Occupational Exposure Of Blood-borne Pathogens Analysis And Control Strategy Research In Medical Staff

Occupational exposures blood-borne infection disease is the most common medical staff occupational injuries. under the background of the the current doctor-patient and doctor-nurse in proportion,the nowadays increasingly strained doctor-patient relations, increasing competition and increasingly harsh environment in the medical, medical workers for a long time at a high intensity, high risk, high response, high input, low output working condition, the medical industry with increase in the risk of occupational exposure, caused our country medical personnel situation increasingly serious blood-borne occupational exposure. In recent years, the hospitals have realized the importance of occupational protection and exposure management, paid attention to the training of medical staff occupational protection consciousness gradually, lectures and training of occupational protection conducted by various forms, and formulated the corresponding specification and preventive measures, but still difficult to resist the effect of occupational exposure to the hospital.Currently for a hotspot of study in medical staff occupational exposure is for a region, a group of people or nationwide medical staff occupational exposure of large sample study, using stratified random sampling method to carry out epidemiological investigations and the influence factors analysis, the conclusions are basically very system and perfect. And for a hospital or a group of people and the damage of a small scale study is not enough comprehensive and meticulous, in the study, the lack of management approaches are applied to solve the problem.Although there are a large number of research materials, hospitals are also based on the study and establish the corresponding specification and preventive measures, but due to lack of management method of the application, the condition of lack of accord with empirical evidence and case studies can be used for reference, so each hospital is hard to resist the erosion of occupational exposure.So this article aims to occupational exposure and protection to blood-borne infectious diseases as the starting point, to manage the control of three phases as a full line, select a representative throughout the country as an example in third rate synthetic hospital, and from the management of feedforward control, feedback control stage of understanding its blood-borne pathogens present situation of the occupational exposure, according to the theory of management control, put forward perfect the occupational exposure and protection management framework, to explore comprehensive control model of occupational protection and safety, to improve medical staff blood-borne occupational protection consciousness, the standard diagnosis and operation behavior, reduce the medical staff occupational exposure blood-borne pathogens in the ultimate goal. It work provides experience and reference for other domestic hospital of blood-borne pathogens of occupational exposure and protection, and scientific basis for general hospital medical personnel in further prevention and occupational exposure of blood-borne occupational exposure to research and formulate policies and regulations for prevention and control of occupational exposure and management measures.This research altogether is divided into the following four parts:The first part:the introduction Literature analysis both at home and abroad medical staff of blood-borne occupational protection and exposure management present situation, analyzed the domestic research on occupational exposure situation, elaborated the research background, content, method, purpose, significance, formulate research technique route. The second part:theoretical foundation Literature review and analysis about the occupational exposure control related theory, related concepts and management to provide strong theoretical basis for this study.The third part:empirical analysis This study include two parts to analyze the occupational protection and exposure of the hospital management status:One is for a hospital medical staff occupational exposure to personnel of baseline data that were retrospectively analyzed. Collected from the hospital after occupational exposure from2009to2012in the registration form, will be collected by the279medical staff occupational exposure blood-borne pathogens reported all information included in the study area. Using SPSS18.0statistical software to analyse the characteristics of occupational exposure population sociology, including gender, department, title, age, seniority, education, etc., blood-borne pathogens, exposure modes, personal protection and exposed to the differences of processing behavior, concentrated period of time, focus groups, such as conditions for data analysis, reflect the characteristics of the hospital blood-borne occupational exposure occurs, thus further analysis of its status of occupational exposure occurred in recent years.The other is to investigate occupational exposure protection awareness and exposure for the hospital management by making a questionnaire. This stage with the method of random sampling, choose the hospital clinical work more than40clinical departments,3months of550in hospital medical workers for questionnaire survey. Recycling effective questionnaire520copies of effective recovery rate was94.55%.Sociology of population data from questionnaire by staff, blood-borne occupational exposure cognitive situation, hospital occupational exposure management behavior, personal occupational exposure conditions and occupational protection act, the medical staff of blood-borne occupational exposure management job satisfaction and Suggestions and so on six parts, respectively reflect the feedforward control of the occupational exposure control, scene control, feedback control the present situation of the three stages of management. According to the consultion to some experts and hospital manager,I adjust and repair the questionnaires.The end is combined with retrospective analysis and questionnaire analysis toget the results:1.Medical personnel lack of occupational protection knowledge and lack of systemic blood-borne occupational exposure is the hospital management of a particular problem, especially know very little about the management of the hospital clinical blood-borne occupational exposure knowledge.2. Occupational protection knowledge comes mainly from the hospital propaganda and work experience. Most protection gradually fostered in cognitive is to work in hospitals.3. Different department and job title, different age groups, different length of medical staffs cognition has significant difference, different degree and no significant difference between gender.Self protective consciousness and cognition of occupational protection is obvious insufficient between lower seniority job title and haveier labor. Protective knowledge is relatively good between higher title and qualification, length of service in7to10years, and low intensity of labor department staff.4. Nursing staff relative doctor group is better solid grasp of the theoretical knowledge, but lack the focus of hospital occupational exposure management system. For hospitals and doctors’ group related knowledge cognition of occupational exposure management system is better.5. Hospital education training is scattered,limited and irregular. The feedforward control stage of occupational protection, not form a viable system of education. The rules and regulations of hospital occupational protection is propaganda is not enough.6.The phenomenon about medical staff occupational protection in site operation behavior is not standard that is relatively common. In routine diagnostic operation not in accordance with the standard standard operating behavior is more in occupational protection. Doctor gloves protective behavior is better than that of nursing group, wearing a mask of protective behavior worse than nursing group. Not according to the standard operation is the main reason of the hospitals lack protective facilities or lack of protective gear (36.8%), their work is too busy, think that trouble (23.6%), subjective think it is not necessary or infectious diseases (22.5%), and other reasons, there are a few people reflect certain operations after wearing gloves, difficult to operate. Medical personnel to handle after occupational exposure is not enough skilled, emergency ability is weak.7. In the feedforward control phase, the hospital is the lack of perfect management system of occupational protection of occupational exposure management, hospital management and medical staff of the occupational protection ability.8. Occupational exposures crowd of non-response rates is75.9%, reported at a rate of24.1%. Report rate is better than that of domestic hospitals, but compared with foreign and our country Taiwan still has certain gap. The main cause of the high non-response rates is for work busy have no time, reporting process trouble, then there is no need to report, the last is I don’t know how to report and report to whom.9. Needle stick injuries damage is the main damage types blood-borne occupational exposure. Composition of pathogen mainly HBV (42.28%) and syphilis (20.47%), HCV (8.39%) and HIV (6.71%) is less, but not be ignored.10. Nursing staff was the high-risk groups in sharp injury. Prone to occupational exposure of title focuses on hospital physician, physician, nurse and nurses, college degree in nursing, a doctoral candidate in the doctor. Ranging in age from22to25, length of0to3years is high incidence stage of blood-borne occupational exposure.11.More sharp injury in August、September、October. Concentrated time is in night shift and afternoon rest time. Concentration is major in surgery, specialized subject and Outpatient department.The fourth part puts forward problem by analyzing the results discussed above, the following research conclusions:1. The feedforward control occupational exposure protection management system and education system is lack of systemic and normative.2. The control of neglect the regulation the scene of the action, make standard operation become a mere formality.3. The feedback control of the monitoring system is lag, and high non-response rates.The fifth part:Proposed framework According to the research conclusion, based on the relevant theory of management control, and puts forward three stages at the scene of the feedforward, and feedback control,Build occupational protection and exposure management framework, to further improve the management system of occupational exposure of the strategy.It includes:1. The feedforward control, establish and improve the occupational exposure of management system and education training system:(1) Pay more attentions to the protection management of the hospital, establish and improve the system of management of occupational exposure;(2) Make the system of the medical personnel professional knowledge education of occupational protection perfect, train medical staff stable protective behavior;(3)Strengthen the occupational exposure of internship staff management.2. The control to carry out the operation specification, supervise and protection quality, build security medical environment:(1) Carry out operation specification strictly, perform standard protective measures;(2)Provide operation Site Supervisor, supervise the quality of occupational protection;(3) Improve the working conditions and provide occupational protection atmosphere, build safe medical environment.3. Simplify the reporting process in the feedback control, strengthen the monitoring,build feedback and follow-up after occupational exposure system:(1) Strengthen the monitoring of occupational exposure, establishing occupational exposure monitoring and feedback system;(2) Build a perfect occupational exposure system, establish the convenient reporting process and the corresponding emergency response mechanism;(3) Establish occupational exposure after psychological intervention mechanism and follow-up system.