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2014 年至 2017 年印度尼西亚一所三级教学医院的针刺伤和锐器伤:一项队列研究。

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study.

机构信息

Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia

HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia.

出版信息

BMJ Open. 2020 Dec 8;10(12):e041494. doi: 10.1136/bmjopen-2020-041494.

Abstract

OBJECTIVE

Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.

METHODS

A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).

RESULTS

Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.

CONCLUSION

In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.

摘要

目的

医护人员(HCWs)发生针刺和锐器伤会带来严重的职业健康问题。本研究旨在提供印度尼西亚一所三级教学医院中 HCWs 发生针刺和锐器伤(NSSI)的发生率和其他流行病学特征,为评估 NSSI 预防计划提供信息。

方法

在雅加达 Cipto Mangunkusumo 医院进行了一项队列研究。我们分析了 2014 年 1 月至 2017 年 12 月期间医院锐器伤计划的数据。计算了 NSSI 的发生率,每 1000 人-年(1000-PY)计算一次。

结果

在 4 年期间,共报告了 286 例 NSSI。4 年的平均 NSSI 发生率为 13.3/1000-PY,2015 年达到峰值(15.5/1000-PY),随后有所下降。大多数 NSSI 发生在护士身上(42.7%),但发生率最高的是助产士(18.9/1000-PY),其次是护士、医学生和医生(15.2/1000-PY、12.6/1000-PY 和 11.8/1000-PY)。导致 NSSI 比例最高的器械是空心针(66.8%),其次是缝合针(14.3%)和实心针(10.8%)。9.4%的 NSSI 与胰岛素笔注射有关。在所有事件中,31.3%发生在手术过程中,25.9%发生在采血过程中,14.3%发生在药物注射给药过程中,13.3%发生在废物清理过程中。

结论

总之,本研究显示不同职业 NSSI 的发生率不同,其中助产士和护士的发生率最高。许多不安全的工作做法仍在继续,这令人极为关注。我们建议包括培训和培养更安全的工作场所做法在内的预防机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8d8/7725075/30df71ed10fa/bmjopen-2020-041494f01.jpg

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