區域醫院及醫學中心醫療人員，使用安全針具扎傷之經驗

Experience in using of safety-engineered medical devices and related needlestick injuries in healthcare workers in regional hospitals and medical centers

目標：台灣醫療法規範醫療院所應提供安全針具後，醫療人員之扎傷率已有下降趨勢；但在台灣EPINet通報系統的扎傷事件統計中，仍可看到有工作人員沒有適時選用安全針具，或是安全針具未能避免扎傷事件的情形。本研究目的為探索台灣區域醫院與醫學中心之醫療人員使用安全針具仍發生扎傷的狀況與困境。方法：本研究對象為曾被安全針具扎傷之醫療人員，訪談內容以遭安全針具扎傷之事件經過以及安全針具使用之心得為主，並透過質性內容分析法歸納出核心主題。結果：共有25位醫療人員接受訪談，訪談後歸納出醫療人員認為安全針具使用上不夠便利與安全針具替代範圍不全面兩個主題，其中包含沒有真正好用的安全針具、未上過教育訓練、缺乏便於使用安全針具的環境以及醫師的治療項目沒有安全針具共四個次主題。結論：台灣在安全針具的使用上仍有進步的空間。建議針具製造商應持續改善現存安全針具的設計並拓展更多安全針具種類，也建議醫療院所配合所引進之安全針具，調整安全針具教育時機以及調整尖銳物回收桶、工作車等工作環境配置。（台灣衛誌 2022；41（2）：200-210）

Objectives: The incidence of sharps injury in Taiwan has declined after the enactment of the Needlestick Safety and Prevention Act. However, some healthcare workers still use conventional devices in high-risk procedures, and some safety-engineered medical device (SEMD) users experience sharps injury. In this study, we explored the problems of using SEMDs in regional hospitals and medical centers in Taiwan. Methods: We included healthcare workers who had sharps injury due to the use of SEMDs. The interviews focused on the process of sharps injury and participants’ experience of using SEMDs. We analyzed the interview data by using the qualitative content analysis method. Results: Twenty-five healthcare workers were interviewed. We noted that the participants did not find the use of SEMDs to be sufficiently convenient. This indicated that SEMDs were not easy to use and that improper training and unfavorable work environment further reduced their use. Our findings also revealed that replacement of SEMDs were not comprehensive, especially in the procedure of the physicians. Conclusions: We recommend the manufacturers to improve the existing SEMDs and introduce more types of SEMDs. Healthcare facilities should involve the users in the purchase process, provide appropriate training, and establish a more convenient work environment for promoting the use of SEMDs. (Taiwan J Public Health. 2022;41(2):200-210)