Department of General Surgery, York District Hospital, Wigginton Road, York YO31 8HE, UK.
Occup Med (Lond). 2010 Mar;60(2):139-44. doi: 10.1093/occmed/kqp175. Epub 2010 Jan 11.
Needlestick injuries are common during surgical procedures. Following such an injury, local protocols should be followed to minimize the risk of infection.
To identify who sustains such injuries, under what circumstances and what actions are taken to minimize the risk and in response to intraoperative needlestick injuries.
A questionnaire was submitted via e-mail to all staff in a National Health Service trust who took part in operations. The results were checked against occupational health department (OHD) records.
One hundred and thirty-six of 255 appropriate responders completed the questionnaire (53%). Fifteen of 31 consultants (48%), 12/36 junior doctors (33%), 0/39 midwives (0%) and 8/30 theatre staff (27%) reported having had at least one intraoperative needlestick injury over the past year. Awareness of local protocols was significantly worse in the junior doctor group. Ninety-three percent of consultants, 67% of junior doctors and 13% of theatre staff did not comply with local protocols. The length of time it takes to do so (48%) and a perceived low infection risk of the patient (78%) were the commonest reasons for this. Hand dominance, role during surgery and double gloving were not significant risk factors; however, rare use of a no-touch technique was. Comparison with OHD records suggested that a maximum of 16% of intraoperative needlestick injuries were dealt with in accordance to local policy.
Non-compliance with needlestick injury protocols is commonest among senior surgical staff. A revision of the protocol to reduce the time it takes to complete it may improve compliance.
手术过程中经常发生针刺伤。发生此类损伤后,应遵循局部方案以将感染风险降至最低。
确定哪些人会遭受此类损伤、在什么情况下发生以及采取什么措施来将风险降至最低,以及针对术中针刺伤。
通过电子邮件向在国民保健服务信托机构中参与手术的所有工作人员发送问卷。将结果与职业健康部门 (OHD) 的记录进行核对。
在 255 名合适的应答者中,有 136 名(53%)填写了问卷。31 名顾问中有 15 名(48%)、36 名初级医生中有 12 名(33%)、39 名助产士中没有(0%)和 30 名手术室工作人员中有 8 名(27%)报告在过去一年中至少发生过一次术中针刺伤。初级医生组对当地方案的认识明显较差。93%的顾问、67%的初级医生和 13%的手术室工作人员未遵守当地方案。常见的原因是完成它所需的时间(48%)和患者感染风险低(78%)。手的优势、手术期间的角色和双层手套并不是重要的危险因素;但是很少使用无接触技术。与 OHD 记录的比较表明,只有最多 16%的术中针刺伤按照当地政策进行了处理。
不遵守针刺伤方案在高级外科工作人员中最为常见。修订方案以减少完成时间可能会提高依从性。