对225名临床护士HIV职业暴露知识、行为、态度的调查研究

目的:了解临床护士的HIV职业暴露防护意识、知识、行为现状,对比培训前后的变化,提供防护策略参考.方法:无记名问卷调查知识和操作行为情况,测量针刺伤及皮肤、粘膜血液体液暴露发生率.基线调查225人,培训后调查196人,运用SPSS13.0软包对数据进行分析.结果:预防HIV职业暴露重要且关键的知识点和暴露后预防用药知识知晓率分别由培训前的46.6%~91.6%和3.6%~57.3%提高到培训后的93.4%~99.5%和92.3%~96.4%;徒手掰安瓿、回套针帽、分离针具、接触污染针头发生率分别由培训前的59.6%、16.1%、20.4%、18.2%降低到培训后的48.5%、8.2%、9.2%、8.7%;皮肤、粘膜血液体液暴露发生率分别由培训前的8.5%、26.8%降低到培训后的2.1%、15.3%;以上各项培训前与培训后对比差异均有统计学意义(P<0.05).针刺伤发生率培训前后差异无统计学意义(P＞0.05).结论:当前临床护士对HIV职业暴露防护意识和知识不足,建立系统化的培训和管理,必然对其安全防护起到积极的作用.

Investigation on Knowledge, Behavior and Attitude towards Occupational Exposure to HIV in 225 Nurses

Objective ： To investigate protection awareness, knowledge and behavior towards occupational exposure to HIV in nurses and to provide with references to protection strategy. Methods：Investigation was conducted using an anonymous questionnaire and results were compared before and after training and education. Events of needle stick injuries, skin and mucosal exposure to blood and body fluid were recorded and analyzed statistically with SPSS 13.0 software among 225 subjects in the baseline survey before training and 196 subjects in the post -training survey. Results：The awareness rate of important knowledge and preventive medications towards occupa- tional exposure to HIV was 46. 6% - 91.6% and 3.6% - 57.3% respectively before training, then it was elevatedto 93.4% N99.5% and 92.3% ~96. 4% respectively aftertraining; the incidence rate of breaking ampoules bare - handed, recapping, separating needles, contacung contaminated needles, skin and mucosal exposure to blood and body fluid was 59. 6%, 16. 1%, 20. 4%, 18.2%, 8.5%, 26.8% respectively before training, then it was decreased to 48.5% , 8.2%, 9.2%, 8.7%, 2. 1%, 15.3% respectively after training, and the difference was signifi- cant （P 〈 0. 05）. Incidence rate of needle stick injuries showed no significant difference before and after training （ P 〉 0. 05 ）. Conclusion ： The protection awareness of occupational exposure to HIV in clinical nurses is not well established at present, and the installation of comprehensive education and management system will play an active role in the occupation protection of nurses.