某三级综合医院医务人员职业暴露调查

目的了解某三级综合医院医务人员职业暴露情况,分析职业暴露发生原因及预防对策。方法对某院2010年1月—2013年12月134例发生职业暴露的医务人员进行调查。结果暴露人群中,护士所占比率最高(59.70%),其次是医生(19.40%)、医技人员(9.70%)。职业暴露主要原因为锐器管理不规范(占46.27%,62例),其次为操作意外(占42.54%,57例)、防护措施不足所致(占11.19%,15例);暴露方式以锐器伤为主(占94.78%,127例),黏膜接触暴露占5.22%(7例),暴露源不明确者占42.54%,暴露源明确者占57.46%,其中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒螺旋体(TP)、人类免疫缺陷病毒(HIV)分别占35.82%、12.69%、3.73%、2.24%;HBV、HCV合并感染占2.24%(3例);HIV、HBV、HCV、TP合并感染占0.74%(1例)。职业暴露后正确处理率为95.52%。结论护士是职业暴露高危群体,做好职业防护,并规范锐器管理,可以减少医务人员职业暴露发生。

Occupational exposure among health care workers at a tertiary comprehensive hospital

ObjectiveTo investigate occupational exposure among health care workers (HCWs) in a tertiary comprehensive hospital, and analyze the causes and preventive measures of occupational exposure. Methods134 cases of occupational exposure among HCWs in a hospital from January 2010 to December 2013 were analyzed. ResultsOf HCWs sustained occupational exposure, doctors， nurses, and technicians accounted for 59.70%， 19.40%, and 9.70% respectively. The main cause for occupational exposure was non standardized management of the sharps （46.27%，n=62）,followed by unexpected operation（42.54%，n=57）and inadequate protective measures ( 11.19%， n=15);The main exposure mode was sharp injury(94.78%，n=127), mucosal exposure accounted for 5.22% (n= 7); 42.54% of exposure sources were not clear， 57.46% of exposure sources were clear， 35.82%, 12.69%, 3.73%, and 2.24% of which were hepatitis B virus(HBV)， hepatitis C virus(HCV)， Treponema pallidum(TP), and human immunodeficiency virus(HIV); 2.24%(n=3）of exposure sources were co infection of HBV and HCV；0.74%(n=1) was co infection of HIV, HBV,HCV, and TP. 95.52% of occupational exposures were treated correctly. ConclusionThe high risk population for occupational exposure are nurses, standard occupational precautions and management of the sharps can reduce the occurrence of occupational exposure among HCWs.