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1、台灣醫療人員的針扎問題-流行病學、國際經驗與防治現況台大醫學院護理學系所醫療人員安全衛生中心蕭淑銖(RN;PhD)台灣醫學教育學會2010.04.24HealthcareworkersWorkinginhealthcareenvironmentButnotnecessarilyinhealthyenvironment醫療人員最常見之職業傷害之一後果可小可大醫護人員針扎傷害針扎後的感染機率HBV:30%HCV:1.8HIV:0.3%CMESH-醫療人員安全衛生中心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.臺灣針頭與銳物扎傷，體液、血液暴觸長期研究架構CenterforMedicalEmployeeSafety&Health(C-MESH)ChineseEPINet醫護人員針扎傷害–與國際同步之通報系統網址：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件醫療工作意外事件。合作醫院之職業類別人數分佈職業類別加入系統工作人員數醫師5,220(16.7)護理人員18,204(58.1)醫技人員5,914(18.9)清潔人員2,001(6.4)總計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-醫療人員安全衛生中心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
