基层医疗机构安全注射现状调查

目的了解基层医疗机构安全注射现状。方法随机抽取湖北省55所基层医疗机构,采用问卷调查基层医疗机构安全注射工作现状。结果共发放问卷55份,收回有效问卷50份,有效回收率为90.91%。50所有效问卷的回答单位均为湖北省各市区一级及以下的医疗机构,其中社区卫生服务中心16所、乡镇卫生院和村卫生室各17所。50所基层医疗机构均未重复使用注射器、采血器,全部采用一次性无菌注射器,仅7所(14.00%)医疗机构使用了回缩自毁型安全注射器。所有手卫生设施和锐器盒均配置的医疗机构仅5所(10.00%),32所(64.00%)医院机构治疗车上未配备锐器盒,21所(42.00%)注射室未配备干手设施,18所(36.00%)治疗车上未配备速干手消毒剂和治疗室未配备干手设施。2015年医护人员上报的锐器伤中,有114人发生了117次锐器伤,其中由安瓿引起的锐器伤74人次(63.25%)。医疗废物处置中,仍存锐器盒渗漏、重复使用、满3/4未及时封闭和未做到每个可能产生锐器的场所均配备锐器盒的现象。结论基层医疗机构中仍存在设施设备不足、医疗废物处置监管不规范等安全注射隐患。

Survey on safe injection practice in primary medical institutions

ObjectiveTo investigate the status of safe injection practice in primary medical institutions.Methods55 primary medical institutions in Hubei Province were randomly selected, questionnaire survey on status of safe injection in primary medical institutions was conducted.ResultsA total of 55 questionnaires were distributed, 50(90.91%) valid questionnaires were obtained. All valid questionnaires were from primary level medical institutions of Hubei Province, 16 of which were from community health centers, 17 from township health centers, and 17 from village health clinics. None of 50 primary medical institutions repeatedly used syringe and hemostix, all used disposable sterile syringe, only 7(14.00%) medical institutions used retraction type self destructing syringe. Only 5 (10.00%) medical institutions were equipped with hand hygiene facilities and sharps containers, 32 (64.00%) medical institutions didn’t provide sharps containers on treatment carts, 21 (42.00%) injection rooms didn’t install hand drying facilities, 18（36.00%）medical institutions didn’t provide alcohol based hand rub on treatment carts and didn’t install hand drying facilities in treatment rooms. Of sharp injures among health care workers(HCWs) reported in 2015,114 HCWs sustained 117 times of injuries, 74 cases（63.25%） were caused by ampoule. Of medical waste disposal, there existed some problems,such as leakage and repeated use of sharps box, didn’t close sharps box timely, as well as without providing sharp containers in locations where sharps might be produced.ConclusionThere are a variety of hidden risks of unsafe injection in primary medical institutions, like insufficient facilities and unsafe disposal of medical waste.