台灣醫療人員針扎與血液體液暴觸之監控

Needlestick Injury, Blood & Body Fluid Exposure Surveillance System in Health Care Workers in Taiwan

蕭淑銖(Shiao, JSC) ； 林洺秀(Lin, MH) ； 林曉玫(Lin, HM) ； 陳秋蓉(Chen, CJ)

《中華職業醫學雜誌》 12卷3期 (2005/07) Pp. 135-147

https://doi.org/10.30027/CJOM.200507.0002

摘要

醫療人員常在執業過程中受到針扎傷害或接觸到病患的血液、體液。這些暴觸是醫療人員感染B型及C型肝炎、AIDS、梅毒等血清感染性病原的重要原因。為瞭解“針扎與血液、體液暴觸發生事件”問題之嚴重程度，並確定所有受到針扎與血液體液暴觸之醫療人員均提出報告且受到恰當的治療，我們建立“針扎和血液、體液暴觸事件通報系統。國際間包括美、澳、英、義、日等國家所使用的EPINet (Exposure Prevention Information Network)通報系統是目前針扎暴觸監控的常用系統。研究者於2003年取得EPINet之授權將其翻譯成繁體中文版；目前有十一家醫療院所參與此通報系統。截至93年10底為止，共有130位個案，其中126位醫療人員受到針頭或尖銳物的刺傷，另外4位醫療人員則受到病患血液、體液的暴觸。
受到針頭或銳物刺傷的126位醫療工作者中以護理人員佔多數（82人；65.1%）；刺傷事件出現最頻繁的地點以病房單位為主（52人；41.3%）；在意外事件發生後可確認病人源的共有104位(82.5%)。造成刺傷事件的針頭或銳物中，有114件(90.5%)是受到污染的；其中，超過一半以上（66人；52.4%）的刺傷事件是由拋棄式針頭所引起。將已使用過的針頭重新套上針帽仍是造成針刺意外常見的原因（25人；19.8%）。
本研究顯示在國內使用中文版EPINet可以對醫療人員進行有效的針扎與血液、體液暴觸事件的監控；其中最重要的功能是確認這些事件的發生原因，以提供管理者未來尋求預防或解決問題的方法。

關鍵字

醫療工作人員 ； 針扎 ； 血液體液暴觸

並列摘要

The risk of acquiring an occupational bloodborne pathogen (BBP) is high among health care workers (HCWs) in Taiwan because of the high incidence of needlestick injury (NSI) and high prevalence of Hepatitis B and Hepatitis C Virus (HBV; HCV) in the general community. To better understand the magnitudes of such problems in health care workers, we tried to implement a surveillance system in health care settings in Taiwan. The Exposure Prevention Information Network (EPINet) is well adapted in most advanced countries, i.e. the US, Australia, England, Italy and Japan, and has been proven to be the best surveillance tool nowadays. The investigators acquired the authorization to translate and modify the tool to fit Chinese speaking community's use. Up to the end of October 2004, a total of 130 accidents were reported through the Chinese EPINet system, including 126 NSIs and 4 exposure to blood and body fluids (BBF). Nurses accounted for 65.1% of NSIs, and the most common place of occurrence was patient's room (41.3%). The total number of identifiable source patients was 82.5%. Just over 90% of NSIs were caused by contaminated items, while the most common device causing the NSI being disposable syringes (52.4%). This study showed that Chinese EPINet can be a useful surveillance tool for NSI & BBF exposure in Taiwan HCWs. Further use to determine preventive strategies for these exposures are warranted.

並列關鍵字

Health care worker ； needlestick ； blood and body fluid exposure