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某大学医院中不同器械导致的针刺伤发生率。

Rates of needle-stick injury caused by various devices in a university hospital.

作者信息

Jagger J, Hunt E H, Brand-Elnaggar J, Pearson R D

机构信息

Department of Neurosurgery, University of Virginia, Charlottesville 22908.

出版信息

N Engl J Med. 1988 Aug 4;319(5):284-8. doi: 10.1056/NEJM198808043190506.

Abstract

We identified characteristics of devices that caused needle-stick injuries in a university hospital over a 10-month period. Hospital employees who reported needle sticks were interviewed about the types of devices causing injury and the circumstances of the injuries. Of 326 injuries studied, disposable syringes accounted for 35 percent, intravenous tubing and needle assemblies for 26 percent, prefilled cartridge syringes for 12 percent, winged steel-needle intravenous sets for 7 percent, phlebotomy needles for 5 percent, intravenous catheter stylets for 2 percent, and other devices for 13 percent. When the data were corrected for the number of each type of device purchased, disposable syringes had the lowest rate of needle sticks (6.9 per 100,000 syringes purchased). Devices that required disassembly had rates of injury of up to 5.3 times the rate for disposable syringes. One third of the injuries were related to recapping. Competing hazards were often cited as reasons for recapping. They included the risk of disassembling a device with an uncapped, contaminated needle and the difficulty of safely carrying several uncapped items to a disposal box in a single trip. New designs could provide safer methods for covering contaminated needles. Devices should be designed so that the worker's hands remain behind the needle as it is covered, the needle should be covered before disassembly of the device, and the needle should remain covered after disposal. Such improvements could reduce the incentives for recapping needles and lower the risk of needle-stick injuries among health care workers.

摘要

我们确定了在一家大学医院10个月期间导致针刺伤的器械特征。对报告针刺伤的医院员工就致伤器械类型和受伤情况进行了访谈。在研究的326起损伤中,一次性注射器占35%,静脉输液管和针头组件占26%,预充式注射器占12%,翼形钢针静脉输液器占7%,采血针占5%,静脉导管芯占2%,其他器械占13%。当根据每种器械的购买数量对数据进行校正后,一次性注射器的针刺发生率最低(每购买100,000支注射器中有6.9起针刺伤)。需要拆卸的器械的损伤发生率高达一次性注射器的5.3倍。三分之一的损伤与重新盖帽有关。相互竞争的危险因素常被引述为重新盖帽的原因。这些因素包括拆卸带有未盖帽、受污染针头的器械的风险,以及一次将几个未盖帽物品安全运送到处置箱的困难。新设计可以提供更安全的覆盖受污染针头的方法。器械的设计应使工人在覆盖针头时手位于针头后方,在拆卸器械前应覆盖针头,并且在处置后针头应保持被覆盖状态。这样的改进可以减少重新盖帽针头的动机,并降低医护人员针刺伤的风险。

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