Injections are stabbed by needles, cuts by knives during surgery, and patients' blood splashes into their eyes during resuscitation. ...... Medical staff are known as white angels, but the specificity of their profession makes them vulnerable to exposure to the dangers of disease and infection. A survey cited by the Municipal Medical Bureau shows that about 80% of medical staff have been stabbed by sharp instruments at work. In some of the city's tertiary hospitals, incidents of occupational exposure among healthcare workers are occurring every month. Yesterday, the reporter learned from the Beijing Municipal Medical Bureau that the "Beijing Hospital Medical Staff Infectious Occupational Exposure Management Measures (for Trial Implementation)" is expected to be introduced this week.
Needle occasionally cut the skin is very common
When medical personnel engaged in diagnosis and treatment, nursing activities, contact with toxic, harmful substances, or infectious disease pathogens, potentially damaging to the health or life-threatening, medically referred to as "occupational exposure". From the well-known Dr. Bai Qiun surgery infected tetanus, to the 2003 SARS epidemic doctors and nurses infected with SARS sacrifice, medical personnel occupational exposure risk has never been eliminated.
"It is common for needles to occasionally cut the skin in our daily work." Gao Fengli, director of the Department of Nursing at Chaoyang Hospital, said that in the emergency, when rescuing patients with hemorrhage or stab wounds, there may be three or four medical staff in the same time, such as injections, suturing, blood draws, etc., and the use of sharp instruments will be particularly high, in emergency situations, especially prone to needlestick injuries. In the course of treatment, some patients may be drastically agitated when their consciousness is not clear; some young children may cry or make sudden movements when blood is drawn or injections are given - at this time, medical staff may easily stab themselves. During the operation, the patient's blood is also easy to splash on the mask of the medical staff, if not coincidentally into the eyes, there will be mucous membrane exposure; in the operation, the medical staff to use the scalpel and other sharp instruments, in the process of mutual cooperation, it is inevitable that there will be bumped into each other's situation occurs. There is also the seemingly safe stomatology, the most common drilling is also a high-risk treatment. Because when drilling, the patient's saliva and blood sometimes form an aerosol, these particles mixed with saliva and blood floating in the air, but also easy to cause exposure to blood-borne diseases.
"Occupational exposure of medical staff is happening in Ditan Hospital, almost every month." Guo Jiazhen, deputy chief physician of the infection management department at Beijing's Ditan Hospital, said the probability can be lowered through a variety of protections, but as long as medical staff are working, the situation cannot be completely avoided.
Medical protection products need to be improved
"Sometimes the situation is more urgent, there is no time to wear gloves, protective clothing, masks." In addition to this too late to protect health care workers. Reporters in the interview found a strange phenomenon, ? Even if the time is too late, many medical personnel on goggles, gloves and other such protective products that can protect their own safety, but also often stay away.
In this regard, a surgeon said, "Goggles this product, the current domestic manufacturers are particularly few, the quality is not particularly good. Once worn is likely to affect the precision of surgical operations, so many doctors do not like to wear."
"Surgery is a very delicate technical work, protective equipment is protective function, but the medical staff of the surgical operation is not favorable." Guo Jiazhen said, take the goggles, some products can not be used for a few minutes will be fogging, so the medical staff is not willing to use; there are gloves, wearing two layers or very thick gloves when the medical staff operation will not be very smooth; there are also masks, because different people's faces are not the same, in the design of the model should also be considered to differentiate. "Overall, I hope these medical protective items can be more refined in terms of production."
? Reporting must not be 'fearful of trouble'
Currently, the rate of reporting of occupational exposures occurring in medical staff is yet low.
"In the event of occupational exposure such as needlestick injuries, everyone should report it in a timely manner." Gao Fengli said that every hospital in the city currently has a reporting mechanism for occupational exposure of medical staff, but not many people actually report it.
The reporter learned that in their daily work, some nurses give patients injections when they are accidentally stabbed by a needle, no bleeding feel that they should be fine, coupled with the results of the patient's blood test is not much of a problem, it will be left unattended. There are also doctors bluntly said, "a day busy feet hit the back of the head, but also for these things again to type a report, too much trouble."
And in fact, some infectious diseases have a window period, and not reporting them can put the health of medical staff at great risk. On the contrary, when the medical staff occurs occupational exposure and timely reported, if not coincidentally met with HIV, hepatitis B or hepatitis C and other infectious diseases patients, the hospital to track the medical staff whether there is a possibility of infection in the later stage, once it is clear that the occurrence of occupational exposure, through the early prevention and advance the use of medication, can reduce the probability of infection. "Our hospital is also actively streamlining this reporting mechanism, encouraging people to report occupational exposures as soon as they occur." Gao Fengli said.
In addition, many occupational exposures can actually be prevented by standardizing operations, and it is especially important to strengthen occupational protection training. For example, training medical personnel to form good working habits, and respiratory infectious disease patients talk, the mask level of protection should be increased; resuscitation of patients with hemorrhage, medical staff would be best to wear protective isolation gowns; do endotracheal intubation, it is best to wear goggles and N99 protective masks; in the use of needles to operate to ensure that as far as possible when the light is sufficient, busy, but not chaotic; to conduct contact with the patient's blood, body fluids, the operation, the Gloves must be worn; when passing sharp instruments intraoperatively, they should not be passed with bare hands, but with a tray. In addition, it is also necessary to strictly enforce hand hygiene, remove gloves and other protective equipment, the first time to go to wash their hands.
Yesterday, the reporter learned from the Beijing Municipal Medical Bureau, "Beijing hospital medical staff infectious occupational exposure management approach (for trial implementation)" is expected to be formally introduced this week. At that time, in response to occupational exposure, the city's 22 municipal tertiary hospital medical staff will have a chapter to follow.