Grimmond and Associates, Microbiology Consultants, New Zealand.
Employee Occupational Health Services, Scripps Health, San Diego, CA, USA.
Am J Infect Control. 2019 Dec;47(12):1465-1470. doi: 10.1016/j.ajic.2019.07.004. Epub 2019 Aug 8.
The annual Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.), conducted by the Association of Occupational Health Professionals in Healthcare, provides a U.S. national overview of sharps injuries (SIs) and mucocutaneous exposures (MCEs). This study presents the 2016 and 2017 surveys.
An 18-item survey was distributed to Association of Occupational Health Professionals in Healthcare members and colleagues and requested total SIs and MCEs; SI in nurses, doctors, and surgery; staffed beds; teaching status; full-time equivalent staff (FTE), nurse FTE, and average daily census (ADC).
In 2016, 170 hospitals reported 10,271 exposures (72.9% SIs); in 2017, 224 hospitals reported 12,672 exposures (74.4% SIs). In 2016, SI rates were 27.0 per 100 ADC, 2.3 per 100 FTE, and 2.8 per 100 nurse FTE. Of the total SIs, 36.4% were nurses, 35.6% were doctors, and 39.0% occurred during surgery. In 2017, the respective SI rates were 27.7 per 100 ADC, 2.5 per 100 FTE, and 2.7 per 100 nurse FTE. Of the total SIs, 37.6% were nurses, 32.7% were doctors, and 39.9% occurred during surgery. In 2016, MCE rates were 11.2 per 100 ADC and 0.82 per 100 FTE, and in 2017, MCE rates were 9.6 per 100 ADC and 0.87 per 100 FTE. Teaching hospitals had higher rates than nonteaching hospitals.
EXPO-S.T.O.P. SI rates have risen year-on-year for 3 years and now match 2001-2005 levels.
There is an urgent need for aggressive SI-reduction strategies, including leadership support, safety-engineered devices (SED) training/education, and adoption of safer, less user-dependent SED. Further research on SI mechanisms, SED effectiveness, and reduction strategies is required.
医疗保健职业健康专业人员协会开展的年度职业实践趋势暴露调查（EXPO-S.T.O.P.），提供了美国锐器伤（SIs）和粘膜暴露（MCEs）的全国性概述。本研究介绍了 2016 年和 2017 年的调查结果。
向医疗保健职业健康专业人员协会成员和同事分发了一份包含 18 个项目的调查，要求报告所有锐器伤和粘膜暴露；护士、医生和外科手术中的锐器伤；员工床位；教学状态；全职等效员工（FTE）、护士 FTE 和平均每日患者人数（ADC）。
2016 年，170 家医院报告了 10271 例暴露（72.9%的 SIs）；2017 年，224 家医院报告了 12672 例暴露（74.4%的 SIs）。2016 年，锐器伤发生率为每 100 ADC 27.0 例，每 100 FTE 2.3 例，每 100 护士 FTE 2.8 例。在所有的锐器伤中，36.4%是护士，35.6%是医生，39.0%发生在手术中。2017 年，相应的锐器伤发生率为每 100 ADC 27.7 例，每 100 FTE 2.5 例，每 100 护士 FTE 2.7 例。在所有的锐器伤中，37.6%是护士，32.7%是医生，39.9%发生在手术中。2016 年，粘膜暴露发生率为每 100 ADC 11.2 例，每 100 FTE 0.82 例，2017 年，粘膜暴露发生率为每 100 ADC 9.6 例，每 100 FTE 0.87 例。教学医院的发生率高于非教学医院。
EXPO-S.T.O.P. 的锐器伤发生率连续 3 年呈上升趋势，现已达到 2001-2005 年的水平。
迫切需要采取积极的锐器伤减少策略，包括领导层的支持、安全工程器械（SED）的培训/教育，以及采用更安全、用户依赖性更低的 SED。需要进一步研究锐器伤机制、SED 的有效性和减少策略。
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