Alamgir Hasanat, Cvitkovich Yuri, Yu Shicheng, Yassi Annalee
Statistics and Evaluation Department, Occupational Health and Safety Agency for Healthcare, Vancouver, BC, Canada.
Occup Environ Med. 2007 Nov;64(11):769-75. doi: 10.1136/oem.2006.031914. Epub 2007 May 23.
To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada.
Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent (FTE) positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations (registered nurses [RNs], licensed practical nurses [LPNs) and care aides [CAs]) by healthcare setting (acute care, nursing homes and community care).
CAs had higher injury rates in every setting, with the highest rate in nursing homes (37.0 injuries per 100 FTE). LPNs had higher injury rates (30.0) within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates (21.9) occurred in acute care, but their highest (13.0) musculoskeletal injury (MSI) rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs (21.3% of their total injuries) compared with LPNs (14.4%) and CAs (3.7%). Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs (11.1%) than for LPNs (7.2%) and CAs (5.1%).
Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.
研究在加拿大不列颠哥伦比亚省的医疗环境中，不同直接护理职业的伤害发生率和伤害类型如何不同。
数据来自不列颠哥伦比亚省三个卫生区域的标准化运营数据库。伤害发生率定义为每100个全时当量（FTE）岗位的伤害数量。采用泊松回归和广义估计方程，以确定不同医疗环境（急性护理、养老院和社区护理）中与直接护理职业（注册护士[RN]、执业护士[LPN]和护理助理[CA]）相关的伤害风险。
护理助理在每种环境中的伤害发生率都更高，在养老院中的发生率最高（每100个FTE岗位有37.0起伤害）。执业护士在急性护理环境中的伤害发生率（30.0）高于在养老院中的发生率。很少有执业护士在社区护理工作。对于注册护士而言，最高伤害发生率（21.9）出现在急性护理环境中，但他们最高的肌肉骨骼损伤（MSI）发生率（13.0）出现在养老院中。肌肉骨骼损伤在所有职业的总伤害中占比最大。在急性护理和养老院环境中，护理助理的肌肉骨骼损伤风险是注册护士的两倍。在所有环境中，注册护士的穿刺伤（占其总伤害的21.3%）比执业护士（14.4%）和护理助理（3.7%）更为常见。与执业护士（7.2%）和护理助理（5.1%）相比，皮肤、眼睛和呼吸道刺激性损伤在注册护士的总伤害中占比更大（11.1%）。
直接护理职业因其在每个医疗环境中所履行的特定任务和角色而面临不同的职业伤害风险。护理助理最容易遭受肌肉骨骼损伤，因为他们的工作主要包括在患者/居民/客户护理期间进行转移和重新安置任务。策略应侧重于预防所有职业的肌肉骨骼损伤，同时针对注册护士和执业护士的穿刺伤和刺激性损伤。
