某院医务人员锐器伤目标性监测

目的了解某院医务人员发生锐器伤的人群分布特征和风险环节，为制定有效防护措施提供依据。方法回顾性调查2014年1-12月该三级甲等医院医务人员上报医院感染管理科的职业暴露情况，分析发生锐器伤者的职业类别、暴露地点及环节、暴露源等情况。结果2014年1-12月共监测医务人员2 643名，发生锐器伤61名，其中护士43名（占70.49%），医生13名（占21.31%）。医务人员锐器伤职业暴露科室主要为骨科（9名，占14.75%），致伤锐器主要为输液针（33名，占54.10%），发生的主要操作环节为拔针（21名，占34.43%）；暴露源主要为乙型肝炎病毒（HBV），共36例（占59.01%）；34名（占55.74%）锐器伤职业暴露医务人员在操作中均未戴手套。锐器伤职业暴露后进行局部处理者54名（占88.52%），进行药物治疗（含预防用药）者仅18名（占29.51%）；追踪随访43名（占70.49%），均未因暴露而发生感染。结论医院应建立完善的锐器伤职业暴露监控体系，加强对发生锐器伤高危人群的培训，强化标准预防，对风险环节进行监控和干预，有效减少医务人员锐器伤的发生。

Targeted monitoring of sharp injuries among health care workers in a hospital

ObjectiveTo understand the population distribution characteristics and risk links of sharp injuries among health care workers(HCWs) in a hospital, and provide basis for making effective protection measures.MethodsOccupational exposure of HCWs in a tertiary first class hospital between January and December 2014 were retrospectively surveyed. Occupations of HCWs sustained sharp injuries, exposure locations and links, exposure sources and so on were analyzed.ResultsA total of 2 643 HCWs were monitored in January December 2014, 61 cases of sharp injuries occurred, 43(70.49%）sharp injuries occurred in nurses, 13（21.31%）in doctors. Sharp injuries mainly occurred in HCWs in department of orthopedics(n=9, 14.75%), the major device causing sharp injuries was transfusion needles(n=33, 54.10%), the main manipulation was pulling out the needles (n=21, 34.43%), the main exposure source was hepatitis B virus(n=36, 59.01%); 34（55.74%）HCWs with sharp injuries didn’t wear gloves during manipulation. 54（88.52%）HCWs performed local treatment following sharp injuries, only 18（29.51%）HCWs received medication(including preventive medication), 43(70.49%) HCWs with occupational exposure were followed up and didn’t develop infection.ConclusionHospital should establish comprehensive monitoring system for occupational exposure injuries, strengthen the training of sharp injuries among high risk population, improve standard prevention, monitor and intervene risk links, so as to effectively reduce the incidence of sharp injuries among HCWs