某醫學中心針扎事件調查及預防成效的探討

The Report of Needle Sticks and the Efficacy of Prevention in a Medical Center

丘亮(Liang Chiu) ； 林忠順(Tiing-Soon Ling) ； 羅錦泉(Jiin-Chyuan Luo)

《中華職業醫學雜誌》 8卷3期 (2001/07) Pp. 149-155

摘要

執行醫護工作時被針扎是醫療保健機構最常見且潛在危險的事件。針扎的潛在危險主要來自血液或體液性傳染的病菌，使用後的針器若已沾染了病患的血液或體液時，即屬於污染性針器；此時若工作人員再遭其扎傷，則可能因而感染病菌。文獻顯示目前已知可藉由污染的針頭傳播之病原菌包括B型肝炎病毒、C型肝炎病毒、愛滋病、梅毒等20種以上。本次調查為該院最近二年半之針扎事件報告加以分析整理，總計針扎件數共 697件，結果如下：(1)被扎人員職別中以護士最多，佔363人(52.1%)；(2)針扎時從事之醫療活動以靜脈針留置最多，佔133人(19.1%)；(3)發生針扎之地點以病房最多，佔331人(47.5%)(4)操作針器步驟以移除或更換針頭時最多，佔140人(20.1%)；(5)針扎時針之類別以一般丟棄式注射用針最多，佔322人(47.6%)。在做這項針扎事件調查期間，醫院安全衛生委員會在預防針扎意外之防治實務上，曾在民國八十八年五月(即調查期間的期中)做全院性預防針扎的宣導，經分析及統計檢定後，發現全院性預防針扎宣導前後的針扎通報比率並沒有明顯差異。持續的教育可使每個工作人員瞭解針扎的危害，進而採取適當的預防措施避免針扎。即使被扎傷也能較正確的處置。確實執行全院污染性針扎的通報及處理系統，才能減少針扎所造成的職業傷害。

關鍵字

針扎 ； 污染性針器

並列摘要

The needle stick injuries of health care workers were the most common and latent dangerous in the health care organizations. The latent dangerous of needle sticks come from the blood and the body fluid transmitted diseases. The contaminative needles mean that the needles were contaminated by the blood or the body fluid of patients. If the health care workers unfortunately get the contaminative needle stick injuries, they may infect the diseases. The results of many studies showed that the contaminative needles can spread more than 20 types disease including hepatitis B virus, hepatitis C virus, AIDS, and syphilis etc. We collected the needle stick reports of the medical center during recent 2.5 years. Totally 697 reports were analyzed. The data indicated as follows: (1) Among the occupational kinds, the amount of needle stick injuries from nurse was the most, share 363 peoples (52.1 %) ; (2)among the activity of medical treatment, the detention of intravenous catheter insertion was the most, share 133 peoples( 19.1 %); (3)the ward was the most common space of needle sticks, share the 331 peoples(47.5%) ; (4)the operated procedure of removing or changing needles was the most, share 140 peoples (20.1 %); (5)the disposable syringe was the most kind of needle sticks, share the 332 people (47.6%). The safe hygiene committee of the hospital had ever guided the prevention of the needle sticks during the period of our investigation. The propaganda of the needle stick prevention was started since 1999, May. The reporting rate of needle sticks was compared with the before and after propaganda. There is no significant difference after analysis of statistic methods. However every health care worker would know the dangerous of needle sticks via education continuously. The measures of appropriate prevention may avoid needle sticks. Although get the injury from the needle stick, they can make the fitting management. If the reporting and the management systems of contaminative needle sticks carry out assuredly in the hospital, the occupational hurt of needle sticks will be decreased.

並列關鍵字

Needle stick ； contaminative needles