某综合医院684例医务人员职业暴露案例的回顾分析

张鸿; 陈炜; 刘玉馥; 舒逸平; 金浩龙

doi:10.16016/j.1000-5404.201709081

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某综合医院684例医务人员职业暴露案例的回顾分析

公共卫生与预防医学 | 更新时间：2026-01-09

- 某综合医院684例医务人员职业暴露案例的回顾分析
- Occupational exposure of medical staffs from a general hospital: a retrospective analysis of 684 cases
- 第三军医大学学报 2018年40卷第3期页码：264-269
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第二附属医院医院感染控制科
- 作者简介：
  
  [ 陈炜，电话：(023)68763990，E-mail：chongqingchenwei@126.comCHEN Wei, Tel:86-23-68763990, E-mail: chongqingchenwei@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201709081
  中图分类号： R181.31;R192;R197.3
- 收稿：2017-09-12，
  
  修回：2017-10-30，
  
  纸质出版：2018-02-15
- 稿件说明：
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张鸿, 陈炜, 刘玉馥, 等. 某综合医院684例医务人员职业暴露案例的回顾分析[J]. 第三军医大学学报, 2018,40(3):264-269.

Hong ZHANG, Wei CHEN, Yufu LIU, et al. Occupational exposure of medical staffs from a general hospital: a retrospective analysis of 684 cases[J]. Journal of Third Military Medical University, 2018, 40(3): 264-269.
张鸿, 陈炜, 刘玉馥, 等. 某综合医院684例医务人员职业暴露案例的回顾分析[J]. 第三军医大学学报, 2018,40(3):264-269. DOI： 10.16016/j.1000-5404.201709081.

Hong ZHANG, Wei CHEN, Yufu LIU, et al. Occupational exposure of medical staffs from a general hospital: a retrospective analysis of 684 cases[J]. Journal of Third Military Medical University, 2018, 40(3): 264-269. DOI： 10.16016/j.1000-5404.201709081.

摘要

目的

分析医务人员职业暴露流行病学特点。

方法

收集2012年至2016年684例医务人员职业暴露信息

根据其流行病学特点

分析职业暴露原因

提出防控措施。

结果

工作年限不超过5年的工作人员(76.46%)易发生职业暴露; 护士(65.64%)是主要的人群; 手术室的发生密度最高; 第3季度和每日10:00-10:59是高发季节和时段。锐器伤(79.39%)是主要的暴露方式; 处理治疗后污物、拔针、手术操作是职业暴露的高危操作。随访发现1例HCV感染

感染率为0.15%。

结论

护理人员与低年资工作人员是医务人员职业暴露的高危人群

手术室是职业暴露的高发地点

每年第3季度与每日交接班之前时段是职业暴露的高发季节和高发时段。构建安全工作环境

合理分配人力资源、优化工作流程、加强职业安全培训、规范操作过程、建立职业暴露“多学科协作(multidisciplinary-teamwork

MDT)”快速反应机制或可预防职业暴露发生。

Abstract

Objective

To analyze the epidemiological characteristics of occupational exposure in medical staffs.

Methods

The data of occupational exposure among medical staffs in a hospital from 2012 to 2016 were collected. According to the epidemiological characteristics

the main causes of occupational exposure were analyzed in order to bring forward to preventive and control measures.

Results

The medical staffs with length of working shorter than 5 years (523/684

76.46%) were prone to occupational exposure

and the nurses (64.65%) were the highest risk-taking group. Operation room was the most susceptible and centralized place. The third quarter was the main time of occupational exposure of the year

and 10:00 to 10:59 was the main duration during the day. Management of medical wastes

pulling out the needle

and surgical operation were high-risk operations for occupational exposure. One staff who exposed to HCV risk conditions developed acute HCV infection

with an infection rate of 0.015%.

Conclusion

Nurses and fresh staffs are high-risk population of occupational exposure. Operating room is high-risk area

the third quarter and the duration before shifting are main season and duration of occupational exposure. Therefore

safer working environment

rationale human resource

optimized workflow

well training for occupational safety and protection

standardized operative procedure and rapid response mechanism based on multidisciplinary-teamwork may effectively prevent occupational exposure.

关键词

Keywords

references

胡必杰.医务人员血源性病原体职业暴露预防与控制最佳实践[M].上海:上海科学技术出版社, 2012: 3-4.

HU B J. Best practices for prevention and control of occupational exposure to blood-borne pathogens among health care workers[M]. Shanghai:Shanghai Scientific and Technical Publishers, 2012:3-4.

王焕强, 张敏, 李涛, 等.我国医院临床护士职业性锐器刺伤调查[J].中华劳动卫生职业病杂志, 2009, 27(2): 65-70. DOI:10.3760/cma.j.issn.1001-9391.2009.02.001.

WANG H Q, ZHANG M, LI T, et al . A pooling analysis of occupational sharp injury on clinical nurses in China[J ] . Chin J Ind Hyg Occup Dis, 2009, 27(2): 65-70. DOI:10.3760/cma.j.issn.1001-9391.2009.02.001.

张轶, 黄霞. 250例医务人员职业暴露成因分析[J].上海交通大学学报, 2014, 34(12): 1816-1818. DOI:11.3969/j.issn.1674-8115.2014.12.022.

ZHANG Y, HUANG X. Analysis of causes of occupational exposure of 250 medical staff[J]. J Shanghai Jiaotong Univ, 2014, 34(12):1816-1818.DOI:11.3969/j.issn.1674-8115.2014.12.022.

王晓艳, 平宝华, 林永杰, 等.关于综合医院医务人员血源性职业暴露现状调查及伦理对策探讨[J].中国医学伦理学, 2015, 28(3): 308-311.

WANG X Y, PING B H, LIN Y J, et al . Investigation and ethical countermeasures for blood-borne occupational exposure in medical workers in general hospitals[J ] . Chin Med Ethics, 2015, 28(3): 308-311.

桂筱玲, 黄素芳, 潘小平, 等.军队中小医院医务人员职业暴露危险因素分析[J].解放军医院管理杂志, 2014, 21(9): 864-866. DOI:10.16770/j.cnki.1008-9985.2014.09.033.

GUI X L, HUANG S F, PAN X P, et al . Risk factors of professional exposure among medical staff in middle-small-scale military hospitals[J ] . Hosp Adm J Chin PLA, 2014, 21(9):864-866.DOI:10.16770/j.cnki.1008-9985.2014.09.033.

花静, 李家斌, 王进, 等.某三级甲等综合性医院医务人员血源性职业暴露现状调查分析及干预措施评价[J].中华医院感染学杂志, 2017, 27(18): 4286-4289. DOI:10.11816/cn.ni.2017-172504.

HUA J, LI J B, WANG J, et al . Current status of bloodborne occupational exposures among health care workers in a three-A hospital and intervention measures[J ] . Chin J Nosocomiol, 2017, 27(18): 4286-4289. DOI:10.11816/cn.ni.2017-172504.

张咏梅, 江智霞, 酒井顺子, 等.医务人员血源性职业暴露防护措施的应用研究[J].中华医院感染学杂志, 2009, 19(11): 1400-1402. DOI:10.3321/j.issn:1005-4529.2009.11.033.

ZHANG Y M, JIANG Z X, SAKAI J, et al . Hematogenic occupational exposure and protection measures in medical staff[J ] . Chin J Nosocomiol, 2009, 19(11): 1400-1402. DOI:10.3321/j.issn:1005-4529.2009.11.033.

罗斌华, 吴志勇, 李福太, 等.医务人员职业暴露相关危险因素调查与分析[J].中华医院感染学杂志, 2014, 24(24): 6223-6225. DOI:10.11816/cn.ni.2014-133682.

LUO B H, WU Z Y, LI F T, et al . Investigation and analysis of the related risk factors of occupational exposure in medical staff[J ] . Chin J Nosocomiol, 2014, 24(24): 6223-6225. DOI:10.11816/cn.ni.2014-133682.

谈宜斌, 孙代艳, 宋世会, 等.医务人员血源性职业暴露的风险及防控分析[J].中华医院感染学杂志, 2017, 27(1): 221-223. DOI:10.11816/cn.ni.2016-161053.

TAN Y B, SUN D Y, SONG S H, et al . Risk factors and the prevention for hematogenous occupational exposure in medical staff[J ] . Chin J Nosocomiol, 2017, 27(1): 221-223. DOI:10.11816/cn.ni.2016-161053.

王金贤, 杨利亚.医务人员职业暴露调查分析与预防[J].中华医院感染学杂志, 2012, 22(4): 763-765.

WANG J X, YANG L Y. Prevention of occupational exposure to medical staff[J]. Chin J Nosocomiol, 2012,22(4): 763-765.

章泽豹, 蒋景华, 陈文光.医务人员锐器伤发生时间与工作规律关系的研究[J].中国消毒学杂志, 2008, 25(3): 286-287. DOI:10.3969/j.issn.1001-7658.2008.03.024.

ZHANG Z B, JIANG J H, CHEN W G. Study on relationship between occupational injury and job exposure regularity[J]. Chin J Disinf, 2008, 25(3): 286-287. DOI:10.3969/j.issn.1001-7658.2008.03.024.

孙绍娟.手术室护士锐器伤的原因分析与防护对策研究进展[J].中国医学创新, 2010, 7(22): 189-191. DOI:10.3969/j.issn.1674-4985.2010.22.125.

SUN S J. Analysis of the causes of sharp injuries among nurses in operation room and progress in protective[J]. Med Innov China, 2010, 7(22):189-191. DOI:10.3969/j.issn.1674-4985.2010.22.125.

孙吉花, 于苏国, 陈晓琳, 等.多学科协作模式在医院感染预防控制中的应用及管理[J].中华医院感染学杂志, 2010, 20(17): 2639-2641.

SUN J H, YU S G, CHEN X L, et al . Application and management of multi-disciplinary team model in prevention and control of nosocomial infection[J ] . Chin J Nosocomiol, 2010, 20(17): 2639-2641.

GERSHON R R, KARKASHIAN C D, GROSCH J W, et al . Hospital safety climate and its relationship with safe work practices and workplace exposure incidents[J ] . Am J Infect Control, 2000, 28(3):211-221.DOI:10.1067/mic.2000.105288.

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