急诊科护士尖锐器械损伤的危险因素分析及防护建议

目的分析急诊科护士尖锐器械损伤的危险因素，并给出防护建议。 方法采用问卷方式对166名急诊科室护士近一个月尖锐器械损伤情况进行回顾性调查分析，根据是否发生尖锐器械损伤将其分为发生组和未发生组。应用单因素和多因素logistic回归分析法明确影响急诊科护士尖锐器械损伤的相关因素。 结果参与问卷调查的166名急诊科护士近一个月内尖锐器械损伤率为16.86%。2组性别、年龄、婚姻状况、学历、职称、尖锐器械操作带手套、注射器使用后回套针帽护士构成比差异均无统计学意义（P>0.05），发生组与未发生组比，急诊室工作年限 < 5年、非正式护士、经常为不合作病人进行侵入性操作、掰安瓿未使用纱布、工作环境光线不充足、工作环境吵杂、无尖锐器械伤上报制度、认为尖锐器械伤不可避免护士构成比均较高（P < 0.05）；logistic回归分析显示，急诊室工作年限 < 5年、非正式护士、经常为不合作病人进行侵入性操作、掰安瓿未使用纱布、工作环境光线不充足、工作环境吵杂均是导致急诊科护士尖锐器械损伤的危险因素（OR=3.955、6.481、7.478、2.906、2.627、2.321，P < 0.05~P < 0.01），而接受有尖锐器械伤上报制度、认为尖锐器械伤可避免是急诊科护士尖锐器械损伤的保护因素（OR=0.557、0.652，P < 0.05）。 结论急诊科护士尖锐器械损伤发生率较高，影响尖锐器械损伤的危险因素较多，应引起临床关注和重视，从改善工作环境、加强防护知识和意识着手，尽量避免尖锐器械损伤。

Analysis of risk factors for sharp instrument injury in emergency department nurses and protection suggestions

ObjectiveTo analyze the risk factors of sharp instrument injury in emergency department nurses, and to provide protection suggestions. MethodsRetrospective survey was conducted on the sharp instrument injury of 166 emergency department nurses for the near one month by questionnaire.According to whether sharp instrument injury occurred, the subjects were divided into occurrence group and non-occurrence group.Factors affecting sharp instrument injury in emergency department nurses were determined by univariate and multivariate logistic regression analysis. ResultsThe rate of sharp instrument injury was 16.86% in 166 emergency department nurses for the near one month.There were no statistically significant differences between the two groups in the composition ratio of gender, age, marital status, education, professional title, sharp instrument operation with gloves, and returning the syringe cap after use(P>0.05).The composition ratio of nurses with working experience in emergency room less than 5 years, informal nurses, often performing invasive operation for uncooperative patients, breaking ampoule with no gauze, insufficient light in the working environment, noisy working environment, no reporting system for sharp instrument injury, and thinking sharp instrument injury inevitable in occurrence group was higher than that in non-occurrence group(P < 0.05).Logistic regression analysis showed that working experience in emergency room less than 5 years, informal nurses, often performing invasive operation for uncooperative patients, breaking ampoule with no gauze, insufficient light in the working environment, and noisy working environment were the risk factors of sharp instrument injury for emergency department nurses(OR=3.955, 6.481, 7.478, 2.906, 2.627, 2.321, P < 0.05 to P < 0.01), while reporting system for sharp instrument injury, thinking sharp instrument injury evitable were the protective factors of sharp instrument injury for emergency department nurses(OR=0.557, 0.652, P < 0.05). ConclusionsThe incidence of sharp instrument injury is high in emergency department nurses, and there are many risk factors affecting sharp instrument injury, so more attention should be paid to it.It is important to improve working environment, strengthen protection knowledge and awareness, to avoid sharp instrument injury as far as possible.