病院清掃における針刺し・切創実態調査
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概要
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An on-site study in 1998 investigated a number of needle stick and cutting injuries among housekeepers engaged in the cleaning of hospital environments. Subsequently, training programs to prevent such injures among housekeepers were promoted strongly. However, the expected improvement was not observed. The recent situation of such injuries was restudied for the development of more effective prevention programs. Questionnaires for survey of the occurrences of needle stick and cutting injuries during cleaning procedures in clinical settings between April 2006 and March 2009 were sent to 1,368 of all qualified companies authorized as healthcare service providers with the health care service mark in 2009. Replies from 340 of 1,368 companies were obtained (response rate: 24.9%). The number of effective replies was 323/340, 23.6%, and the number of hospitals included were 1,493 in three years. Among 361 cases of occupational injuries from April 2006 to March 2009, around 100 cases of needle stick injuries, and around 10 cases of cutting injuries were reported. Among those needle stick injuries, ordinary injection needle was the main cause with 68 cases and insulin needle with 20 cases. The needles incorrectly discarded were mainly found in the wards and then in nurse stations (staff stations). The incidence of such injuries was not decreased at all whereas the effort for improving educational programs for employees had continuously progressed. The main risk factor for injuries was that the housekeepers are not aware of the needle or sharp edge within some wastes. Very thin needles for insulin injection are another risk factor for the injury. Moreover, as most housekeepers are part-time workers, education and training for preventing injuries are unfortunately insufficient in many cases. More effective short programs for the education and training of the employees have to be considered carefully again. Much better communication systems between hospital personnel and housekeepers should be established. Vaccination rates for blood-borne infections among housekeepers should also be reevaluated.