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基層醫(yī)院醫(yī)務(wù)人員HIV職業(yè)暴露與防護(hù)

發(fā)布時(shí)間:2018-08-28 08:45
【摘要】:目的 HIV的流行在中國(guó)已從高危人群向普通人群擴(kuò)展,隨著HIV感染者或AIDS患者越來(lái)越多地出現(xiàn)在基層醫(yī)療機(jī)構(gòu),醫(yī)務(wù)人員在診療過(guò)程中接觸HIV感染者的機(jī)會(huì)也隨之增加,對(duì)HIV的職業(yè)暴露問(wèn)題日趨嚴(yán)重。通過(guò)調(diào)查了解太倉(cāng)市第一人民醫(yī)院醫(yī)務(wù)工作者在HIV職業(yè)暴露防護(hù)中存的問(wèn)題,分析其主要原因及其影響因素,提出改善建議,以提高基層醫(yī)院醫(yī)務(wù)人員對(duì)HIV職業(yè)暴露防護(hù)的認(rèn)識(shí),減少診療過(guò)程中的HIV職業(yè)暴露,從而提高醫(yī)療護(hù)理質(zhì)量。 方法 通過(guò)回顧法了解太倉(cāng)市第一人民醫(yī)院2010-2013年HIV陽(yáng)性患者接診和2013年職業(yè)暴露情況,以及對(duì)2起HIV職業(yè)暴露及應(yīng)急處理情況和1例HIV確診陽(yáng)性患者手術(shù)中采取的有效防護(hù)措施。結(jié)合自行設(shè)計(jì)問(wèn)卷調(diào)查,用EXCEL建立數(shù)據(jù)庫(kù),生成柱狀圖和餅狀圖等,用SPSS18.0進(jìn)行統(tǒng)計(jì)分析,主要運(yùn)用描述性方法進(jìn)行分析。 結(jié)果 1太倉(cāng)市第一人民醫(yī)院2010-2013年間接診48位初篩陽(yáng)性患者,經(jīng)蘇州市疾病預(yù)防控制中心確診16位,其中出現(xiàn)2起HIV初篩陽(yáng)性患者的職業(yè)暴露。 2通過(guò)對(duì)2013年職業(yè)暴露分析,醫(yī)務(wù)人員職業(yè)暴露上報(bào)主要以利器傷為主,工作三年內(nèi)護(hù)理人員為高危人群。 3結(jié)合調(diào)查問(wèn)卷分析醫(yī)務(wù)人員主觀上存在對(duì)職業(yè)暴露危險(xiǎn)性認(rèn)識(shí)不足、標(biāo)準(zhǔn)預(yù)防措施不到位等問(wèn)題,特別對(duì)HIV初篩陽(yáng)性病人管理仍存在漏洞。 結(jié)論 基層醫(yī)院存在HIV職業(yè)暴露風(fēng)險(xiǎn),職業(yè)暴露主要以預(yù)防利器傷為主,,工作三年內(nèi)護(hù)理人員為高危人群。通過(guò)建立、健全各項(xiàng)HIV防護(hù)制度、措施、流程,并有效落實(shí),特別加強(qiáng)對(duì)高危人群在HIV患者手術(shù)中的防護(hù)將可有效降低基層醫(yī)務(wù)人員HIV職業(yè)暴露風(fēng)險(xiǎn)。
[Abstract]:Objective the prevalence of HIV has expanded from high-risk population to general population in China. With the increasing emergence of HIV infected persons or AIDS patients in primary health care institutions, The chance of medical staff contact with HIV infection increases in the course of diagnosis and treatment, and the problem of occupational exposure to HIV becomes more and more serious. By investigating the problems of medical workers in the first people's Hospital of Taicang City in HIV occupational exposure protection, the main causes and influencing factors are analyzed, and suggestions for improvement are put forward. In order to improve the understanding of HIV occupational exposure protection and reduce the HIV occupational exposure in the course of diagnosis and treatment, the medical staff can improve the quality of medical care. Methods the data of HIV positive patients in Taicang first people's Hospital from 2010 to 2013 and occupational exposure in 2013 were analyzed retrospectively. Two cases of occupational exposure and emergency management of HIV and one case of HIV positive patients were treated with effective protective measures. In combination with the self-designed questionnaire, the database is built with EXCEL, the histogram and pie chart are generated, and the statistical analysis is carried out by SPSS18.0, mainly by descriptive method. Results 1 the first people's Hospital of Taicang City received 48 primary screening positive patients from 2010 to 2013, 16 of whom were confirmed by the Suzhou Center for Disease Control and Prevention. Among them, there were 2 occupational exposures of HIV positive patients. 2 through the analysis of occupational exposures in 2013, medical workers' occupational exposures were mainly reported as sharp injuries. Nurses were high risk groups within three years of work. 3 combined with questionnaire analysis, medical staff had some problems, such as insufficient understanding of occupational exposure risk, inadequate standard prevention measures, and so on. In particular, there are still loopholes in the management of HIV positive patients. Conclusion there is occupational exposure risk of HIV in primary hospital. The occupational exposure is mainly to prevent sharp weapon injury and nursing staff is the high risk group within 3 years of work. By establishing and perfecting the HIV protection system, measures, procedures and effective implementation, especially strengthening the protection of high risk groups in HIV patients surgery will effectively reduce the risk of occupational exposure to HIV of primary health care workers.
【學(xué)位授予單位】:蘇州大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2014
【分類號(hào)】:R512.91

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