北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (4): 711-714. doi: 10.19723/j.issn.1671-167X.2020.04.022

• 论著 • 上一篇    下一篇

抗击新型冠状病毒肺炎一线护理人员防护暴露风险事件调查

王秋1,郭金玉1,孙红1,王泠2,(),应菊素2,刘慧鑫3   

  1. 1.北京大学人民医院 急诊科, 北京 100034
    2.北京大学人民医院 护理部, 北京 100034
    3.北京大学人民医院 科研处,北京 100034
  • 收稿日期:2020-04-07 出版日期:2020-08-18 发布日期:2020-08-06
  • 通讯作者: 王泠 E-mail:wanglingyaoyao@sina.com

Investigation of protective exposure risk events in nurses against corona virus disease 2019 in Wuhan

Qiu WANG1,Jin-yu GUO1,Hong SUN1,Ling WANG2,(),Ju-su YING2,Hui-xin LIU3   

  1. 1. Department of Emergency, Peking University People’s Hospital, Beijing 100034, China
    2. Department of Nursing, Peking University People’s Hospital, Beijing 100034, China
    3. Office of Academic Research, Peking University People’s Hospital, Beijing 100034, China
  • Received:2020-04-07 Online:2020-08-18 Published:2020-08-06
  • Contact: Ling WANG E-mail:wanglingyaoyao@sina.com

摘要:

目的: 调查抗击新型冠状病毒肺炎(corona virus disease 2019,COVID-19)一线护士防护暴露风险事件现状,为管理者做好护理人员防护提供依据。方法: 便利选取支援武汉的308名护理人员,采用研究团队自行编制的网络问卷进行调查,通过事件回顾的方式对护理人员在防护状态下的7种防护暴露风险事件进行调查。结果: 共有304人填写了有效问卷,88.8%的护理人员接受了防护暴露风险事件预防与应对的培训。7种防护暴露风险事件中,鞋套污染、脱落的发生率相对较高,为53.6%;由于有手套的保护,手部或皮肤污染发生率相对较低,为14.1%;护士心理负担最重的防护暴露风险事件是N95口罩污染、脱落或移位,分值达8.2±2.3。单因素分析发现,支援武汉天数不同,防护风险事件发生的种类数量不同(χ2=14.562,P=0.024);多元有序Logistic回归发现,男性是防护暴露风险事件发生的种类数量的独立保护因素(P=0.019)。结论: 支援武汉的一线护理人员工作中会出现防护暴露风险事件,在工作中既要指导护士防止风险事件的发生,又要指导其有效应对,从而减轻心理负担。

关键词: 冠状病毒感染, 肺炎, 病毒性, 护士, 个人防护装备, COVID-19

Abstract:

Objective: To investigate the current situation of virus exposure risk incidents of nurses against corona virus disease 2019 (COVID-19) in Wuhan, and to provide reference evidence for nursing managers to protect nursing staff who were working in the isolation ward. Methods: In the study, 308 nursing staff against COVID-19 working in the isolation ward in Wuhan were conveniently selected to participate in the investigation. The designed questionnaires including 7 kinds of protective exposure risk events were made by the team of researchers on the basis of literature review and interview with the nurses in Wuhan. All the participants recalled their working experience in the status of dressing in personal protective equipment and filled in the questionnaires online by WeChat according to the same instruction. Results: The questionnaires were filled in validly by a total of 304 nursing staff, of whom 88.8% received emergency training on the prevention and dealing measurement of exposure risk events. The incidence of shoe cover contamination, falling off or torn was relatively high, about 53.6%. Due to the protection of gloves, the incidence of hand or skin contamination was relatively low, about 14.1%. The most nervousness of protective exposure risk event for nurses was N95 mask contamination, falling off or shifting, with a score of 8.2±2.3, showing a higher psychiatric burden. Single factor analysis found that the number of days in Wuhan was different, the number of the types of protective risk events occurred was different (χ2=14.562, P=0.024), orderly multivariate Logistic regression found that men were the independent protective factor for the number of the types of protective exposure risk events that occurred (P=0.019). Conclusion: Protective exposure risk events may occur in the work of nursing staff working in the isolation ward in Wuhan. It is necessary to guide nurses to prevent the occurrence of protective exposure risk events and effectively deal with them, so as to prevent virus exposure and reduce psycholo-gical burden.

Key words: Coronavirus infections, Pneumonia, Viral, Nurses, Personal protective equipment, COVID-19

中图分类号: 

  • R563.1

表1

暴露风险事件发生情况(n=304)"

Items 0 time 1 time 2 times 3 times ≥4 times
Contamination of hand and skin 261 (85.9) 17 (5.6) 9 (3.0) 5 (1.6) 12 (3.9)
Contamination, falling off, or torn of shoe cover 144 (47.4) 62 (20.4) 60 (19.7) 15 (4.9) 23 (7.6)
Contamination, falling off or torn of isolation gown 215 (70.7) 33 (10.9) 25 (8.2) 14 (4.6) 17 (5.6)
Falling off or shifting of N95 mask 241 (79.3) 29 (9.5) 24 (7.9) 6 (2.0) 4 (1.3)
Falling off or shifting of surgical mask 266 (87.5) 19 (6.3) 10 (3.3) 8 (2.6) 1 (0.3)
Contamination, falling off or shifting of goggles 290 (95.4) 4 (1.3) 7 (2.3) 3 (1.0) 0
Contamination, falling off or shifting of splash screen 222 (73.0) 51 (16.8) 19 (6.3) 7 (2.3) 5 (1.6)

表2

防护暴露风险事件发生后的紧张程度"

Items Higher nervoursness
(score of nervousness≥6), n (%)
The degree of nervousness, x?±s
Contamination of hand and skin (n=42) 23 (54.8) 5.8±3.0
Contamination, falling off, or torn of shoe cover (n=160) 71 (45.5) 5.0±2.5
Contamination, falling off or torn of isolation gown (n=84) 55 (65.5) 6.1±2.6
Falling off or shifting of N95 mask (n=62) 55 (88.7) 8.2±2.3
Falling off or shifting of surgical mask (n=38) 29 (78.4) 6.4±2.4
Contamination, falling off or shifting of goggles (n=13) 9 (69.2) 6.6±2.4
Contamination, falling off or shifting of splash screen (n=81) 49 (60.5) 6.1±2.8

表3

支援武汉天数与暴露风险事件发生种类数量的关系"

Days in Wuhan ≤1 kind 2-4 kinds ≥5 kinds
10-20 d 11 (61.1) 6 (33.3) 1 (5.6)
21-30 d 110 (52.4) 94 (44.8) 6 (2.9)
31-40 d 32 (53.3) 27 (45.0) 1 (1.7)
≥41 d 10 (62.5) 3(18.8) 3 (18.8)

表4

防护暴露风险事件发生的种类数量的多元有序Logistic回归"

Items n (%) B SE Wald P OR 95%CI
Age -0.009 0.094 0.008 0.927 1.022 1.201-0.871
Working years 0.041 0.083 0.244 0.621 0.937 1.079-0.813
Gender
Male 41 (16.0) 1.053 0.450 5.480 0.019 0.349 0.843-0.144
Female 216 (84.0)
Days in Wuhan
10-20 d 18 (5.9) -1.050 0.904 1.348 0.246 2.858 16.827-0.485
21-30 d 210 (69.1) -0.890 0.722 1.517 0.218 2.435 10.024-0.591
31-40 d 60 (19.7) -0.849 0.762 1.241 0.265 2.337 10.412-0.525
≥41 d 16 (5.3)
Shifts of one week
≤5 204 (79.4) -0.440 0.390 1.272 0.259 1.552 3.333-0.723
≥6 53 (20.6)
Working hours for one shift
≤4 h 140 (54.5) 1.513 1.121 1.822 0.177 0.220 1.982-0.025
5-8 h 113 (44.0) 1.266 1.102 1.319 0.251 0.282 2.445-0.033
≥9 h 4 (1.6)
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