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Medical staff because of occupational relations, the frequency of exposure to pathogenic factors is higher than the general population. For a long time, hospital infection control is mainly aimed at patients, but little attention has been paid to the infection of blood-borne diseases by medical staff due to occupational exposure. At present, the total infection rate of hepatitis B in the population of our country is as high as 60%, and there are more than one 0.3 billion of hepatitis B virus carriers. The epidemic of AIDS in our country has also entered a period of rapid growth, and the number of AIDS patients has shown a sharp increase. Domestic scholars found that the total infection rate of hepatitis such as HBV, HCV and HGV among clinical medical staff was 33.3%, which was significantly higher than that of the general population (12.3%). Medical staff are facing the risk of severe occupational exposure. Therefore, it is particularly important for operating room staff to clarify the protection and treatment procedures for occupational exposure to blood-borne infectious diseases.

1. Definition of occupational exposure to blood-borne infectious diseases of medical personnel

In the process of diagnosis and treatment, nursing, medical waste removal and transportation, medical personnel are accidentally contaminated by the blood and body fluids of infected persons or carriers of blood-borne infectious diseases, or by blood and body fluids containing blood-borne infectious diseases. The skin is punctured by needles and other sharp instruments, including scratches and bites by such patients. Events that may be infected by blood-borne infectious diseases are called occupational exposure to blood-borne infectious diseases.

2. Occupational hazards of nurses infected with blood-borne diseases

There will be pathogenic factors in the blood of 2.1 patients, which is a prerequisite for medical staff to be infected with blood-borne diseases. Medical staff often contact the blood and body fluids of patients, and the probability of infection after occupational exposure is higher than that of ordinary people. The infection of blood-borne pathogenic factors to medical personnel often occurs in the way of sharp instrument and needle injury of skin and mucous membrane or broken skin contact, and it mostly occurs in nurses, followed by laboratory personnel and doctors.

2.2 a long time engaged in blood collection, first aid work and gynecology, obstetrics and hematology operations, the chance of contact with patients' blood and body fluids is greatly increased. The greater the amount of contact blood, the longer the time, the greater the amount of pathogenic factors the body can obtain. All operations that may be in contact with blood and body fluids in medical and nursing activities, including injection, blood collection, blood transfusion, surgery, endoscopy, dialysis, and the collection, transmission, inspection and disposal of various specimens of patients, can cause occupational infections. Comprehensive research data from different countries or regions, medical staff due to acupuncture or injury, contact with contaminated blood, the risk of hepatitis B infection is 2% ~ 40%, the risk of hepatitis C infection is 3% ~ 10%. The risk of HBV infection in nursing occupational exposure was significantly higher than that of HCV and HIV.

3. Protection of medical personnel from occupational exposure to blood-borne infectious diseases

3.1 protection focuses on avoiding direct contact with the blood and body fluids of patients or carriers.

It is 3.2 to strengthen the publicity and education of medical staff's awareness of prevention and establish a good concept of disinfection and sterilization.

3.3 medical personnel should abide by the principle of standard prevention, regard all patients' blood, body fluids and articles contaminated by blood and body fluids as infectious substances. In the process of operation, they must strictly implement correct operation procedures and take appropriate protective measures.

4. Medical personnel must wash their hands before and after contacting patients, and take appropriate protective measures when contacting any substances containing pathogens:

When the 4.1 carries out operations that may touch the patient's blood and body fluids, it is necessary to wear gloves. After the operation, take off the gloves and wash hands immediately, and disinfect the hands when necessary.

4.2 in the process of operation, the patient's blood, body fluids may be splashed, must wear gloves, anti-penetration mask, goggles; in the operation if the blood, body fluids may be a large area of splash or may pollute the body of medical personnel, must also wear anti-penetration isolation gown or apron, in order to provide effective protection.

4.3 suggest that staff should avoid participating in the nursing work of people infected with blood-borne infectious diseases such as AIDS and hepatitis B if there are wounds and dermatitis in the exposed parts, and do not come into contact with contaminated instruments and equipment.

4.4 During invasive operation, medical staff should ensure sufficient light and pay attention to standardized operating procedures to prevent accidental needle stick injuries.

4.5 contaminated needles and other disposable sharps are immediately placed in stab-resistant, impermeable sharps boxes or safely disposed.

It is 4.6 to abandon the operation method of returning the needle cap with both hands. If it is necessary to return the needle cap with one hand, it is recommended to return the needle cap with one hand. Prohibit direct contact with the use of the needle, blade and other sharp. It is forbidden to walk around the workplace with contaminated sharp tools to avoid accidental stabbing or self-injury.

5. Emergency handling procedures

5.1 immediately squeeze gently near the wound, as far as possible to squeeze out the blood of the injury, and then wash the wound with soap and running water, and then disinfect with 0.5 iodophor, if it is mucosal injury, rinse with running water and normal saline.

The medical personnel concerned are 5.2 to fill in the "Medical Sharp Injury Registration Form" of the unit carefully, which should include: the time, place, process, specific location and injury, etc., and carry out relevant inspections at the same time.

5.3 Medical staff should complete the HIV and HBsAg related tests within 24-48 h after the accident. The serological follow-up time is 1 year, and the corresponding treatment should be carried out according to the situation.

Source: Operating Room Nursing