Smith Derek R, Leggat Peter A
Department of Hazard Assessment, National Institute of Industrial Health, Kawasaki, Japan.
J Adv Nurs. 2005 Sep;51(5):449-55. doi: 10.1111/j.1365-2648.2005.03526.x.
This paper reports the first investigation of the prevalence and nature of needlestick injuries among Australian nursing students.
Needlestick and sharps injuries are the most efficient method of transmitting blood-borne pathogens between patients and healthcare staff. Although nurses are known to be a high-risk subgroup for these events, nursing students may be at even greater risk due to their limited clinical experience. Despite this fact, the epidemiology of needlestick and sharps injuries among nursing students has not been clearly elucidated in Australia.
A questionnaire-based methodology adapted from other international investigations was conducted among nursing students. We recruited a complete cross-section of students from a large university nursing school in North Queensland, Australia, in March 2004, and analysed needlestick and sharps events as a percentage of all students and also as a proportion of all cases. Risk factors were evaluated using logistic regression.
From a group of 319 students, 274 successfully completed questionnaires were obtained (overall response rate 85.9%). A total of 38 students (13.9%) reported a needlestick or sharps injury during the previous 12 months. By causative item, 6.2% of students had been injured by a normal hollow-bore syringe needle, 3.6% by a glass item and 3.3% by an insulin syringe needle. Regarding prior usage, 81.6% of all injuring items were unused, 15.8% had been used on a patient and the status of 2.6% was unknown. Most needlestick injuries occurred either in the nursing laboratory (45%) or the teaching hospital (37%). Opening the needle cap was the most common causative event (28% of all cases). A total of 39.5% of needlestick injuries were not reported. The main reason for non-reporting was that the item was unused (42%). Logistic regression analysis revealed that students in the third year were 14.8 times more likely to have experienced a needlestick injury than their counterparts in other years (odds ratio 14.8, 95% confidence interval 5.2-50.3, P < 0.01). These injury rates were higher among Australian nursing students than in other international studies.
Although hepatitis B vaccination coverage among the students was excellent, it is important that the principles of infection-control training and reporting of all needlestick and sharps continue to be emphasized throughout undergraduate nursing education.
本文首次对澳大利亚护理专业学生针刺伤的发生率及性质进行调查。
针刺伤和锐器伤是患者与医护人员之间传播血源性病原体最有效的途径。虽然已知护士是这类事件的高风险亚组，但护理专业学生由于临床经验有限，可能面临更大风险。尽管如此，澳大利亚护理专业学生针刺伤和锐器伤的流行病学情况尚未得到明确阐明。
采用基于问卷的方法，该方法改编自其他国际调查，对护理专业学生进行调查。2004年3月，我们从澳大利亚北昆士兰一所大型大学护理学院的全体学生中进行了抽样，分析针刺伤和锐器伤事件占全体学生的百分比以及占所有病例的比例。使用逻辑回归评估风险因素。
在319名学生中，共获得274份有效问卷（总体回复率85.9%）。共有38名学生（13.9%）报告在过去12个月内发生过针刺伤或锐器伤。按致伤物品分类，6.2%的学生被普通空心注射器针头刺伤，3.6%被玻璃物品刺伤，3.3%被胰岛素注射器针头刺伤。关于先前使用情况，所有致伤物品中81.6%未使用过，15.8%曾用于患者，2.6%的状态不明。大多数针刺伤发生在护理实验室（45%）或教学医院（37%）。打开针帽是最常见的致伤事件（占所有病例的28%）。共有39.5%的针刺伤未报告。未报告的主要原因是物品未使用（42%）。逻辑回归分析显示，三年级学生发生针刺伤的可能性是其他年级学生的14.8倍（比值比14.8，95%置信区间5.2 - 50.3，P < 0.01）。这些伤害发生率高于其他国际研究中的澳大利亚护理专业学生。
尽管学生中乙肝疫苗接种率很高，但在本科护理教育中持续强调感染控制培训原则以及报告所有针刺伤和锐器伤情况非常重要。
