醫學中心尖銳物扎傷意外事件之分析

Sharp Medical-Object Injuries among Hospital Personnel at a Medical Center in Southern Taiwan

許玉媚(Yu-Mai Hsu) ； 劉建衛(Jien-Wei Liu)

《感染控制雜誌》 13卷1期 (2003/02) Pp. 1-10

https://doi.org/10.6526/ICJ.200302_13(1).0001

摘要

本研究目的是就某醫學中心工作人員，於1998年1月至2001年12月間發生扎傷事件中統計發生密度，分析扎傷物品、原因及扎傷人員之B型肝炎病毒(HBV)、C型肝炎病毒(HCV)、人類免疫缺乏病毒(HIV)及梅毒螺旋體(Treponema pallidum)之血清學變化，並定期追蹤扎傷後血清學變化。4年期間，扎傷事件共計538例，以實習醫師扎傷發生密度最高（2.7次／100人年）、再依次爲清潔員（2.3次／100人年）、護理人員（1.3次／100人年）、技術人員（0.6次／100人年）、醫師（0.6次／100人年）。扎傷人員年資一年以下者佔最多(33.2%)。發生時間以白班最常發生(58.6%)，扎傷物品以注射針頭最多(63.2%)，扎傷原因或情況最常發生在替病人注射或抽血後從病人身上抽出針頭時(20.6%)。血清學方面，致傷物確定遭HBV、HCV、HIV及Treponema Pallidum感染者的血液污染分別有13例、73例、3例及14例，研究期間追蹤結果無血清陽轉情形。本研究與其他醫院的研究比較顯示，醫院工作人員扎傷的危險行爲，原因會隨著醫療環境的時空不同而有所差異。各醫療院所應自行調查，建立資料，供醫院各自制定適當醫院工作人員扎傷政策參考依據。

關鍵字

醫療尖銳物 ； 發生率 ； 扎傷原因 ； 血清陽轉

並列摘要

This investigation was carried out at a 2,368-bed medical center, having 27,273 employees, in southern Taiwan over a 4-year period from January 1998 till December, 2001. The purposes are (1) to assess the incidences of sharp object injuries among hospital personnel; (2) to study the risky behaviors that led to the injury; and (3) to ascertain the seroconversion rate to hepatitis B and C viruses, human immunodeficiency virus, and serological test for syphilis among the injured. The result showed that the incidence was highest among interns (2.7/100 person-years), followed by the house keeping personnel (2.3/100), nurses (1.3/100), medical technologists (0.6/100), and medical doctors (0.6/100). It was highest among workers with less than one year (33.3%), and then among those with more than 5 years (27.7%), of hospital services. It occurred more frequently during the day shift (58.6%) than in the evening or night shift. Injuries from needles for injection were the most common cause (63.2%), compared to other sharp object injuries. The needle stick injury occurred most frequently (20.6%) when withdrawing needle at the time of injection or blood-drawing. There were 13, 73, 3, and 14 cases of injuries by sharp objects involved in the care of patients with positive HBsAg, anti-HCV, anti-REV, and VDRL, respectively. Of those who completed one year of follow-up examinations, 13, 37, 2, and 14 cases, respectively, none had positive conversions. The result of this study and others reveal that some variations may be present in the circumstances when sharp object injuries occur. We suggest that these analytical surveys be conducted at each hospital periodically, and preventive measures established or modified accordingly.

並列關鍵字

sharp medical-object injury ； incidence ； risky behaviors ； seroconversion