Investigation On The Sharp Injuries And Occupational Stress Of Health Care Workers In Medical Institutions In Gansu

Objective:(1)To study the occurrence of sharp injuries,the implementation of occupational safety protection measures and the current situation of occupational stress in health care workers at different level hospitals in Gansu province.(2)According to the results,providing scientific evidence for the occupational safety training for the medical institutions of the whole province and the health education for occupational stress.(3)To provide a feasible basis for the in-depth understanding of the risk factors of occupational exposure and the study of intervention strategy.Methods: According to the cross-sectional survey and convenient sampling method,each county-level medical institution in 14 municipal administrative regions of Gansu province was selected as the study site from 2017 to 2018,and sharp injuries and occupational stress of health care workers at all levels were investigated.The sharp injury investigation adopted the self-designed questionnaire,and the Effort-Reward Imbalance(ERI)questionnaire was used to evaluate the occupational stress.Results:(1)Among the 9453 health care workers involved in the sharp injuries investigation in 1022 medical institutions,the secondary medical institutions(6580,69.6%),female(7487,79.2%),under 30-year old(4711,49.8%),working life less than 5 years(3222,34.1%),and college degree(3700,39.1%),nurses(5536,58.6%)and a weekly working duration of 40 to 50 hours(4371,46.5%)took up the majority.The incidence of sharp injury in the past year was 51.8%,the rate of sharp injury was 1.45 times per person year,and the incidence of sharp injury was high,of which the multiple sharp injury incidence was 32.0%.The highest occurrence of the sharp injury was the double-handed re-cap(no liquid pollution,1919,14.0%),followed by the surgical needle puncture(1420,10.3%),and the procedure when the needle was put in the sharp box(1194,8.7%).The sites with the highest incidence of sharp injury were the treatment room(3668,26.7%),the general ward(2562,18.7%)and the operating room(2271,16.5%).The first three medical devices involved in the sharp injury were disposable syringes(4826,35.2%),surgical needles(2271,16.5%)and scalp steel(1581,11.5%),and the number of the first three devices involved in sharp injury was 8678(63.2%).Hepatitis B virus accounted for the highest proportion of blood-borne infections in sharp injury,accounting for 62.6%(1097)of all known blood-borne infectious diseases.There were concerns,tension and anxiety in most health care workers after a sharp injury.Only 22.3 per cent(2108)of medical staff have two or more types of safety equipment provided by their medical institutions.More than 10% of the health care workers did not inject hepatitis B vaccine.After the sharp injury occurred,the total reported rate was only 8.4%,and no sharp injury reporting mechanism was set in some hospitals.The health care workers never received the protection knowledge education and training for the prevention of the sharp injury was 27.8%.The GDP in the city of the hospital,the per capita GDP of the local city and the age,working life,working category,professional title,marital status,working time of the working week and the provision of the sharp injury protection equipment in the hospital all affected the occurrence of the sharp injury of the health care workers.(2)Among the 2524 health care workers involved in occupational stress survey,secondary medical institution(1434,56.8%),female(2022,80.1%),under 30 years old(1218,48.3%),working life less than 5 years(812,32.2%),college degree(1007,39.9%),the nurses(1565,62.0%),a weekly working duration of 40 to 50 hours(1147,45.4%)took up the majority.The third-level medical institution worker,the male,the age above more than 45 years,the working life above more than 15 years,the undergraduate degree or above,the doctor,the working time of the week above more than 50 hours,the senior professional title,the married person thought that the self-paying was higher than those of others.The health care workers in tertiary medical institutions,more than 45 years of age,more than 15 years of working life and no more than 40 hours of working hours per week thought they got more achievements than those of others.The incidence of high occupational stress was 42.5%,and the affective factors of the degree of occupational stress were the hospital grade,the working years of the medical staff,the occupation and the weekly working hours.(3)The incidence of sharp injury among health care workers with low occupational stress was 49.2%,and the incidence of sharp injuries among health care workers with high occupational stress was 58.7%.The health care workers with higher occupational stress were more prone to sharp injury than others(p <0.001).Conclusion:(1)The incidence of sharp injury of health care workers in medical institutions in Gansu is high.The greatest risk of medical staff sharp injury to blood-borne infectious diseases is hepatitis B,and the health care workers lack the knowledge about the risk of acute injury and the prevention strategy.So,the protective measures and the measures for the protection of the sharp device in the medical institutions in Gansu should be improved.The medical institutions need to provide targeted education and training for the high-risk population according to the local economic development level,age,the working life,the condition of the protective equipment provided by the medical institutions,the occupation,the professional title,the marital status and the weekly working time.(2)The factors that affect the occupational stress of health care workers are medical institutions grade,working years,occupation and weekly working time.The medical institutions need to relieve the occupational stress of medical staff by improving their working environment,strengthening the construction of the department's culture,reducing its working pressure and improving the job security and the promotion expectation.(3)The health care workers with high occupational stress are more prone to sharp injuries.It is necessary to improve the professional health of medical staff by reducing the occupational stress of medical staff.