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目的了解基层医院医务人员职业暴露的态势及危险因素,并提出应对措施。方法对佛山市南海区第四人民医院2012-2015年发生的149例职业暴露案例中医务人员的职业、暴露过程、暴露物品、处理过程等进行追踪和调查,掌握医务人员职业认知和预防标准的依从性,根据该院实际情况建立预防体系,防止血源性职业暴露的发生。结果 2012-2015年血源性职业暴露人次达149例,平均每年受伤37.25例,其中锐器伤139名(93.29%)。暴露地点:病房占52.35%,门急诊注射输液室占26.17%,手术室占10.74%,污物间占6.04%,其他占4.70%。暴露后处理:及时规范伤口处置占比75.84%,伤口处置不规范、不及时占比17.45%,未现场伤口处置占比6.71%。结论基层医院护理队伍不稳定是血源性锐器伤发生率逐年递增的主要原因。暴露因素主要包括个人素质、职业暴露防护认知缺乏,个人自我保护意识及操作过程不规范等。建立并强化血源性职业防控机构工作制度,可有效避免锐器伤引发的血源性传播疾病。
Objective To understand the situation and risk factors of occupational exposure of medical workers in primary hospitals and to put forward countermeasures. Methods Follow-up and investigation were conducted in occupational exposure, exposure, handling and so on in 149 cases of occupational exposure in Fourth People’s Hospital of Nanhai District, Foshan City in 2012-2015, to grasp the standards of occupational cognition and prevention of medical staff Compliance, based on the actual situation of the hospital to establish a preventive system to prevent the occurrence of blood-based occupational exposure. Results A total of 149 blood-related occupational exposures were reported between 2012 and 2015, with an average of 37.25 cases of injuries per year, of which 139 (93.29%) were acute injuries. Exposure sites: ward accounted for 52.35%, outpatient and emergency department infusion infusion room accounted for 26.17%, operating room accounted for 10.74%, dirt accounted for 6.04%, others accounted for 4.70%. Post-exposure treatment: 75.84% of wounds were treated in a timely manner. Irregular wounds were handled in less than 17.45% of the wounds and 6.71% of the unwounded wounds. Conclusions The instability of the nursing team in primary hospitals is the main reason for the increasing incidence of blood-borne injuries. Exposure factors include personal qualities, lack of awareness of occupational exposure protection, personal awareness of self-protection and non-standard operating procedures. Establishing and strengthening the working system of blood-borne occupational prevention and control agencies can effectively prevent blood-borne diseases caused by sharp wounds.