發(fā)布時(shí)間：2018-03-09 18:18

  本文選題：實(shí)習(xí)護(hù)生　切入點(diǎn)：銳器傷　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：調(diào)查湖南省實(shí)習(xí)護(hù)生銳器傷后規(guī)范處理的依從性現(xiàn)狀,分析原因及影響因素,為提高實(shí)習(xí)護(hù)生銳器傷后規(guī)范處理的依從性提供依據(jù),減少銳器傷對(duì)實(shí)習(xí)護(hù)生造成的不良影響,提高實(shí)習(xí)護(hù)生對(duì)銳器傷的認(rèn)識(shí)。方法：采用方位布局和分層抽樣的原則對(duì)湖南省內(nèi)5所三級(jí)醫(yī)院的479名正在實(shí)習(xí)的護(hù)生進(jìn)行問卷調(diào)查,使用Excel2013和Spss17.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,用率和構(gòu)成比對(duì)計(jì)數(shù)資料進(jìn)行統(tǒng)計(jì)描述,用卡方檢驗(yàn)和非條件二分類lojistic回歸分析對(duì)實(shí)習(xí)護(hù)生發(fā)生銳器傷后規(guī)范處理依從性的影響因素進(jìn)行單因素和多因素分析。結(jié)果：實(shí)習(xí)護(hù)生銳器傷發(fā)生率為65.34%,其中24.22%實(shí)習(xí)護(hù)生發(fā)生過2次或2次以上的銳器傷,39.67%實(shí)習(xí)護(hù)生至少發(fā)生過一次被病人血液或體液污染的銳器傷。發(fā)生銳器傷后,只有36.43%實(shí)習(xí)護(hù)生能規(guī)范處理傷口,63.57%實(shí)習(xí)護(hù)生未規(guī)范處理傷口。36.71%護(hù)生對(duì)是否需要規(guī)范處理傷口持無所謂態(tài)度,28.32%護(hù)生因?yàn)楣ぷ髅]時(shí)間按規(guī)范流程處理傷口。只有10.86%實(shí)習(xí)護(hù)生每次發(fā)生銳器傷后都向帶教老師或護(hù)士長上報(bào),將近三分之二的實(shí)習(xí)護(hù)生不上報(bào),42.33%實(shí)習(xí)護(hù)生認(rèn)為上報(bào)程序繁瑣,28.81%實(shí)習(xí)護(hù)生認(rèn)為醫(yī)院不重視上報(bào)。只有12.78%實(shí)習(xí)護(hù)生每次發(fā)生銳器傷后都查閱病人病例,查看病人有無血源性傳播疾病。無實(shí)習(xí)護(hù)生填寫銳器傷登記表,只有29.71%實(shí)習(xí)護(hù)生去抽血做相關(guān)檢查或做預(yù)防性治療,還有一部分人未做任何處理。教育程度、實(shí)習(xí)時(shí)間、每周上班時(shí)間、對(duì)銳器傷相關(guān)知識(shí)的了解程度、工作量、師生關(guān)系、操作環(huán)節(jié)、醫(yī)院內(nèi)張貼銳器傷規(guī)范處理流程圖情況、工作情形、學(xué)校職業(yè)防護(hù)教育、醫(yī)院崗前培訓(xùn)、帶教老師傳授防護(hù)知識(shí)情況與護(hù)生銳器傷后規(guī)范處理的依從性有關(guān),性別、年齡、宗教信仰、乙肝疫苗接種及免疫力等情況與護(hù)生銳器傷后規(guī)范處理的依從性無關(guān)。實(shí)習(xí)時(shí)間、每周上班時(shí)間、醫(yī)院內(nèi)張貼銳器傷規(guī)范處理流程圖情況、工作情形及帶教老師傳授防護(hù)知識(shí)情況是影響護(hù)生銳器傷后規(guī)范處理依從性的主要因素。結(jié)論：實(shí)習(xí)護(hù)生銳器傷發(fā)生率高,但銳器傷后規(guī)范處理依從性低,護(hù)生職業(yè)防護(hù)教育欠缺,銳器傷防護(hù)意識(shí)不強(qiáng),醫(yī)院職業(yè)防護(hù)制度不健全,應(yīng)引起有關(guān)部門重視。
[Abstract]:Objective: to investigate the current situation of compliance with standard management of sharp instrument for nursing students in Hunan Province, analyze the causes and influencing factors, and provide the basis for improving the compliance of standard treatment after acute instrument injury in practice nursing students. To reduce the adverse effect of sharp instrument injury on nursing students and to improve their understanding of sharp instrument injury. Methods: a questionnaire survey was conducted among 479 nursing students in 5 tertiary hospitals in Hunan Province by using the principle of orientation layout and stratified sampling. Excel2013 and Spss17.0 statistical software are used to analyze the data, and the counting data are described with the ratio and composition comparison. Using chi-square test and non-conditional two-classification lojistic regression analysis, single factor and multi-factor analysis were carried out to analyze the influencing factors of nursing students' compliance with standard treatment after acute instrument injury. Results: the incidence rate of sharp instrument injury was 65.34, of which 24.22% was in practice nursing students. 39.67% of the intern nursing students had at least one sharp instrument injury contaminated by the patient's blood or body fluid after two or more sharp instrument injuries. Only 36.43% nursing students were able to deal with wounds in a standardized manner. 63.57% of nursing students did not handle wounds properly. 36.71% of nursing students were indifferent to the need for standardized treatment of wounds. 28.32% of nursing students were not able to handle wounds according to the standard procedure because they were busy at work. Only 10.86% of them had to deal with wounds according to the standard procedure. The intern nursing students report to the teacher or head nurse after each sharp instrument injury. Nearly 2/3 of the nursing students did not report the report. 42.33% of the students thought that the reporting procedure was cumbersome. 28.81% thought the hospital did not attach importance to the report. Only 12.78% nursing students looked up patients' cases after sharp instrument injury. Check whether the patient has blood-borne sexually transmitted disease. No intern nursing students fill out sharp instrument injury registration form, only 29.71% probationary nursing students take blood to do related examination or do preventive treatment, and some people do not do any treatment. Education level, internship time, The degree of understanding, workload, relationship between teachers and students, operation links, flow chart of standard handling of sharp instrument injury, working situation, vocational protection education in school, pre-post training in hospital, etc. The teaching of protective knowledge was related to the compliance of nursing students with the standard treatment of sharp instrument injury. Sex, age, religious belief, hepatitis B vaccination and immunity were not related to the compliance of nursing students with the standard treatment after sharp instrument injury. During the weekly working hours, the hospital posted sharp instrument injury standard handling flow chart, Working conditions and teaching teachers were the main factors influencing the compliance of nursing students with standardized treatment after acute instrument injury. Conclusion: the incidence of acute instrument injury is high, but the compliance of standardized treatment is low after acute instrument injury. The vocational protection education of nursing students is deficient, the awareness of sharp instrument injury is not strong, and the occupational protection system of hospital is not perfect, which should be paid attention to by relevant departments.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：G645.5;R47

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