[Risk factors analysis and intervention of blood-borne occupational exposure in medical staff]

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2022 Jan 20;40(1):53-56. doi: 10.3760/cma.j.cn121094-20201217-00696.
[Article in Chinese]

Abstract

Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade Ⅲ, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.

目的: 分析医务人员发生血源性职业暴露的危险因素并探讨相关干预对策。 方法: 于2020年6月,采用回顾性调查方法,对某三级甲等综合性医院的2011至2019年上报的血源性职业暴露数据及相关因素进行统计分析。 结果: 431例血源性职业暴露人员中,护士占69.37%(299/431);工龄0~4年的医务人员占63.57%(274/431);职业暴露主要发生场所主要在病房[占47.56%(205/431)];职业暴露途径以锐器伤为主[占91.65%(395/431)];职业暴露科室以外科为主[占17.87%(77/431)];暴露源主要以乙型肝炎病毒(HBV)为主[占37.12%(160/431)],其次为梅毒螺旋体[占20.19%(87/431)]。不同职业岗位的暴露场所、血源性暴露源、暴露操作环节间差异均有统计学意义(χ(2)=22.693、43.585、126.726,P<0.01);暴露后的处理方式(挤血、冲洗、消毒)差异均有统计学意义(χ(2)=18.866、31.963、14.216,P<0.01)。 结论: 加强医务人员职业防护培训、规范操作流程,加强重点人群重点科室的监管,完善上报、监测和随访制度实现信息化,做好风险管控,是降低血源性职业暴露的有效措施。.

Keywords: Blood borne; Intervention countermeasures; Medical personnel; Occupational exposure; Occupational protection; Statistical analysis.

MeSH terms

  • Blood-Borne Pathogens
  • Humans
  • Medical Staff
  • Needlestick Injuries*
  • Occupational Exposure* / prevention & control
  • Retrospective Studies
  • Risk Factors