和防护设施不足,监督机制欠完善。结论加强职业安全教育,提高个人防护意识,完善监督机制,保护设备,提高医务人员的自身防护素质,促进职业感染防护的实现。     

上海市青浦区医务人员职业安全现况与管理对策

目的调查上海市青浦区医务人员的职业安全工作现状,探讨医务人员的职业安全风险,以制定有效的职业安全管理措施。方法对青浦区现有20家医院100名医务人员的职业安全意识,职业安全教育及培训等现状进行问卷调查,并对医院硬件设施,医院对职业安全的重视等方面进行督导。结果在调查的100名医务人员中对职业暴露意义不了解的50名,占50%;认为岗前职业暴露教育没必要的18名,占18%;8家民营医院均不开展职业安全教育和培训工作,对职业安全执行情况也不进行检查和督导;医院的硬件设施调查显示,20家医院均无静脉配置中心,仅1家医院供应室能达到集中清洗。放射科硬件达标9家。结论该区医务人员的职业安全防护方面存在一定的问题,基层医疗机构应严格执行相关的政策法规,重视和完善医务人员职业安全防护工作。     

消毒供应室护理人员的职业暴露因素与防护措施(综述)

目的:探讨和分析消毒供应室护理人员职业暴露因素及其防护的措施.方法:查阅文献,按照消毒供应室中护理人员职业所暴漏出来的危险因素进行相关的探讨和分析,并且制定落实相应的规范化的防护措施,以保证消毒供应室中护理人员的职业暴露因素可得到良好的预防和改善.结果:消毒供应室中护理人员的职业暴露因素主要有物理、化学、生物等方面,相关的防护措施能够加强护理人员对于职业暴露情况的防护.结论:加强对消毒供应室中护理人员职业暴露情况的相关知识培训,能够加强工作人员的个人防护意识,切实落实预防措施也能够减少暴露因素出现的危害,促进消毒供应室护理人员的工作安全.     

检验科医务人员职业暴露防护调查分析

目的：增强检验科医务人员的职业暴露防护意识。方法：采用自行设计的调查表以访谈和问卷相结合的方法进行调查分析。结果：43名检验科医务人员中正确洗手的仅占13．9％；正确应用擦手工具9．3％；每个工作日洗手次数〈30次72．1％，〉30次27．9％；皮肤被利器刺伤过95．3％；被利器刺伤后能正确处理伤口69．8％；正确掌握消毒剂用途及效能41．9％；认为有必要参加防护知识培训93．0％。结论：构建检验科医务人员职业暴露防护的措施与方案。重视职业暴露安全教育，可以有效降低和减少职业暴露发生率，确保检验科医务人员职业安全。     

Psychiatric morbidity, service use, and need for care in the general population: results of The Netherlands Mental Health Survey and Incidence Study

OBJECTIVES: This study examined the use of primary health care, mental health care, and informal care services, as well as unmet care needs, by individuals with different psychiatric diagnoses. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study and were based on a representative sample (n = 7147) of the general population (aged 18-64 years). RESULTS: In a 12-month period, 33.9% of those with a psychiatric disorder used some form of care; 27.2% used primary care, and 15.3% used mental health care. Patients with mood disorders were the most likely to enlist professional care; those with alcohol- and drug-related disorders were the least likely to do so. Higher educated persons who live alone, single parents, unemployed persons, and disabled persons were more likely to use mental health care. Unmet need for professional help was reported by 16.8% (men 9.9%, women 23.9%) of those with a disorder. CONCLUSIONS: Care use varies widely by diagnostic category. The role of general medical practitioners in treating persons with psychiatric disorders is more limited than was anticipated. Patients in categories associated with extensive use of professional care are more likely to have unmet care needs.     

出国留学对医院科技人员职业设计的影响

目的：了解出国留学对医院科技人员职业设计的影响。方法：采用对某医院有留学经历的科技人员随机发放问卷调查的方法。结果：出国前46．8％和55．9％的人认为通过留学可以增加个人收入和获得晋升技术职称或行政职务;回国后23．4％的人获得晋升技术职称,11．7％的人获得晋升行政职务;29．9％的人发表3篇以上英文论文,27．3％和54．6％的人分别获国家和军队科研基金、科研成果或学术称号,61．0％的人开展了一项以上临床新业务或新技术;90．9％和94．8％的人认为自己所取得的成就及个人综合素质的提高与出国留学相关或密切相关;94．8％的人对自己目前的工作满意或比较满意,5．2％和14．3％的人不甚满意和认为没有人尽其才,11．7％的人曾经有过或目前仍有离开医院的想法。结论：出国留学对留学人员在职称、职务的晋升,学术成果的取得,综合能力的提高和个人职业的重新设计等方面产生明显影响。     

The impact of the introduction of market incentives on occupational health services and occupational health professionals: experiences from The Netherlands

OBJECTIVES: This paper describes the reform of the regulations on safety and health in the Netherlands towards a more competitive market and its impact on occupational health services (OHSs) and the health professionals over the period 1994-2005. Aims are to identify the crucial factors that bring about the intended effects (such as lower disability rates) and to evaluate the outcomes from the perspective of the occupational health professional. The paper contributes to the discussion of how the professionals could define and contain their professional identity and credibility in competitive circumstances. METHODS: Open interviews were completed with 12 key persons and secondary analyses were made on documents and various monitors. RESULTS: The reform changed the OHS safety market fundamentally. OHSs were transformed from medium sized regional units into business organizations mostly operating on a national level. Private insurance companies became key players. Only after the development of an effective social infrastructure, however, intended effects (lower absenteeism and disability) occurred. Occupational health professionals were initially opposed but by redefining their professional domain and identity, they finally succeeded in gaining negotiating power in order to preserve and develop expertise and professional integrity. CONCLUSIONS: The effectiveness of the introduction of market incentives depends strongly on their social embeddedness. Health professionals should adapt their strategy to the conditions of the competitive market, in order to preserve a credible and professional identity.     

出国劳务人员性病艾滋病健康干预不同阶段相关态度变化研究

目的探讨适合出国劳务人员性病艾滋病健康干预模式。方法采取随机整群抽样方法,自行设计问卷,对829名劳务人员采取专业健康教育和同伴教育相结合的模式进行干预,并进行效果评价。结果全程干预结束后,认为讲授避孕套知识不会引起教唆的,比例从44.6%增加到54.7%;对自慰行为持宽容态度,认为可缓解性压力的比例从45.2%提升到48.6%;对感染者态度除认为"被查出的感染者应该公开身份还是保密"外,同干预前相比均有统计学差异(P0.05)。结论对劳务人员宜采取"出国前专业干预+出国后同伴教育"相结合的模式,有助于劳务人员防治性病艾滋病目标的实现。     

实习护士生276名职业接触感染认知情况调查

目的了解实习护士生预防职业接触感染的认知水平,分析其影响因素,探讨相关对策与措施。方法采用自行设计的问卷,对276名实习护士生进行职业接触感染知识和态度调查。结果实习护士生对经血液传播疾病知识的掌握情况和有关职业防护方面的意识存在明显的欠缺。实习护士生中仅有12.7%接受过职业防护方面的教育,有78.6%的学生非常希望接受有关职业防护方面的教育。结论实习护士生预防职业接触感染方面的意识和知识均严重不足。护理院校、临床带教教师和实习医院应相互协作,制定有效的措施,加强护士生职业安全教育与培训。     

Engaging Agribusinesses: Feasibility and Cost of an ATV Safety Poster Project

ABSTRACT

Objectives: All-terrain vehicle (ATV)-related deaths and injuries continue to be a significant problem. Influential change agents such as agribusinesses could be important partners for improving safety behaviors among rural ATV users. Our objective was to determine how effectively an injury prevention project could engage agribusinesses through the postal service and to assess their willingness to display a safety poster. Methods: One thousand two hundred forty-four agribusinesses received an ATV safety poster and a postcard survey by mail. A randomized sampling of these businesses was surveyed by telephone 4–7 weeks later. Telephone survey questions included whether they recalled receiving the poster, and if so, whether, where and how long the poster was displayed. Results: One hundred six postcards were returned. Of the 192 eligible business persons contacted by telephone, 89% agreed to participate. Approximately one-third of telephone survey participants recalled receiving the poster. Among these, 81% with walk-in customers posted it, and 74% still had it displayed 1 month later. Of participants who did not recall receiving the poster, 83% stated they would have displayed the poster. The cost of displaying each poster in a business was 16.6 cents/day during the first month. Final costs/day would be much less because of continued display. Conclusion: A high percentage of agribusinesses displayed or would have displayed an ATV safety poster, and most displayed it beyond 1 month. Unfortunately, participant recruitment via postal delivery alone was challenging. Nevertheless, mass mailing of injury prevention materials to be displayed in the retail setting may be a low cost method for raising safety awareness.     

Unmet Need for Medical Care and Safety Net Accessibility among Birmingham’s Homeless

Although homeless individuals often experience health problems requiring care, there are limitations to available research concerning the scale of their needs and the accessibility of safety net agencies to meet them. Traditional access-to-care surveys calculate unmet need among all persons queried (rather than persons needing care), making it difficult to calculate what percentage of persons requiring care actually obtain it. Additionally, no research has compared the relative accessibility of safety net programs to homeless persons in need. This cross-sectional, community-based survey assessed the prevalence of unmet need for several specific types of health care and compared the accessibility of agencies in Birmingham, AL. Substantial proportions of respondents reported unmet needs for general medical care (46 %), specialty care (51 %), mental health care (51 %), dental care (62 %), medications (57 %), and care of a child (23 %). The most commonly mentioned sites where care was sought included a federally funded Health Care for the Homeless (HCH) program (59 %), a religious free clinic (31 %), and a public hospital emergency department (51 %). The HCH program was most commonly cited as the location where care, once sought, could not be obtained (15 %), followed by the county hospital primary care clinics (13 %). In this survey, unmet need was common for all types of care queried, including primary care. Key components of the safety net, including a federally funded homeless health care program, had suboptimum accessibility.     

A user's manual for the IOM's 'Quality Chasm' report

Fifteen months after releasing its report on patient safety (To Err Is Human), the Institute of Medicine released Crossing the Quality Chasm. Although less sensational than the patient safety report, the Quality Chasm report is more comprehensive and, in the long run, more important. It calls for improvements in six dimensions of health care performance: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity; and it asserts that those improvements cannot be achieved within the constraints of the existing system of care. It provides a rationale and a framework for the redesign of the U.S. health care system at four levels: patients' experiences; the "microsystems" that actually give care; the organizations that house and support microsystems; and the environment of laws, rules, payment, accreditation, and professional training that shape organizational action.     

Perceived potential risk factors in child care

This study is based on semi-structured interviews focusing on staff members' opinions about potential risk factors that could threaten patient safety. The aim was to acquire more in-depth knowledge about the causes of patient injuries. The study, which was conducted at a children's hospital, has a qualitative approach that is influenced by the critical incident technique. A total of 28 persons were interviewed. Analysis of the data resulted in five qualitatively differentiated categories of potential risk factors: a large influx of patients, a lack of professional experience, a lack of inter-professional communication and cooperation, and deficiencies related to work hours and to the physical environment. The results reflect a complex picture where the risks, as described by the informants, can either alone or in concert directly or indirectly affect the individual in the practice of his or her profession or contribute to a mistake.