南部某醫學中心尖銳物品扎傷發生率及其相關因素之探討

The Incidence of Sharps Injuries and Related Factors at a Medical Center in Southern Taiwan

李璧伊(Pi-I Li) ； 黃建元(Chien-Yuan Huang) ； 王建楠(Jian-Nan Wang)

《中華職業醫學雜誌》 15卷1期 (2008/01) Pp. 43-53

https://doi.org/10.30027/CJOM.200801.0004

摘要

尖銳物品扎傷(sharps injuries)事件一直以來都是醫療照護人員(health-care workers, HCW)所必須面對的職業傷害，但由於未通報的案例數不明，使得扎傷的預估比率有許多不同的結果。本研究之樣本取自台灣南部某醫學中心,於民國93年1月至民國95年12月間所有主動通報之針扎事件，共計528人次，男女比將近1:4。以當年12月底所有全院醫護人員為分母，93~95年發生率分別為6.25%(192/3073)、5.34%(166/3109)及5.41%(170/3144)，平均年發生率是5.66%。所有發生針扎之平均年齡是28.2歲。所有發生針扎者之工作年資，以未滿1年比例最高，佔36.7%(194/528)。以職業別的發生比例來看，護理人員是最大族群佔60.0%(317/528)，其次是技術人員佔11.7%(62/528)。以發生地點來看，最常發生在一般病房佔37.7%(199/528)。以扎傷物種類分析，最常見為一般的注射針頭，佔42.2%(223/528)。扎傷發生的情境以「清理用畢尚未丟棄之器材扎傷自己或他人」為最常見佔13.8%(73/528)。依95年各職業別發生率來看，護理人員之年發生率最高，為9.32%(107/1148)。本篇研究針對相關針扎意外因子的分析，也對目前針扎預防及處理等實務運作上所遇到的問題加以探討，以供醫療照護人員擬定職前、在職教育及防護措施等訓練之參考。

關鍵字

尖銳物品扎傷 ； 針扎

並列摘要

Sharps injury is the most common occupational injuries among health-care workers (HCW). Reporting of an sharp injury is imperative because penetrative and splash injuries can be potentially life threatening and require health care workers to have vital assessments of their risk of acquiring HIV, syphilis, hepatitis B, and hepatitis C. We analyzed 528 cases of needle stick injuries at a medical center in southern Taiwan from January 2004 to December 2006. The highest incidence of needlestick accidents was found among nurses (317/528, 60%). Most injuries occurred in the general ward (199/528, 37.7%). The most common type of activity taking place when the injuries occurred was during needle disposal (13.8%, 73/528). The most common device used during the injuries was syringe injection needles (42.2%, 223/528).No one in our series was found to have been infected HBV, HCV or HIV during the needle point injuries. The total incidence rates for the year 2004.2005 and 2006 were 6.25%(192/3073)、5.34%(166/3109) and 5.41%(170/3144), respectively. However the estimated rates of injury can vary due to uncertainties about underreporting. Together, health-care personnel, hospital managers, and the government should work to prevent needle stick injuries through modifying procedures, ongoing education, engineering control, use of safety devices and a post-exposure prophylaxis policy.

並列關鍵字

sharps injuries ； needlestick