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细针穿刺抽吸过程中的针刺伤:频率、原因以及细胞病理学家的知识、态度和实践

Needle stick injuries during fine needle aspiration procedure: Frequency, causes and knowledge, attitude and practices of cytopathologists.

作者信息

Kumar Neeta, Sharma Prashant, Jain Shyama

机构信息

Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.

出版信息

J Cytol. 2011 Apr;28(2):49-53. doi: 10.4103/0970-9371.80727.

Abstract

BACKGROUND

There is no study available on the frequency, predisposing factors and outcome of needle stick injury (NSI) in cytopathologists who perform fine needle aspiration (FNA).

AIM

To know the frequency, circumstances and sequlae of NSI sustained by cytopathologists, assess their knowledge about risks of NSI and attitudes and practices towards use of standard precautions and post-injury wound care.

STUDY DESIGN

cross sectional.

SETTING

Tertiary care teaching and non-teaching hospitals and private laboratories.

DATA COLLECTION METHOD

Knowledge, attitude and practices survey using a questionnaire.

RESULTS

Majority (90.5%) of the respondents have had NSI in their total career. In the previous year, more than half (71.4%) had at least one NSI (mean 3.2). NSI was the most common in index finger of non-dominant hand (59.6%) and occurred during step two of FNA procedure when the needle was being manipulated within the lump. The major predisposing factors were uncooperative patients (88.9%), small children (54%), deep masses (36.5%), hot humid climate (88.9%), heavy workload (76.2%) and poor administrative arrangement (54%). The adherence to standard precautions was not optimal (74.6%). None of them reported NSI to the authorities, nor investigated source patient or themselves. 82.5% of the respondents were not aware of any formal exposure reporting system in their hospital.

CONCLUSION

Cytopathologists frequently experience NSI while performing FNA. Frequency of injury is also related to patient characteristics and work site factors. Education and motivation for adhering to standard precautions and post-exposure prophylaxis are often lacking.

摘要

背景

目前尚无关于进行细针穿刺抽吸(FNA)的细胞病理学家针刺伤(NSI)的发生率、诱发因素及后果的研究。

目的

了解细胞病理学家发生NSI的频率、情况及后遗症,评估他们对NSI风险的认知以及对使用标准预防措施和受伤后伤口护理的态度和做法。

研究设计

横断面研究。

研究地点

三级护理教学医院、非教学医院及私立实验室。

数据收集方法

使用问卷进行知识、态度和做法调查。

结果

大多数(90.5%)受访者在其整个职业生涯中都曾发生过NSI。在前一年,超过一半(71.4%)的人至少发生过一次NSI(平均3.2次)。NSI最常发生在非优势手的食指(59.6%),且发生在FNA操作的第二步,即针在肿块内操作时。主要的诱发因素是不合作的患者(88.9%)、幼儿(54%)、深部肿块(36.5%)、炎热潮湿的气候(88.9%)、工作量大(76.2%)和管理安排不佳(54%)。对标准预防措施的遵守情况并不理想(74.6%)。他们中没有人向当局报告NSI,也没有对源患者或自身进行调查。82.5%的受访者不知道他们医院有任何正式的暴露报告系统。

结论

细胞病理学家在进行FNA时经常经历NSI。受伤频率也与患者特征和工作场所因素有关。通常缺乏关于遵守标准预防措施和暴露后预防的教育和激励措施。

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