某醫學中心護理人員對污染性針扎的認知與處理方法之探討

Nurses' Knowledge and Mnagement of Contaminated Needlesticks in a Medical Center

護理人員是針扎的高危險群，被接觸過病人體液的污染性針頭所扎傷，可傳染愛滋病、B型肝炎、C型肝炎、梅毒…等各種傳染病。為瞭解那些單位或特性之護理人員較未能有正確的知識，期盼所得結果可提供醫院規劃衛生教育的參考。本研究以面談問卷方式調查某醫學中心護理人員1123人。回應率91.4%（1026人），其中43人因在衛教、研究、行政或中央供應室等沒有接觸針頭的單位，另外27人的問卷填寫不完整，35人為護理長以行政工作為主，皆不列入計算，共921份問卷進行統計分析。結果發現護理人員對污染性針扎的認知仍嫌不足，只有33.8%是完全答對所問關於污染性針扎可能傳染的疾病。開刀房及年資1年到4年者認知較差。對污染性針扎可能傳染疾病認知得分愈高者，愈會採取單手套回針頭蓋，以預防針扎。過去一年有428人（46.5%）曾發生污染性針扎，其中只有28%正確的處理；且只有30人（7%）在發生污染性針扎時曾向上級報告。正確認知者比較會採取正確的處理方式。因此，應依各單位需要，加強衛教，使每個護理人員都能認知污染性針扎的危害，採取適當的預防措施來避免針扎，萬一被扎傷也能做正確的處理，建立起全院污染性針扎的通報及處理系統，以減免針扎的危害。

Nurses are at high risk of needlesticks, which can transmit AIDS (Acquired immunodeficiency syndrome), syphilis, viral hepatitis B and C, etc., as reported in many studies. This study was conducted by questionnaire interview to all of the nurses in a medical center to determine the nurses' knowledge and management of contaminated needlesticks. 1026 (91.4%) of 1123 nurses responded, but 43 nurses who worked in education, administration, or central supply departments, and 35 directors of units were excluded because they usually did not work with needles. 27 nurses with incomplete questionnaires were also excluded. The results revealed 33.8% nurses answered correctly about the kinds of diseases transmitted by contaminated needlesticks. Nurses at operation unit and with 1~4 years of working experience got a significantly lower score in knowledge. The higher the score she got, the more frequently would she use one hand technique to recap contaminated needles. 46.5% nurses were injuried by contaminated needles within the past one year, 72% of them did not treat themselves comprehensively and only 30 persons (7%) reported to the nosocomial infection control unit. The score of knowledge is positively associated with the score of management. We recommend continuous educations of practicing nurses about comprehensive prevention and treatment of contaminated needlesticks should be advocated together with the establishment of a complete reporting system.