ICU护士的职业损伤及管理

医务人员在诊疗病人的过程中,有可能意外地被感染病人的血液、体液污染了自身破损皮肤或非胃肠道黏膜,或被含有病原微生物的血液、体液污染了的针头及其他锐器刺破皮肤,而导致被感染,造成医务人员的职业损伤。ICU环境封闭,设备繁杂,且实施介入性检查和治疗多,有创监测和护理操作频繁,护士在工作中有较高的职业损伤率[1,2],主要为锐器伤和黏膜暴露,最常见的是感染血源性传播疾病和呼吸道感染性疾病,如乙肝、丙肝、艾滋病以及呼吸道疾病等。护士的防护意识不强、防护知识欠缺和防护措施落实不严,可致使护士发生感染性疾病的危险性增大。因此…     

The influence of organizational factors on occupational low back injuries

The unique home care environment puts nurses at risk of low back injuries. Protecting nurses may mean the difference between delivering cost-effective quality care and no care at all. This study, conducted in Alberta, Canada, disclosed a lack of organizational resources and use of occupational health services in home care providers. Involving frontline staff as management partners may provide a solution for the development of an effective injury prevention program in home care.     

Sources of occupational stress among firefighter/EMTs and firefighter/paramedics and correlations with job-related outcomes

INTRODUCTION/OBJECTIVE: This paper reports the results of an initial effort to develop and test a measure of the various sources of job-related stress in firefighter and paramedic emergency service workers. METHODS: A 57-item paper and pencil measure of occupational stressors in firefighter/Emergency Medical Technicians (EMTs) and firefighter/paramedics was developed and administered by anonymous mail survey. RESULTS: More than 2,000 (50% rate of return) emergency service workers completed and returned the surveys. The responses of 1,730 firefighter/EMTs and 253 firefighter/paramedics were very similar in terms of the degree to which job stressors were bothersome. A factor analysis of replies yielded 14 statistically independent "Occupational Stressor" factors which together accounted for 66.3% of the instrument's variance. These Sources of Occupational Stress (SOOS) factor scale scores essentially did not correlate with a measure of the social desirability test-taking bias. Finally, SOOS factors were identified that correlated with job satisfaction and work-related morale of the respondents. Conflict with administration was the job stressor factor that most strongly correlated with reports of low job satisfaction and poor work morale in both study groups. CONCLUSION: The findings suggest that firefighter and paramedic job stress is very complicated and multi-faceted. Based on this preliminary investigation, the SOOS instrument appears to have adequate reliability and concurrent validity.     

The Korean Nurses Association in New England

Forging new ground for minority nurses in the community.     

The psychological consequences of occupational blood and body fluid exposure injuries

Purpose. This article describes the psychological impact of occupational blood and body fluid (BBF) exposure injuries and provides suggestions for improving clinical practice.

Method. A literature review was conducted to search for articles relating to the psychological consequences and management of these work injuries.

Results. Acute psychological symptoms including posttraumatic stress, anxiety and depression are frequently experienced postexposure, which appear to be the major contributing factors of time loss from work. Furthermore, a subgroup is at risk for chronic symptoms and disability that persists beyond notification that no disease transmission occurred. Distressed workers often go unrecognised and untreated, and their assistance needs are largely unknown. Accordingly, this article draws upon the posttraumatic stress literature to offer suggestions for advancing the postexposure management of these injuries.

Conclusions. This clinical commentary underscores the serious yet understudied secondary psychological effects of occupational BBF exposure injuries. Postexposure management programmes need to place greater emphasis on psychosocial and educational initiatives to improve the identification and treatment of symptomatic workers.     

Age-related prevalence of cytomegalovirus IgG antibody in north-west England

We assessed the prevalence of cytomegalovirus (CMV) IgG antibody in north-west England. The prevalence of antibody was low in pre-school children, but rose rapidly on school entry (age 5 years). About 40% of female blood donors of child-bearing age were seropositive. Hospitalised young adults had a higher prevalence of antibody than blood donors of similar age. Our results emphasised the need for local data on CMV seroprevalence when planning the counselling of women about acquisition of CMV during pregnancy and when planning the provision of CMV seronegative blood and blood products.     

Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants.

BACKGROUND AND PURPOSE: Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. SUBJECTS: A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. METHOD: Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. RESULTS: Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. CONCLUSION AND DISCUSSION: Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.     

加强职业防护 减少血透室工作人员的职业伤害

目的了解加强职业防护对减少血透室工作人员职业伤害的影响情况。方法对80例血透室工作人员进行职业防护知识强化培训,在培训前后各进行一次问卷调查。结果在防护观念和行为方面:标准预防与普遍预防、戴口罩及防护目镜习惯、医疗垃圾分类盛放及时倾倒、包纱布折安培、针头分离等10项内容有统计学意义,P<0.01;职业伤害方面:针刺伤、胃炎、神经衰弱结果有统计学意义,P<0.05。结论通过加强职业防护知识培训,血透室工作人员的防护观念和行为都有了明显改进,职业伤害明显减少。     

加强职业防护 减少血透室工作人员的职业伤害

目的了解加强职业防护对减少血透室工作人员职业伤害的影响情况。方法对80例血透室工作人员进行职业防护知识强化培训，在培训前后各进行一次问卷调查。结果在防护观念和行为方面：标准预防与普遍预防、戴口罩及防护目镜习惯、医疗垃圾分类盛放及时倾倒、包纱布折安培、针头分离等10项内容有统计学意义，P〈0．01；职业伤害方面：针刺伤、胃炎、神经衰弱结果有统计学意义，P〈0．05。结论通过加强职业防护知识培训，血透室工作人员的防护观念和行为都有了明显改进，职业伤害明显减少。     

消毒供应中心锐器伤发生现状及影响因素

目的 分析集中供应模式下消毒供应中心工作人员锐器伤的发生现状及影响因素.方法 2012年10～11月采用问卷调查法对湖南省30所医院的342名工作人员进行多中心横断面调查.结果 自进入消毒供应中心工作后,有288名(84.2％)工作人员发生过锐器伤,274名(72.2％)在调查前1年内发生过锐器伤,其中93名(27.2％)的锐器伤是被患者血液或体液污染的针头或锐器引起的.是注册护士、发生锐器伤后上报、认为锐器伤可避免、职业安全知识渠道丰富、医院提供防护检查措施为锐器伤发生的保护因素,环境嘈杂程度、经常接触锐器为锐器伤的危险因素.结论 消毒供应中心工作人员锐器伤发生率高,与个人因素及环境因素有关,应加强个人相关知识培训,提高其防范意识,并引起有关部门的重视.     

加强职业防护减少血透室工作人员的职业伤害

目的 了解加强职业防护对减少血透室工作人员职业伤害的影响情况.方法 对80例血透室工作人员进行职业防护知识强化培训,在培训前后各进行一次问卷调查.结果 在防护观念和行为方面:标准预防与普遍预防、戴口罩及防护目镜习惯、医疗垃圾分类盛放及时倾倒、包纱布折安培、针头分离等10项内容有统计学意义,P＜0.01;职业伤害方面:针刺伤、胃炎、神经衰弱结果有统计学意义,P＜0.05.结论 通过加强职业防护知识培训,血透室工作人员的防护观念和行为都有了明显改进,职业伤害明显减少.     

在针刺伤防范中应用风险管理程序的做法与体会

目的　防范医院护理工作中的针刺伤。方法　使用风险管理程序控制护士针刺伤的风险,成立风险管理小组,进行全员职业安全培训, 建立风险管理呈报系统,对呈报的针刺事件进行分析,制定干预措施。结果　护士自身防范意识加强,针刺伤明显减少。结论　运用风险管理 程序可以有效防范护士发生针刺伤。     

Economic growth and the incidence of occupational injuries in Austria

OBJECTIVES: The aim of this paper was to analyze the impact of economic growth measured by real gross domestic product (GDP) on the incidence of occupational injuries in Austria. METHODS: The relationship between GDP and the occupational injury rate of the wage-earning population between 1955 and 2004 was analyzed using an error correction model. The sample size increased from 1.568,371 persons in 1955 to 2.656,952 in 2004. Occupational injuries were divided into fatal and non-fatal injuries. RESULTS: Occupational injuries (fatal and non-fatal) decreased from 8.59% to 4.08%: non-fatal injuries decreased from 8.56% to 4.07%; fatal injuries decreased from 0.03% to 0.01%. Austrian GDP increased from EUR 37.7 billion to EUR 202.8 billion (base year 1995). Statistical analysis clearly shows that a growing economy is associated with declining injury rates (fatal and non-fatal). Two mechanisms are discussed. Firstly, rising GDP is accompanied by greater investment in safer technologies and occupational safety measures. Secondly, booming economies are associated with a reduced risk of unemployment, which is already known to be a risk factor for occupational injuries. CONCLUSIONS: Economic development appears to have an impact on the incidence of occupational injuries in Austria. Health policy should emphasize the necessity for safety at work particularly in phases of economic slowdown.     

Epidemiology of fatal occupational injuries in Jefferson County,Alabama

BACKGROUND: In Alabama, little is known about the overall characteristics of job-related injuries. METHODS: We examined fatal occupational injuries that occurred in Jefferson County, Alabama, from 1990 through 1999 using files maintained by the Jefferson County Coroner/Medical Examiner Office. Mortality rates were calculated by sex, age, race, occupation, and industry. RESULTS: There were 186 fatal occupational injuries; 136 were unintentional. The overall fatality rate was 4.45 deaths per 100,000 worker-years. Mortality rates were higher among men than among women, and they increased with advancing age. The homicide rate was higher among black workers than among whites. Mining, manufacturing, and transportation were the industries with the highest fatal injury rates. Transportation-related jobs and manual labor were high-risk occupations. CONCLUSION: High-risk industries should consider worker-targeted injury prevention programs, and particular attention should be paid to elderly workers.