- 期刊
南部某地區護理科系應屆畢業生針扎研究
Needlestick Injuries Among the Final Year Student Nurses from One Area of Southern Taiwan
摘要
醫療工作人員的職業傷害中，針扎是最常見的一種。針扎亦是醫療工作人員感染B型肝炎、C型肝炎、後天性免疫不全症候群、梅毒等血清性感染性病原的重要來源之一。本研究的目的在瞭解護理科系應屆畢業生對針扎的認知，包括對血清性感染性病原的認知、個人針扎的經驗及針扎後的處理情形等。研究對象為某地區四所護理學校，包括大學、專科及護校共１４４９位不同學制之應屆畢業生。結果發現僅三分之一的學生（３４．６％，５０１人）完全答對針扎與感染血清性病原的相關問題。共有３８．６％（５５９人）的護生曾有針扎經驗，最常發生地點為內外科病房；打開針頭蓋子或回套針頭蓋是發生針扎最常見的情境（５８．１％，３３２人），一般注射針頭則是造成針扎最常見的物品（５２．７％，３６４人），而５２．２％的針頭曾被使用於病人身上。被扎傷的護生中６４．４％（３１６人）曾擔心會感染到血清性病原，擔心時間約持續一週，此外，僅３８．５％（２１５人）的護生被針扎傷後會向老師或單位報告；未做任何處理者佔５３．１％（２９７人），主要原因是剌傷她的針頭未被使用過。大多數的護生認為討扎後應該處理的方式包括將污血擠出（８５．３％），發生污染性針扎時應向指導老師報告（７８．７％），以清水沖洗傷口（７２．３％），以酒精或優碘等消毒傷口（６７．２％），並追查針頭是否使用過。根據本研究結果我們建議學校應加強謢生對污染性針扎的危害認知，且臨床實習時應被提供適當的針扎預防措施，如安全空針的使用及合格的空針收集盒等。此外，亦應考慮強制護生向老師或實習指導者報告任何的針扎事件，不僅可提高針扎報告率更重要的是能在針扎意外發生後做最恰當的處理。
並列摘要
Needlestick injuries (NSIs) are the major cause of occupational transmission of hepatitis Band C viruses, human immunodeficiency virus, and syphilis in health care workers (HCWs). The purpose of this study was to determine student nurse (SNs),percentions of NSI including their knowledge of contracting bloodborne pathogens (BBPs) after sustaining an NSI and its management. A total of 1449 final year SNs from tour nursing schools of different disciplines were recruited into this study. Only one third (34.6%, n=501) of the surveyed students had correctly answered questions relating to seroconverion after an NSI; 38.6% (n=559) had sustained an NSI during their internship rotation. The most frequently reported circumstances of NSIs were opening needle caps and recapping of needles. Ordinary needles were the major cause of NSIs, with 52.2% being used on patients. Of the stuck SNs, 64.4% (n=316) ever worried being seroconverted, and the duration of such concern lasted for one week. Although more SNs (78.8%) believed that they should report their incidences. Just over one third (38.5%. n=215) of stuck SNs did, and more than a half (53.1%, n=297) did nothing for this NSI as the needles were believed unused. More SNs than not sustained an NSI during their training which suggests that educators have failed to protect their students with the practical skills required to protect them from BBP contraction and with knowledge of Universal Precautions that would assist them in their adherence to such important practices. In addition, the mandatory of reporting an NSI is warranted for appropriate medical management after sustaining an NSI.