國內針扎文獻的回顧與預防感染處理的建議

Literature review of needle-stick injuries in Taiwan and prophylaxis of post-exposure infection

醫療尖銳物扎傷一直是醫院員工常見的職業傷害，我們分析國內外相關文獻進行有關醫院針扎情況調查事件或與安全措施之相關研究。發現問卷調查與通報 系統調查的針扎比率有相當的差距，且扎傷發生時間在夜間或假日，相關的處理與報導較少。對於受針扎員工可能暴露於B型肝炎，C型肝炎及人類免疫不全 病毒感染源時，為免於遭受感染之威脅，應考量預防投藥之迅速方便性，與是否可以得到立即處置等通報處理原則；但被扎傷者個人隱私暴露、或長官給予特別的關切時，也可能影響被扎傷者通報意願及追蹤報告結果。根據研究，建議未來醫院針對防治工作人員尖銳物品扎傷事件，除應強調在工作執行中預防扎傷方法教育外，亦應考量醫療工作者受到各種血液感染源曝觸後，所帶來令人憂心的血清陽轉威脅，與擬定非上班時間立即處置之改善措施。

Incisive injuries, such as needle-stick injuries, are a common occupation hazard for the entire hospital staff. We reviewed the literature on needle-stick injury events and post-exposure prophylaxis. The number of needle-stick injuries reported was less than that from a questionnaire answered by hospital staff. However, the hospital staff may not report needle-stick injury events or follow up due to personal privacy and concerns of supervisors. We must consider the efficacy, convenience, and safety of staff who might be exposed to hepatitis B, hepatitis C, or human immunodeficiency virus infection due to a needle-stick injury. According to the literature, we suggest that health care institutes set up standard operation procedures for needle-stick events that occur on holidays or at night, and educate employees in order to prevent needle-stick injuries.