目的了解不同级别医院护理人员血源性职业暴露发生情况及自我防护措施执行现状和影响因素,探讨有效干预措施。方法采用自制职业暴露自我防护相关调查表对全市37所不同级别医院的2000名护理人员进行问卷调查。结果主要暴露途径以玻璃割伤、针刺伤、刀片割伤为主,损伤率分别为80.21%、64.55%、14.44%。自我防护措施执行率:抽血戴手套为27.33%,输液戴手套为19.47%,手皮肤有破损时戴手套操作为38.40%,有可能被体液、血液溅到眼部戴护目镜为3.64%。不使用防护用品的主要原因:工作太忙、觉得太麻烦、用品提供不足、认为没必要,发生率分别为76.58%、46.79%、33.48%、14.81%。级别越低的医院锐器损伤发生率越高、自我防护措施执行率越低(P〈0.05)。结论通过行政干预,加强防护知识培训,做好标准预防,是减少职业暴露危害的重要措施。
Objective To investigate the occurrence of blood-borne occupational exposure, implementation status of self-protection measures and influence factors of nursing staffs in different level hospitals, in order to explore the ef- fective interventions. Methods The self-made related questionnaire of self-protection ability for occupational exposure was used for investigation of 2 000 cases of nursing staffs in 37 different level hospitals in Zhongshan City. Results The major routes of exposure were glass cuts, needle stick injuries, blade cuts, and the main injury rates were 80.21%, 64.55%, 14.44%. Implementation rate of self-protective measures: wearing gloves during blood drawing was 27.33%, wearing gloves during transfusion was 19.47%, wearing gloves treatment when hand skin damage was 38.40%, wearing goggles for protecting body fluids and blood splashed into eyes was 3.64%. The main reasons did not use protective equipment were work too busy, feeling trouble, lack of supplies, thought it not necessary, the rate were 76.58%, 46.79%, 33.48%, 14.81%. The lower level hospital had the higher incidence of hospital sharps injuries, and the lower implementation rate of self-protection measures (P 〈 0.05). Conclusion Strengthening the protection knowledge train- ing, doing standard prevention by administrative intervention are important measures to reduce the hazard of occupa- tional exposure.