Yan Yan Yan
2018-01-18 Read 15,000
Concerns
I. By retrospectively summarizing and analyzing the occurrence of occupational exposures in 2017, we hope to warn medical staff: safe practice, starting from the standard preventive and standardized operation!
Two, the reasons for occupational exposure analysis
1, health care workers is a high-risk group of occupational exposure, health care the vast majority of operations are inseparable from the hands, the hands are the main parts of the occurrence of occupational exposure.
2, daily did not develop good working habits, operation is not standardized: such as both hands back to the set of needle cap, used sharps, needles are not put into the sharps box in a timely manner, the second sorting of needles and so on.
3, self-prevention awareness is not strong, resulting in avoidable occupational exposure failed to avoid.
4. Insufficient risk awareness, lack of foresight of high-risk factors in the workplace, inability to take preventive measures proactively in advance, and failure to implement the standard concept of prevention: such as failure to anticipate the possibility of being splashed by patients' bodily fluids in the course of the operation, and failure to wear protective measures such as goggles.
Three, occupational exposure typical cases
1, 3 cases of medical staff back to the set of needle cap caused by needlestick injuries
Problems: violation of the operating norms,
2, 1 case of finishing postoperative organization of medical waste, inadvertently stabbed by the needles in the medical waste bag.
Problems: lack of precautionary awareness, direct contact with medical waste with hands!
3, 2 cases of patients to a bed after removing the needle, back to the dirt disposal room to deal with the needle, inadvertently stabbed fingers.
Problems: failure to dispose of needles in a timely manner, the existence of secondary sorting;
4, 1 case of nurses pulling needles from a patient in a bed, due to entanglement in the infusion stand, inadvertently stabbed fingers when removing the open.
6. 1 case of inadvertent stabbing by a doctor when removing a needle with his bare hands after giving an injection to a patient at an acupuncture point.
Problems: insufficient anticipation of the risk of needlestick injuries; lack of caution and care when touching the needle with bare hands.
7. 3 cases of nurses (including 2 trainee nurses) were stabbed during the process of removing needles from patients.
Problems: unskilled operating procedures, leading to psychological tension.
8. In one case, the physician exerted too much force when removing the guidewire for the patient, causing the patient's blood to splash into the assistant physician's eyes.
Problems: insufficient risk awareness, lack of anticipation of high-risk factors in the workplace, inability to take preventive measures in advance, and failure to implement the standard concept of prevention: such as failure to anticipate the possibility of splashing the patient's bodily fluids during the operation process, and failure to wear protective measures such as goggles.
Remedial measures:
1. The department should continue to strengthen the "medical staff occupational exposure prevention and emergency response" training and drills to improve the awareness of prevention. Everyone is required to familiarize themselves with occupational exposure protection measures and emergency response methods.
2. Strengthen the standardized training of new recruits and junior nurses to improve their operation skills.
3. Strengthen the training of standard prevention to achieve safe injection and standardized operation.
Four, needle wound disposal process
One squeeze, two punch, three elimination, four report
In the department site, the more timely wound disposal, the more thorough, the better the effect!
Reporting
1, report to the director of the department or head nurse.
2, reported to the hospital infection management department, fill out the "occupational exposure registry".
3, signed by the head of the department to confirm.
4, the hospital infection management department is responsible for tracking, data collection and file organization.
V. How to prevent occupational exposure
1. Strengthen the occupational safety education of medical staff, improve the awareness of self-prevention, master the transmission of various diseases, and implement standard prevention.
2. Medical personnel should do a good job of occupational protection when contacting patients' blood, body fluids or objects contaminated by patients' blood or body fluids, so as to reduce occupational exposure.
3. Medical personnel should take the following protective measures when in contact with pathogens:
1) Medical personnel must wear gloves when performing diagnostic and nursing operations that may come into contact with the patient's blood or body fluids, and after the operation is completed, they should wash their hands immediately after removing the gloves, and disinfect their hands if necessary.
2) Medical personnel with broken skin on their hands must wear double gloves when performing diagnostic and nursing operations that may contact patients' blood and body fluids.
3) In the process of diagnosis and treatment, nursing experimental operations, there may be blood, body fluids splash to the face of the medical staff, medical personnel should wear masks, protective glasses; there may be a large area of blood, body fluids splash or may be contaminated with the body of the medical staff, but also should be wearing an impermeable isolation suit or apron.
4) medical personnel in the invasive diagnosis and treatment, nursing operation process, to ensure sufficient light, pay special attention to prevent by needles, suture needles, razor blades and other sharp objects stabbed or scratched.
5) Sharps should be put directly into the puncture-resistant, leak-proof sharps box immediately after use. It is prohibited to break sharp instruments with bare hands, to insert used scalp needles into the cap, to return used disposable needles with both hands to the cap of the sleeve, to touch used needles, blades and other sharps directly with hands, to pass sharps in the surgery it is recommended to use the passing container, and to touch medical waste with bare hands.
6) Adequate protective measures are taken and vaccines and other preventive inoculations are given to high-risk personnel.
Needle stick injuries occurred in our hospital in 2017 accounted for 96% of occupational exposures,For our health, please keep the norms in mind at all times and protect our own hands from further injury!!!!
Updated on 2018-01-21