针刺伤防护方案的临床应用研究

doi:10.3761/j.issn.0254-1769.2021.01.001

摘要/Abstract

摘要：

目的运用证据构建护士针刺伤防护方案,并评价其应用效果。方法对已发布的循证证据进行审查,确定证据的可用性,分析障碍因素,构建护士针刺伤防护方案（SECURITY）:SOP（Standard of practice,建立预防和处理流程）;Unified（统一防护托盘,专利号201921164515X）;Report（制订上报流程）;Elearning（视频学习）;IT（信息支持）;Checklist（制订核查表）;Yes or no（现场核查对与错）。2019年6月—11月在全院实施针刺伤防护方案,比较针刺伤防护方案实施前后针刺伤的发生例数、审查指标的执行率和护士针刺伤预防知识、信念、行为的得分。结果针刺伤防护方案实施后,2019年6月—11月与2018年同期相比,护士针刺伤例数从26例降低到16例（护士总数不变）,发生率降低38.5%;13项审查指标中的12项执行率显著提高（P<0.05）,11项执行率超过80%;针刺伤防护知识得分（8.27±1.21）分,显著高于针刺伤防护方案实施前知识得分（7.57±1.43）分（t=-9.622,P<0.001）;信念得分（43.09±2.86）分,显著高于针刺伤防护方案实施前信念得分（42.45±3.33）分（t=-3.774,P<0.001）;行为得分（51.22±5.48）分显著高于针刺伤防护方案实施前行为得分（50.14±5.82）分（t=-3.058,P<0.001）。结论科学构建针刺伤防护方案,可减少护士针刺伤的发生,改善护士针刺伤预防知识、信念和行为。

关键词: 针刺伤, 防护方案, 护士, 护理管理研究

Abstract:

Objective To construct a protective network for needlestick,and to evaluate its application effects. Methods Published evidence was reviewed;the availability of evidence was determined,and then comprehensive solutions were constructed to build needlestick protection network for nursing staff（SECRURITY）:Standard of Practice（SOP）;Elearning（videos for prevention of needlestick injury）;Checklist;Unified promotion of needlestick protection;Report;IT（information support）;Yes or no. The number of cases of needlestick before and after the use of protective network,the implementation rate of review indicators,the knowledge,attitude,behavior of nursing staff needlestick protection were compared. Results After the use of the protection network,the number of cases of needlestick for nursing staff decreased from 26 to 16 from June to November in 2019,compared with the same period in 2018,and the incidence rate decreased by 38.5%. Out of 13 review indicators,the implementation rates of 12 indicators were significantly higher（P<0.05）,and the implementation rates of 11 indicators were higher than 80%. The protection knowledge score（8.27±1.21） was significantly higher than before（7.57±1.43,t=-9.622,P<0.001）;the protection attitude score（43.09±2.86）was significantly higher than before（42.45±3.33,t=-3.774,P<0.001）;the protective behavior score（51.22±5.48）was significantly higher than before（50.14±5.82,t=-3.058,P<0.001）. Conclusion The needlestick protection network can reduce the occurrence of needlestick and enhance the knowledge,attitude,and behavior of needlestick prevention for nursing staff.

Key words: Needlestick Injury, Protection Network, Nurses, Nursing Administration Research

李佳,黄雪芳,李佳芮,吴剑辉. 针刺伤防护方案的临床应用研究[J]. 中华护理杂志, 2021, 56(1): 7-13.

LI Jia,HUANG Xuefang,LI Jiarui,WU Jianhui. Application and effect of needlestick injury protection network for nursing staff[J]. Chinese Journal of Nursing, 2021, 56(1): 7-13.

图/表 10

表1 针刺伤证据总结及审查指标的基线调查结果

Tab.1 Needlestick injury evidence summary and the baseline survey results of review indicators

表2 评估障碍因素及构建针刺伤防护方案

Assess the obstacle factors and construct need lestick injury protec tion network

图1 针刺伤防护托盘模型

Fig 1 Needlestick injury prevention tray model

图2 针刺伤防护托盘临床应用图注:右上角圆桶为锐器盒

Fig 2 Needlestick injury prevention tray clinical application

图3 针刺伤预防核查表

Fig 3 Checklist for needlestick injury protection

图3 针刺伤预防核查表

Fig 3 Checklist for needlestick injury protection

表3 针刺伤防护方案实施前后审查指标的执行率比较(百分率,%)

Comparison of the implementation rate of review indicators before and after the project(percent,%)

表3 针刺伤防护方案实施前后审查指标的执行率比较(百分率,%)

Comparison of the implementation rate of review indicators before and after the project(percent,%)

表4 针刺伤防护方案实施前后护士针刺伤预防的知信行得分（分,$\overline{x}±s$）

Knowledge,attitude and behavior of needlestick prevention for nurse before and after the project（score,$\overline{x}±s$）

表4 针刺伤防护方案实施前后护士针刺伤预防的知信行得分（分,$\overline{x}±s$）

Knowledge,attitude and behavior of needlestick prevention for nurse before and after the project（score,$\overline{x}±s$）

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