臺灣博碩士論文加值系統

醫療尖銳物品扎傷或血液、體液暴露是醫療相關人員(HCWS)在工作職場上常見的職業傷害，亦為感染B型肝炎、C型肝炎、後天免疫不全症侯群、梅毒等傳染疾病主要來源。高雄醫學大學附設中和紀念醫院自西元1993年5月開始致力於扎傷防護，並以鑑認(Identify)、評估(Evaluate)、發展(Development)、執行(Implement)及監控(Mornitoring)之時序逐步完成『全面性醫療尖銳物品扎傷防護計劃』。本研究藉由問卷調查方式評估各項措施執行成效，主要目標在於比較研究前、後階段扎傷機轉、調查者之感染認知、扎傷感染源分佈及通報率等項目差異，並利用研究中、後階段之配對資料評估新增措施執行成效及作為計劃延續發展之修正參考。
　　目前相關研究所採用扎傷率估算方法不一，本研究嚐試利用2000年問卷資料之扎傷次數分別與「各類針器購買總數量」及「各類針器使用總次數」作扎傷率比較，分析結果分別為1.1×10-4、3.4×10-4，明顯發現針頭購買總數量扎傷率明顯低於總使用次數估算結果，並與游芝亭(15)、Jagger(21) 研究結果相仿。另一種扎傷人次估算方法，2000年研究結果，平均每人每年平均扎傷0.4次，污染性扎傷平均0.2次，明顯低於張靜文博士(11)彙整國內數篇醫療院針扎傷害研究之護理人員每人每年發生1.2~2.8次針扎，污染性針扎為0.7~0.9次。
2000年研究之扎傷通報率為29.5%，具污染性扎傷通報率則為48.6%，高於郭育良博士(16)全省醫院大規模針扎傷通報率18.2%，呈現良好成效，不過，低通報率仍然值得注意。

Health-care workers (HCWs) were easily transmitted contagious diseases after exposure to needlestick or sharps injuries. The pathogens of these diseases included hepatitis B and C viruses, human immunodeficiency virus, and syphilis virus. In May, 1993, Kaohsiung Medical University Hospital implemented the protection program of needlestick injury inside the hospital. To evaluate the performance of this program, we conducted this study to compare the difference of needlestick injury mechanism, infection awareness of participants, distribution of infections, and reported rate between before and after the implementation of this program.
We used two methods to estimate the incidence rate of needlestick and sharp injuries: one is "total amount of syringe devices purchased" and the other is "total amount of syringe devices used" as denominator. We found the incidence rates were 1.1×10-4 and 3.4×10-4, respectively. The annual incidence rates of needlestick injury and infective needlestick injury were 0.4 and 0.2 time per person, respectively. In our study we found that 29.5% of needlestick injury in our hospital had reported and received further medical attentions. 48.6% of those cases were injured by infectious sharps. Even though we implemented the protection program of needlestick injury, the reported rate was still relatively low.

內 容 頁 次
中文摘要 ...............................................................Ⅰ
英文摘要................................................................Ⅱ
誌 謝................................................................Ⅲ
目 錄................................................................Ⅳ
表 目 錄................................................................Ⅴ
壹、前 言 ..............................................................1
貳、相關文獻整理表 ..........................................5
參、研究時序表說明 ..........................................8
肆、材料與方法 ..........................................10
伍、結 果 ...............................................................13
陸、討 論 ...............................................................18
柒、結 論 ...............................................................24
捌、參考文獻 ......................................................26
玖、相關文獻整理內容 .................................... 54
拾、附錄一(1996年問卷) ....................................61
附錄二(1999年問卷) ....................................63
附錄三(2000年問卷) ....................................67
附錄四(相片) ................................................71

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