Smith D R, Mihashi M, Adachi Y, Nakashima Y, Ishitake T
Department of Hazard Assessment, National Institute of Industrial Health, Kawasaki, Japan.
J Hosp Infect. 2006 Sep;64(1):44-9. doi: 10.1016/j.jhin.2006.03.021. Epub 2006 Jul 10.
The epidemiology of needlestick and sharps injuries (NSIs) was investigated among a complete cross-section of 1,162 nurses from a large hospital in southern Japan (response rate 74.0%). Forty-six percent had experienced an NSI in the previous year. Most were caused by ampoules or vials, which injured 32.3% of all nurses and accounted for 42.9% of all NSI events. Twenty-two percent of all NSIs involved a device that had been used on a patient prior to the NSI (contaminated device), while the usage status of a further 2.8% of devices was unknown. Logistic regression indicated that nurses younger than 25 years of age were 2.18 times more likely to have sustained a single NSI in the past 12 months [odds ratio (OR) 2.18, 95% confidence intervals (CI) 1.15-4.17] and 2.39 times more likely to have sustained multiple NSIs (OR 2.39, 95% CI 1.08-5.34). Working mixed shifts (rotating day and night, as opposed to day shifts alone) was associated with a 1.67-fold increased risk of sustaining any NSI (OR 1.67, 95% CI 1.01-2.85) and a 2.72 times greater risk of sustaining an NSI from a contaminated device (OR 2.72, 95% CI 1.71-4.44). Nurses who reported significant fatigue after work were 1.87 times more likely to sustain multiple NSIs (OR 1.87, 95% CI 1.13-3.13) and 1.94 times more likely not to report their NSIs (OR 1.94, 95% CI 1.03-3.71). Perceived high mental pressure was associated with a 1.75-fold increased risk of sustaining an NSI from a contaminated device (OR 1.75, 95% CI 1.07-2.88). Nurses who reported suboptimal staffing levels in their wards were 2.21 times more likely not to report any NSIs they sustained in the previous year (OR 2.21, 95% CI 1.06-4.89). Overall, this study suggests that NSIs represent a complex and multi-faceted problem for Japanese nurses. Intervention strategies should consider the emerging complicity of psychosocial factors on NSI among hospital staff in Japan, as elsewhere.
对日本南部一家大型医院1162名护士的完整横断面群体进行了针刺伤和锐器伤（NSIs）的流行病学调查（应答率74.0%）。46%的护士在前一年经历过针刺伤或锐器伤。大多数此类伤害是由安瓿瓶或药瓶造成的，这些导致了32.3%的护士受伤，占所有针刺伤和锐器伤事件的42.9%。所有针刺伤和锐器伤中有22%涉及在针刺伤或锐器伤发生前曾用于患者的器械（受污染器械），另有2.8%器械的使用状态不明。逻辑回归分析表明，25岁以下的护士在过去12个月内发生单次针刺伤或锐器伤的可能性高2.18倍[比值比（OR）2.18，95%置信区间（CI）1.15 - 4.17]，发生多次针刺伤或锐器伤的可能性高2.39倍（OR 2.39，95% CI 1.08 - 5.34）。轮班工作（日夜轮转，而非仅上日班）会使发生任何针刺伤或锐器伤的风险增加1.67倍（OR 1.67，95% CI 1.01 - 2.85），因受污染器械导致针刺伤或锐器伤的风险增加2.72倍（OR 2.72，95% CI 1.71 - 4.44）。报告下班后极度疲劳的护士发生多次针刺伤或锐器伤的可能性高1.87倍（OR 1.87，95% CI 1.13 - 3.13），不报告针刺伤或锐器伤情况的可能性高1.94倍（OR 1.94，95% CI 1.03 - 3.71）。感知到的高精神压力会使因受污染器械导致针刺伤或锐器伤的风险增加1.75倍（OR 1.75，95% CI 1.07 - 2.88）。报告病房人员配备不足的护士不报告上一年所发生针刺伤或锐器伤情况的可能性高2.21倍（OR 2.21，95% CI 1.06 - 4.89）。总体而言，本研究表明针刺伤和锐器伤对日本护士来说是一个复杂且多方面的问题。干预策略应考虑到日本医院工作人员中社会心理因素对针刺伤和锐器伤影响的新复杂性，其他地方亦是如此。
