Lynch P, White M C
School of Public Health and Community Medicine, University of Washington, Seattle.
Am J Infect Control. 1993 Dec;21(6):357-63. doi: 10.1016/0196-6553(93)90402-p.
Occupational blood exposures among operating room personnel have been substantially underreported in incident reports. Recent research has indicated several common factors influencing exposure rates: surgical service (thoracic, neurosurgery, orthopedic), length of operation, and emergency status.
This report examines further data from a study of 8502 surgical cases in nine hospitals, in which a site coordinator and circulating nurses reported consecutive case information, including blood contacts that occurred during the procedures. For three of the participating hospitals, incident reports of blood exposures among operating room personnel that occurred during a 12-month period before the study were also tabulated.
Incident reports underreported parenteral exposures (punctures, mucous membrane and nonintact skin contact with patient blood) by as much as a factor of 25. Individual hospital rates of occupational surgical blood exposure varied considerably.
To ensure that resources to prevent occupational blood exposure are allocated appropriately, on the basis of actual risk, among all personnel, hospitals must actively monitor blood exposures in their operating rooms.
手术室工作人员职业性血液暴露在事件报告中严重少报。近期研究表明了几个影响暴露率的常见因素:外科手术科室(胸外科、神经外科、骨科)、手术时长和急诊状态。
本报告进一步分析了一项对九家医院8502例外科手术病例的研究数据,其中现场协调员和巡回护士报告了连续病例信息,包括手术过程中发生的血液接触情况。对于三家参与研究的医院,还整理了研究前12个月期间手术室工作人员发生血液暴露的事件报告。
事件报告将非肠道暴露(穿刺、黏膜及破损皮肤接触患者血液)少报多达25倍。各医院职业性外科手术血液暴露率差异很大。
为确保根据实际风险在所有人员中适当分配预防职业性血液暴露的资源,医院必须积极监测手术室中的血液暴露情况。