目的了解护理实习生职业暴露、职业防护现状,为采取干预措施、减少职业暴露提供参考。方法选取2019年1~12月在我院实习的护理实习生408名为研究对象,采用自行设计调查问卷对护理实习生的职业暴露发生情况、职业暴露类型、职业暴露发生原因、职业防护认知水平、职业防护情况等进行调查,描述护理实习生的职业暴露情况、职业暴露类型、职业暴露发生原因、职业防护认知水平及职业防护情况,比较本科和专科护理实习生的差异。结果护理实习生职业暴露的总发生率为41.42%,其中本科护理实习生的发生率为37.71%,专科护理实习生的发生率为51.35%,本科护理实习生的职业暴露发生率显著低于专科护理实习生,差异有统计学意义(P<0.05)。发生职业暴露的169名护理实习生中,污染针刺伤61名,占36.09%;污染尖锐物伤41名,占24.26%;安瓿伤28名,占16.57%;血液体液喷溅暴露21名,占12.43%;其他暴露18名,占10.65%。本科护理实习生污染针刺伤、污染尖锐物伤的职业暴露发生率显著低于专科护理实习生,差异有统计学意义(P<0.05)。发生职业暴露的169名护理实习生中,因防护知识不足发生职业暴露者45名,占26.63%;因经验不足发生职业暴露者44名,占26.04%;因技术不熟练发生职业暴露者35名,占20.71%;因工作负荷大发生职业暴露者24名,占14.20%;因不规范操作发生职业暴露者21名,占12.43%。本科护理实习生因防护知识不足所致的职业暴露发生率显著低于专科护理实习生,差异有统计学意义(P<0.05)。护理实习生的职业防护认知水平合格率为79.66%,本科护理实习生的职业防护认知水平合格率、职业暴露处理流程正确率、乙肝疫苗接种率均显著高于专科护理实习生,差异有统计学意义(P<0.05)。结论护理实习生职业暴露发生风险较高,本科护理实习生的职业暴露发生率、职业暴露类型、职业暴露发生原因、职业防护认知水平和职业防护情况与专科护理实习生比较存在一定的差异,强化职业安全教育和管理、提高职业暴露及其防护认知水平、规范职业暴露防护流程,才能有效减少护理实习生职业暴露的发生。
ObjectiveTo understand the current situation of occupational exposure and occupational protection of nursing interns, to provide a reference for taking intervention measures and reducing occupational exposure. MethodsA total of 408 nursing interns who practiced in our hospital from January to December 2019 were selected as the research subjects, employing the self-designed questionnaire to investigate the occurrence, types, occurrence reasons of occupational exposure, and the cognitive levels and condition of occupational protection. The conditions mentioned above were described, and the differences were compared between the undergraduate interns and specialist nursing interns. ResultsThe overall incidence of occupational exposure among nursing interns was 41.42%, among which the incidence of undergraduate nursing interns was 37.71%, the incidence of specialist nursing interns was 51.35%, and the incidence of occupational exposure among the undergraduate nursing interns was significantly lower than that among the specialists nursing interns, with statistically significant differences (P<0.05). Among the 169 nursing interns who experienced occupational exposure, 61 cases were injured by contaminated needle sticks, accounting for 36.09%; 41 cases were injured by contaminated sharp objects, for 24.26%; 28 cases were injured by ampoule, for 16.57%; 21 cases were exposed to blood and body fluid splashing, for 12.43%; 18 cases belonged to other occupational exposure, for 10.65%. Compared with the specialist nursing interns, the undergraduate nursing interns obtained a significantly lower incidence of occupational exposure in contaminated needle sticks and sharp objects, with a statistically significant difference (P<0.05). Among the 169 nursing interns who experienced occupational exposure, 45 cases of occupational exposure due to insufficient protection knowledge, accounting for 26.63%; 44 cases of occupational exposure due to lack of experience, for 26.04%; 35 cases of occupational exposure due to unskilled manipulation, for 20.71%; 24 cases of occupational exposure due to heavy workload, for 14.20%; 21 cases of occupational exposure due to irregular operations, for 12.43%. The incidence of occupational exposure due to insufficient protection knowledge among the undergraduate nursing interns was significantly lower than that among the specialist nursing interns, with a statistically significant difference (P<0.05). The pass rate of cognitive levels of occupational protection among nursing interns was 79.66%. The undergraduate nursing interns obtained a higher pass rate of cognitive levels of occupational protection, accurate rate of procedure of occupational exposure, and vaccine rate of hepatitis B as compared with the specialist nursing interns, with statistically significant differences (P<0.05). ConclusionNursing interns have a high risk of occupational exposure. The incidence, types, occurrence reasons of occupational exposure, and cognitive levels, conditions of occupational protection of undergraduate nursing interns are different from those of specialist nursing interns. Occupational safety education and management should be strengthened, the cognitive levels of occupational exposure and protection should be improved, and the procedures of occupational exposure and protection should be standardized, which can effectively reduce the occurrence of occupational exposure in nursing interns.