Wilson Sean P, Miller Joseph, Mahan Meredith, Krupp Seth
Department of Emergency Medicine, Henry Ford Hospital System, Detroit, MI.
Department of Statistics, Henry Ford Hospital System, Detroit, MI.
Acad Emerg Med. 2015 Nov;22(11):1348-50. doi: 10.1111/acem.12797. Epub 2015 Oct 15.
Health care workers are at risk for sharps-related injuries while working in the clinical arena. The authors sought to quantify and compare the frequency of these injuries for all health care personnel between the urban and community emergency department (ED).
A retrospective review was performed on the institutional human resources database of all self- or supervisor-reported sharps-related injuries that occurred to ED personnel in a single health system from January 2010 through September 2014. The health system was composed of a single urban academic Level I trauma center and seven community EDs, two of which were academic Level III trauma centers. Each sharps-related injury was reviewed for site of injury, job class, and type of instrument causing the injury.
There were 171 sharps-related injuries reported during 447,986 urban and 1,350,623 community patient visits. Of the 171 injuries, 44.4% occurred to physicians, 39.2% to nurses, 12.9% to support staff, and 3.5% to physician assistants. Injuries occurred more frequently at the urban academic medical center when compared to the pooled community sites: 20.3 per 100,000 patient visits (n = 91) versus 5.9 per 100,000 patient visits (n = 80), respectively (odds ratio = 3.43, 95% confidence interval = 2.54 to 4.63, p < 0.001). They also occurred more frequently at the urban site when individually compared to each community site.
Physicians accounted for the largest proportion of health care workers reporting sharps-related injuries. These injuries occurred more frequently in the urban ED than in the community EDs.
医护人员在临床工作中面临锐器伤风险。作者试图对城市和社区急诊科所有医护人员的此类损伤频率进行量化和比较。
对一个医疗系统中2010年1月至2014年9月期间急诊科人员自我报告或主管报告的所有锐器伤事件的机构人力资源数据库进行回顾性分析。该医疗系统由一家城市一级学术创伤中心和七家社区急诊科组成，其中两家是三级学术创伤中心。对每起锐器伤事件的受伤部位、工作类别和致伤器械类型进行审查。
在城市急诊科的447,986次患者就诊和社区急诊科的1,350,623次患者就诊期间，共报告了171起锐器伤事件。在这171起损伤中，44.4%发生在医生身上，39.2%发生在护士身上，12.9%发生在辅助人员身上，3.5%发生在医师助理身上。与合并的社区场所相比，城市学术医疗中心的损伤发生率更高：分别为每100,000次患者就诊20.3起（n = 91）和每100,000次患者就诊5.9起（n = 80）（优势比 = 3.43，95%置信区间 = 2.54至4.63，p < 0.001）。与每个社区场所单独比较时，城市场所的损伤发生率也更高。
报告锐器伤的医护人员中，医生占比最大。这些损伤在城市急诊科比在社区急诊科更频繁发生。
