基于暴露可能性-后果法的护理人员在重大突发公共卫生事件中职业暴露风险评估研究
Study of the risk assessment of nursing occupational exposure to major public health emergencies based on the Likelihood Exposure Consequence method.
作者信息
Yan Rong, Zeng Li, Li Su-Yun, Wan Ya-Li, Liu Yun-Fang
机构信息
Department of Orthopedic, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
出版信息
J Occup Health. 2025 Jan 7;67(1). doi: 10.1093/joccuh/uiaf022.
OBJECTIVES
To develop an occupational exposure risk assessment scale for nursing staff during major public health emergencies based on the Likelihood Exposure Consequence (LEC) method. The purpose was to provide managers with a reliable tool for assessing occupational exposure risk faced by nursing staff and to serve as a reference for the formulation of occupational protection standards.
METHODS
The item pool of nursing occupational exposure risk factors was screened using the LEC and accident causation theory. This was achieved through a comprehensive literature review, semistructured interviews, and group discussions. The nursing occupational exposure risk assessment scale was developed in conjunction with the Delphi method. The LEC method was used to assess the risk of occupational exposure among nursing staff in hospital clinical fever settings and to determine the level of occupational exposure risk.
RESULTS
Two rounds of expert inquiry were conducted to obtain the results. The recovery rates of the questionnaires deemed effective were 100%. The coefficients pertaining to expert authority were 0.807 and 0.835, and the coefficients associated with expert opinion coordination were 0.785 and 0.808, respectively. In the assessment of nursing occupational exposure risk in fever clinics, 9 risk factors were identified, with a Danger (D) value of ≥70 and risk level of ≥3. These risk factors encompassed personnel, technical, environmental, and management aspects. Considering the prevailing unsafe factors, it is recommended to enhance personnel management training, bolster protection skills, upgrade environmental facilities, improve the supervision system, and implement other appropriate rectification measures.
CONCLUSIONS
The scale is both scientifically rigorous and have the ability to present evidence in order to enhance the occupational environment for nursing personnel and guarantee their occupational safety. Additionally, it can function as a policy reference for enhancing the response mechanism of the medical and health systems.
目的
基于可能性暴露后果（LEC）法，开发重大突发公共卫生事件期间护理人员职业暴露风险评估量表。目的是为管理人员提供一个评估护理人员面临的职业暴露风险的可靠工具，并为制定职业防护标准提供参考。
方法
运用LEC法和事故因果理论筛选护理职业暴露风险因素项目池。这通过全面的文献综述、半结构化访谈和小组讨论来实现。结合德尔菲法制定护理职业暴露风险评估量表。运用LEC法评估医院临床发热科室护理人员的职业暴露风险，并确定职业暴露风险等级。
结果
进行两轮专家咨询获取结果。有效问卷回收率均为100%。专家权威系数分别为0.807和0.835，专家意见协调系数分别为0.785和0.808。在发热门诊护理职业暴露风险评估中，识别出9个风险因素，危险（D）值≥70，风险等级≥3。这些风险因素涵盖人员、技术、环境和管理方面。针对存在的不安全因素，建议加强人员管理培训，提升防护技能，升级环境设施，完善监督体系，并采取其他适当整改措施。
结论
该量表科学严谨，能够提供证据以改善护理人员的职业环境，保障其职业安全。此外，它可作为完善医疗卫生系统应对机制的政策参考。
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