湖南省实习护生锐器伤后规范处理现状与影响因素分析

发布时间：2018-03-09 18:18

本文选题：实习护生　切入点：锐器伤　出处：《湖南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：调查湖南省实习护生锐器伤后规范处理的依从性现状,分析原因及影响因素,为提高实习护生锐器伤后规范处理的依从性提供依据,减少锐器伤对实习护生造成的不良影响,提高实习护生对锐器伤的认识。方法：采用方位布局和分层抽样的原则对湖南省内5所三级医院的479名正在实习的护生进行问卷调查,使用Excel2013和Spss17.0统计软件对数据进行统计分析,用率和构成比对计数资料进行统计描述,用卡方检验和非条件二分类lojistic回归分析对实习护生发生锐器伤后规范处理依从性的影响因素进行单因素和多因素分析。结果：实习护生锐器伤发生率为65.34%,其中24.22%实习护生发生过2次或2次以上的锐器伤,39.67%实习护生至少发生过一次被病人血液或体液污染的锐器伤。发生锐器伤后,只有36.43%实习护生能规范处理伤口,63.57%实习护生未规范处理伤口。36.71%护生对是否需要规范处理伤口持无所谓态度,28.32%护生因为工作忙没时间按规范流程处理伤口。只有10.86%实习护生每次发生锐器伤后都向带教老师或护士长上报,将近三分之二的实习护生不上报,42.33%实习护生认为上报程序繁琐,28.81%实习护生认为医院不重视上报。只有12.78%实习护生每次发生锐器伤后都查阅病人病例,查看病人有无血源性传播疾病。无实习护生填写锐器伤登记表,只有29.71%实习护生去抽血做相关检查或做预防性治疗,还有一部分人未做任何处理。教育程度、实习时间、每周上班时间、对锐器伤相关知识的了解程度、工作量、师生关系、操作环节、医院内张贴锐器伤规范处理流程图情况、工作情形、学校职业防护教育、医院岗前培训、带教老师传授防护知识情况与护生锐器伤后规范处理的依从性有关,性别、年龄、宗教信仰、乙肝疫苗接种及免疫力等情况与护生锐器伤后规范处理的依从性无关。实习时间、每周上班时间、医院内张贴锐器伤规范处理流程图情况、工作情形及带教老师传授防护知识情况是影响护生锐器伤后规范处理依从性的主要因素。结论：实习护生锐器伤发生率高,但锐器伤后规范处理依从性低,护生职业防护教育欠缺,锐器伤防护意识不强,医院职业防护制度不健全,应引起有关部门重视。
[Abstract]:Objective: to investigate the current situation of compliance with standard management of sharp instrument for nursing students in Hunan Province, analyze the causes and influencing factors, and provide the basis for improving the compliance of standard treatment after acute instrument injury in practice nursing students. To reduce the adverse effect of sharp instrument injury on nursing students and to improve their understanding of sharp instrument injury. Methods: a questionnaire survey was conducted among 479 nursing students in 5 tertiary hospitals in Hunan Province by using the principle of orientation layout and stratified sampling. Excel2013 and Spss17.0 statistical software are used to analyze the data, and the counting data are described with the ratio and composition comparison. Using chi-square test and non-conditional two-classification lojistic regression analysis, single factor and multi-factor analysis were carried out to analyze the influencing factors of nursing students' compliance with standard treatment after acute instrument injury. Results: the incidence rate of sharp instrument injury was 65.34, of which 24.22% was in practice nursing students. 39.67% of the intern nursing students had at least one sharp instrument injury contaminated by the patient's blood or body fluid after two or more sharp instrument injuries. Only 36.43% nursing students were able to deal with wounds in a standardized manner. 63.57% of nursing students did not handle wounds properly. 36.71% of nursing students were indifferent to the need for standardized treatment of wounds. 28.32% of nursing students were not able to handle wounds according to the standard procedure because they were busy at work. Only 10.86% of them had to deal with wounds according to the standard procedure. The intern nursing students report to the teacher or head nurse after each sharp instrument injury. Nearly 2/3 of the nursing students did not report the report. 42.33% of the students thought that the reporting procedure was cumbersome. 28.81% thought the hospital did not attach importance to the report. Only 12.78% nursing students looked up patients' cases after sharp instrument injury. Check whether the patient has blood-borne sexually transmitted disease. No intern nursing students fill out sharp instrument injury registration form, only 29.71% probationary nursing students take blood to do related examination or do preventive treatment, and some people do not do any treatment. Education level, internship time, The degree of understanding, workload, relationship between teachers and students, operation links, flow chart of standard handling of sharp instrument injury, working situation, vocational protection education in school, pre-post training in hospital, etc. The teaching of protective knowledge was related to the compliance of nursing students with the standard treatment of sharp instrument injury. Sex, age, religious belief, hepatitis B vaccination and immunity were not related to the compliance of nursing students with the standard treatment after sharp instrument injury. During the weekly working hours, the hospital posted sharp instrument injury standard handling flow chart, Working conditions and teaching teachers were the main factors influencing the compliance of nursing students with standardized treatment after acute instrument injury. Conclusion: the incidence of acute instrument injury is high, but the compliance of standardized treatment is low after acute instrument injury. The vocational protection education of nursing students is deficient, the awareness of sharp instrument injury is not strong, and the occupational protection system of hospital is not perfect, which should be paid attention to by relevant departments.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：G645.5;R47

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