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1、臺(tái)灣醫(yī)療人員的針扎問題-流行病學(xué)、國(guó)際經(jīng)驗(yàn)與防治現(xiàn)況臺(tái)大醫(yī)學(xué)院護(hù)理學(xué)系所醫(yī)療人員安全衛(wèi)生中心蕭淑銖(RN;PhD)臺(tái)灣醫(yī)學(xué)教育學(xué)會(huì)2010.04.24HealthcareworkersWorkinginhealthcareenvironmentButnotnecessarilyinhealthyenvironment醫(yī)療人員最常見之職業(yè)傷害之一後果可小可大醫(yī)護(hù)人員針扎傷害針扎後的感染機(jī)率HBV:30%HCV:1.8HIV:0.3%CMESH-醫(yī)療人員安全衛(wèi)生中心Occupationalinfectionsf
2、ollowingpercutaneousexposuresBacterialBrucellosis1966Diphteritis1923Gonhorrea1947Leptospirosis1937Mycobacteriosis1977Mycoplasmosis1971RockyMountainSpottedFever1967Scrubtyphus1945Staph.aureus1983Strept.pyogenes1980-necrotizingfasciitis1997Syphilis1913Tuberc
3、ulosis1931-fromHIV+1998ViralHaemorragicfevers(Ebola/Marburg)1974HIV1984HerpesSimplex1962SimianImmunodeficiencyvirus1994Herpesvirussimiae1991Dengue1998Creutzfeldt-Jakob1988HerpesZoster1976HepatitisnAnB1987HepatitisB1982HepatitisC1992HepatitisG1998FungalProt
4、ozoalBlastomycosis1903Malaria1972Cryptococcosis1985-fromHIV+1994Toxoplasmosis1951Sporotrichosis1977Leishmaniasis1997TumorsHumancolonicadenocarcinoma1986Sarcoma1996JaggerJ,DeCarliG,PerryJetal.InWenzelRP:PreventionandControlofNosocomialInfections,2003.Update
5、d.臺(tái)灣針頭與銳物扎傷,體液、血液暴觸長(zhǎng)期研究架構(gòu)CenterforMedicalEmployeeSafety&Health(C-MESH)ChineseEPINet醫(yī)護(hù)人員針扎傷害–與國(guó)際同步之通報(bào)系統(tǒng)網(wǎng)址:http://epinet.cmesh.org.twManytimesofmodificationsandLOTSofCOMMUNICATION!!StandardizedsurveillancesystembyReportingtoC-MESHC-MESH:CenterforMedicalEmplo
6、yees’SafetyandHealth截至2009年12月09日為止,通報(bào)了2,924件針頭或尖銳物扎傷意外事件,154件血液體液暴觸事件,共3,078件醫(yī)療工作意外事件。合作醫(yī)院之職業(yè)類別人數(shù)分佈職業(yè)類別加入系統(tǒng)工作人員數(shù)醫(yī)師5,220(16.7)護(hù)理人員18,204(58.1)醫(yī)技人員5,914(18.9)清潔人員2,001(6.4)總計(jì)31,339(100)Annualnumberofpercutaneousinjuriesbynumberofhealthcareworkers#NSI=6.9+0.
7、034*#HCWs.R2=0.67.P=0.0003Annualnumberofpercutaneousinjuriesbypatient-dayscared#NSI=8.5+2.2*#[10,000patient-dayscared].R2=0.79.P<0.0001CMESH-醫(yī)療人員安全衛(wèi)生中心3.198,286PercutaneousInjuries(PCIs)AmongtheParticipatingHospitalsandtheEstimatedPCIsforTaiwan(Shiaoetal.,
8、RINAH2008)IncidenceofindividualkindsofneedlesinTaiwanNeedlesNSIper10,000patient-daysEstimatedannualNSIRate(95%CI)Rate(95%CI)Disposableneedles1.55(1.24-1.87)4,036(3,222-4,850)IVcatheter(stylet)0.15(0.12-0.19)4