医院护士的血液职业暴露：前瞻性、回顾性及机构报告。
Hospital nurses' occupational exposure to blood: prospective, retrospective, and institutional reports.
作者信息
Aiken L H, Sloane D M, Klocinski J L
机构信息
Center for Health Services and Policy Research, University of Pennsylvania, Philadelphia 19104-6096, USA.
出版信息
Am J Public Health. 1997 Jan;87(1):103-7. doi: 10.2105/ajph.87.1.103.
OBJECTIVES
This study examined nurses risk of exposure to blood resulting from injuries with needles and sharps, the methods of estimating those risks, and the factors affecting risks.
METHODS
Nurses on 40 medical units in 20 hospitals in cities with a high incidence of AIDS were studied. Percutaneous injuries were documented for every shift during a 30-day period. These prospective reports were compared with retrospective and institutional reports. Factors affecting the likelihood of injuries were explored.
RESULTS
Based on the prospective reports, the rate of injuries to staff nurses was 0.8 per nurse-year. Prospective and retrospective rates were similar, while institutional rates were significantly lower. Factors associated with increased injuries included recapping needles and temporary work assignments. Working in hospitals characterized by professional nurse practice models and taking precautions to avoid blood contact were associated with fewer injuries.
CONCLUSIONS
Injuries from needlesticks are more common than institutional reports suggest and do not occur at random. Diminishing the frequency with which nurses recap needles, increasing precautions they take, reducing use of temporary nursing personnel, and implementing organizational changes may lower the odds of nurses being injured.
目的
本研究调查了护士因针刺和锐器伤而接触血液的风险、估计这些风险的方法以及影响风险的因素。
方法
对艾滋病高发城市20家医院40个医疗科室的护士进行了研究。在30天的时间里，记录每个班次的经皮损伤情况。将这些前瞻性报告与回顾性报告和机构报告进行了比较。探讨了影响受伤可能性的因素。
结果
根据前瞻性报告，注册护士的受伤率为每年每护士0.8次。前瞻性和回顾性报告的受伤率相似，而机构报告的受伤率显著较低。与受伤增加相关的因素包括重新盖帽针头和临时工作安排。在以专业护士执业模式为特点的医院工作并采取预防措施避免血液接触的护士受伤较少。
结论
针刺伤比机构报告显示的更为常见，且并非随机发生。减少护士重新盖帽针头的频率、增加预防措施、减少临时护理人员的使用以及实施组织变革可能会降低护士受伤的几率。
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