從實證護理的觀點談針扎及預防

Evidence-Based Nursing on Needle Stick Injury and Prevention

方嬋娟(Chan-Chuan Fang) ； 梁幸如(Hsin-Ju Liang) ； 劉永芳(Yung-Fang Liou)

《中華職業醫學雜誌》 20卷1期 (2013/01) Pp. 65-71

摘要

針扎是最常發生於醫療場所的職業傷害，亦是造成醫療工作人員感染血液傳染疾病如B型肝炎、C型肝炎、梅毒及愛滋病等最常見的原因。統計指出，醫療工作人員中又以護理人員的針扎比率最高。針扎後可能對個人造成身、心、社會等層面的影響，尤其在自身及感染源的疾病資料未明、或為取得感染源的檢驗結果，所需面臨的醫療倫理及法律問題，更讓人陷入困境及產生擔憂及恐懼等不確定感，而針扎後續衍生的個人健康問題或整體健康照護體系的處理、追蹤等，更需要額外的成本支出。探討發生針扎可能的相關因素包括：不適當的針頭放置、針頭回套及拔除針頭、工作年資、人員的素質、及醫院的安全氣候等，據此建議預防針扎的方法包括：倡導良性的工作環境安全文化，促進針扎事件通報、選擇適當的預防針扎設備、提供教育訓練，並提供員工定期的健康檢查及免費B型肝炎疫苗接種，希望能提供安全的工作環境，降低職業傷害，保障護理人員的健康。

關鍵字

針扎 ； 預防 ； 實證護理

並列摘要

The needle stick injury is the most common occupational injuries in health facilities, and also been handed is caused by the health-care workers infected with blood-borne diseases such as hepatitis B, hepatitis C, syphilis and AIDS, etc. According to statistics indicate that the nurse have the highest rate of needle stick injury in health-care workers. Needle stick injury may cause the physical, mind, social impact on individuals, especially in their own and the patient's infectious diseases data is unknown, or to obtain the patient's test results, required face of medical ethics and legal issues, the more people trouble and worries and fear of uncertainty, the needle stick injury's follow-up of the personal health problems or the overall health care system processing, tracking, etc., require additional costs to expenditure. To estimate the possible factors related to explore the reasons for needle sticks injury include: inappropriate needle placement, the needle back and removal of needles, working capital, the quality of personnel, and hospital safety climate, it is suggested to adopt the prevention of needle stick injury the methods include: safety culture to promote healthy working environment, and promote the needle incident report, select the appropriate prevention and needle devices, to provide education and training, and provide works for regular health checks and free hepatitis B vaccination, and hope to provide a safe working environment, reducing occupational injuries, to protect the health of nurses.

並列關鍵字

Needle stick injury ； Prevention ； Evidenced-based nursing