一项关于某大学兽医教学医院针头处理操作的前瞻性观察研究。

A prospective observational study of needle-handling practices at a University Veterinary Teaching Hospital.

作者信息

Riley C B, McCallum S, MacDonald J A, Hill K E

机构信息

a Institute of Veterinary, Animal, and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand.

出版信息

N Z Vet J. 2016 Mar;64(2):117-20. doi: 10.1080/00480169.2015.1100100. Epub 2015 Nov 10.

DOI:10.1080/00480169.2015.1100100

PMID:26425795

Abstract

AIM

To determine the period prevalence of needlestick injury (NSI) at the Massey University Veterinary Teaching Hospital (VTH) and to identify handling and disposal practices that may contribute to the risk of NSI.

METHODS

Observations of personnel were conducted in the equine (EVH) and companion animal (CAH) clinics of the VTH during scheduled clinical activities over 9- and 10-day periods, respectively. The number and type of NSI incidents, needle uncapping, capping and disposal events were recorded for veterinarians, nurses and other personnel (visitors and students). The number of needle-related practices, as a proportion of observations, were compared between CAH and EVH, and veterinarians, nurses and others using χ(2) tests.

RESULTS

Needlestick injury was not observed during 190 and 163 needle handling and disposal observations in the CAH and EVH, respectively. Uncapping of needles by mouth was observed and was practised more by veterinarians (15/119; 13%) than nurses (2/42; 5%) and others (6/193; 3%) (p=0.001). Two-handed needle recapping after use was observed 265/354 times, and the one handed scooping technique was rarely observed (8/352). In the case of needle disposal, EVH workers used a container that was not purpose built for disposal more than CAH staff (p=0.02), or placed them in a pocket more frequently (p=0.003). Needle disposal containers were available on adjacent bench tops for 65/190 (34%) CAH observations, but no EVH observations. For 51/163 (31%) EVH observations the needle disposal containers were located on the ground, whereas none were observed there in the CAH. No approved sharps containers were observed in the immediate EVH and CAH work areas for 47/163 (28.8%) and 1/191 (0.5%) needle-handling activities, respectively.

CONCLUSIONS

Unsafe needle-handling practices must be reduced by policies and training programmes to encourage safe needle-related practices, and ensuring that approved sharps containers are available in close proximity to where needles are used.

摘要

目的

确定梅西大学兽医教学医院（VTH）针刺伤（NSI）的期间患病率，并识别可能导致针刺伤风险的操作和处置行为。

方法

分别在VTH的马科动物诊所（EVH）和伴侣动物诊所（CAH）进行为期9天和10天的定期临床活动期间，对工作人员进行观察。记录兽医、护士和其他人员（访客和学生）针刺伤事件的数量和类型、针头开封、盖帽和处置情况。使用χ²检验比较CAH和EVH以及兽医、护士和其他人员之间与针头相关操作的数量（占观察次数的比例）。

结果

在CAH和EVH分别进行的190次和163次针头操作和处置观察中，均未观察到针刺伤。观察到有通过嘴部开封针头的情况，兽医（15/119；13%）比护士（2/42；5%）和其他人员（6/193；3%）更常这样做（p = 0.001）。使用后双手盖帽观察到265/354次，单手舀取技术很少观察到（8/352）。在针头处置方面，EVH的工作人员使用非专门用于处置的容器比CAH的工作人员更频繁（p = 0.02），或者更频繁地将针头放在口袋里（p = 0.003）。在CAH的190次观察中有65次（34%）观察到针头处置容器在相邻的台面上，但在EVH未观察到。对于EVH的163次观察中有51次（31%）观察到针头处置容器放在地上，而在CAH未观察到这种情况。在EVH和CAH的即时工作区域，分别有47/163次（28.8%）和1/191次（0.5%）针头操作活动未观察到经批准的锐器容器。