醫院職業性針扎事件調查與B型肝炎防治成本探討

Evaluating Occupational Needlestick Accidents and cost-effect of Preventing Hepatitis B

林永崇(Jung-Chung Lin) ； 顧淑芳(Shu-Fang Ku) ； 羅美惠(Mei-Huei Lo) ； 葉國明(Kuo-Ming Yeh) ； 彭銘業(Ming-Yieh Peng) ； 張峰義(Feng-Yee Chang)

《中華職業醫學雜誌》 7卷2期 (2000/04) Pp. 51-56

https://doi.org/10.30027/CJOM.200004.0001

摘要

醫療單位之職業傷害中，針扎事件是最常見且潛在危險的事件。針扎可以導致B型肝炎、C型肝炎、梅毒及愛滋病等。此研究為本院一年期間，確定通報的針扎事件調查，及B型肝炎防治成本效益探討。發現47例針扎事件中，以護理人員最高為53%。從事靜脈注射、處理廢棄針頭、肌肉或皮下注射及抽血為最常見的原因。發生地點以病房為最多(67%)。在B型肝炎的防治上，有23例(49%)接受B型肝炎免疫球蛋白的治療，總共花費552,805，此花費可以提供給737人的注射疫苗防治。在健保、醫院營運及院內感染防治時代來臨，使得降低針扎事件，成為防治的重點。教育訓練員工、預防性的疫苗，及持續的後續追蹤，如此才可避免針扎的職業傷害發生。

關鍵字

針扎 ； B型肝炎 ； 免疫球蛋白 ； 疫苗

並列摘要

Needlestick is the most common occupational injuries among medical personnel. Hepatitis B, hepatitis C, syphilis, HIV may by transmitted through needlestick injury. We designed the protocol for needlestick accidents and discussed the cost-effect of preventing hepatitis B. The highest incidence of needlestick accidents was found among nurses (53%). The manipulating intravenous lines, during needle disposal, during injection and venous puncture were the common etiology of needlestick. The ward was common most place where happened the needlestick accidents. In the prevention and treatment of hepatitis B, there was 49% (23 in 47) patients with needlestick accepted the hepatitis B immunoglobulin treatment. The cost of immunoglobulin was 552,805 NTD, which could provide vaccine for 737 patients. Education, prevention and follow-up could decrease the rates of occupational needlestick accidents in hospital infection control viewpoint.

並列關鍵字

needlstick ； hepatitis B ； immunoglobulin ； vaccine