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台灣一醫學中心之針扎分析
Journal Volume
中山醫學雜誌
Journal Issue
v14 n.4 p505-511
Date Issued
2010-07-28T09:23:57Z
Abstract
本研究分析了89位工作於中台灣一醫學中心，分別自民國89年一月至民國90年十二月間，因針扎意外而通報該院感控科之所有個案。研究結果顯示護士是最多發生針扎之族群，佔了66.3％（59/89）。最常見受傷的位置是手部，佔了95.8％（69/72）。最常發生針扎的地方在一般病房，佔了44.8％（39/87）。最常發生的情境是醫療措施執行中，佔了34.8％（31/89）。最常發生的器械是一般注射針頭，佔了42.7％（38/89）。因針扎而暴露到慢性C型肝炎之體液，進而感染了C型肝炎，只發生於一位護士的身上。感染率為11.1％（感染源病人中共有9位呈現C型肝炎抗體陽性反應）。除此之外，並沒有個案顯示因針扎而感染B型肝炎或HIV。以工作年資來看，年資未滿3個月佔18.7％（14/75），未滿6個月佔32.0％（24/75），未滿12個月佔52.0％（39/75）。以整個年度的發生率來看，民國89年及民國90年，各佔2.5％（37/1454）及3.4％（52/1518）。於一年的血液學追蹤檢查過程中，分別只有18.9％（7/37）及19.2％（10/52）完成追蹤。我們希望醫療照護人員（HCP）、醫療事業主管及相關政府行政和立法部門一起來努力，從疫苗接種政策、醫療照護人員繼續教育、環境工程控制、安全醫療器材的設計及有效的暴露後預防政策等全方位預防針扎的危害。
We analyzed 89 cases of needle stick injuries at a medical center in middle Taiwan for the Section of infection Control from January 2000 to December 2001. We found that nurses made up the group that most frequently suffered needle stick injuries (59/89:66.3%) in a hospital setting. The most common site of injury was the right hand in (69/72; 95.8%) of the victims. Most injuries occurred in the general ward (39/87; 44.8%). The most common type of activity taking place when the injuries occurred was medical therapy (31/89; 34.8%). The most common device used during the injuries was syringe injection needles (38/89; 42.7%). Among the 9 nurses that had worked with patients with chronic hepatitis, one was found to have contracted hepatisis C (1/9:11.1%). No one in our series was found to have been exposed to HBV or HIV during the needle point injuries. Of all the needle stick injures, 18.7% (14/75) of the victims had 3 months or less experience, 32% (24/75) had less than half a year, and 52.0% (39/75) had less than 1 year. The total incidence rates for the year 2000 and 2001 were 2.5% (37/1454) and 3.4% (52/1518), respectively. Only 18.9% (7/37) and 19.2% (10/52) of victims had a one-year follow-up examination. 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.
We analyzed 89 cases of needle stick injuries at a medical center in middle Taiwan for the Section of infection Control from January 2000 to December 2001. We found that nurses made up the group that most frequently suffered needle stick injuries (59/89:66.3%) in a hospital setting. The most common site of injury was the right hand in (69/72; 95.8%) of the victims. Most injuries occurred in the general ward (39/87; 44.8%). The most common type of activity taking place when the injuries occurred was medical therapy (31/89; 34.8%). The most common device used during the injuries was syringe injection needles (38/89; 42.7%). Among the 9 nurses that had worked with patients with chronic hepatitis, one was found to have contracted hepatisis C (1/9:11.1%). No one in our series was found to have been exposed to HBV or HIV during the needle point injuries. Of all the needle stick injures, 18.7% (14/75) of the victims had 3 months or less experience, 32% (24/75) had less than half a year, and 52.0% (39/75) had less than 1 year. The total incidence rates for the year 2000 and 2001 were 2.5% (37/1454) and 3.4% (52/1518), respectively. Only 18.9% (7/37) and 19.2% (10/52) of victims had a one-year follow-up examination. 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.