安全注射的現狀及管理對策_West China Medical Journal

Authors：

 張慧 ¹ , 尹維佳 ¹ , 喬甫 ¹ , 朱仕超 ¹ , 李婧聞 ¹ , 黃靜 ¹ ,  宗志勇 ^1,2

1. ;
2. ;

Corresponding?author：

張慧, Email: chuchuhuier@163.com; 宗志勇, Email: zongzhiyong@gmail.com

Keywords：

安全注射; 現狀; 管理

DOI：

10.7507/1002-0179.20150681

Video：

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注射是醫療、預防、保健服務中最常使用的技術手段，而不安全注射已成為嚴重的公共衛生安全問題，在發展中國家尤為突出。不安全注射主要與缺乏安全注射的意識和知識、缺乏有效的方法和設備、經濟利益趨勢導致注射濫用以及缺乏安全注射監管體系等密切相關。安全注射不僅是醫院感染防控和醫務人員職業安全保障的基本措施，也體現了醫療衛生保健機構的整體管理水平和醫療質量。安全注射的管理是系統工程，涉及到國家政策和法規、教育培訓、產品和技術改進及監督管理等方面，應積極采取有效措施推動和促進我國安全注射質量的持續改進，保障注射安全。

Citation： 張慧, 尹維佳, 喬甫, 朱仕超, 李婧聞, 黃靜, 宗志勇. 安全注射的現狀及管理對策. West China Medical Journal, 2015, 30(12): 2377-2380. doi: 10.7507/1002-0179.20150681 Copy

1.	雷利霞, 吳曉蓮, 周繁華. 應用回縮自毀式一次性無菌注射器的必要性[J]. 中國實用醫藥, 2011, 6(16):269-270.
2.	李六億. 安全注射現狀及其管理對策[J]. 中國醫療器械信息, 2006, 12(3):2-3, 28.
3.	Pépin J, Abou Chakra CN, Pépin E, et al. Evolution of the global burden of viral infections from unsafe medical injections, 2000-2010[J]. PLoS One, 2014, 9(6):e99677.
4.	World Health Organization. WHO best practices for injections and related procedures toolkit[EB/OL]. (2010-04-14)[2015-12-01]. http://apps.who.int/iris/bitstream/10665/44298/1/9789241599252_eng.pdf.
5.	Hutin YJ, Chen RT. Injection safety:a global challenge[J]. Bull World Health Organ, 1999, 77(10):787-788.
6.	Yan YW, Yan J, Zhang GP, et al. Prevalence of injections and knowledge of safe injections among rural residents in Central China[J]. Singapore Med J, 2007, 48(8):769-774.
7.	Hutin YJ, Hauri AM, Armstrong GL. Use of injections in healthcare settings worldwide, 2000:literature review and regional estimates[J]. BMJ, 2003, 327(7423):1075.
8.	Ismail NA, Aboul Ftouh AM, El-Shoubary WH, et al. Safe injection practice among health-care workers in Gharbiya Governorate, Egypt[J]. East Mediterr Health J, 2007, 13(4):893-906.
9.	Patel DA, Gupta PA, Kinariwala DM, et al. An investigation of an outbreak of viral hepatitis B in modasa town, gujarat, India[J]. J Glob Infect Dis, 2012, 4(1):55-59.
10.	Eze JC, Ibeziako NS, Ikefuna AN, et al. Prevalence and risk factors for hepatitis C and human immunodeficiency virus coinfection among children in enugu, Nigeria[J]. Afr J Infect Dis, 2014, 8(1):5-8.
11.	Gupta E, Bajpai M, Sharma P, et al. Unsafe injection practices:a potential weapon for the outbreak of blood borne viruses in the community[J]. Ann Med Health Sci Res, 2013, 3(2):177-181.
12.	Kuehn BM. Unsafe injection practices plague US outpatient facilities, harm patients[J]. JAMA, 2012, 308(24):2551-2552.
13.	Dolan SA, Felizardo G, Barnes S, et al. APIC position paper:safe injection, infusion, and medication vial practices in health care[J]. Am J Infect Control, 2010, 38(3):167-172.
14.	Guh AY, Thompson ND, Schaefer MK, et al. Patient notification for bloodborne pathogen testing due to unsafe injection practices in the US health care settings, 2001-2011[J]. Med Care, 2012, 50(9):785-791.
15.	Abkar MA, Wahdan IM, Sherif AA, et al. Unsafe injection practices in Hodeidah governorate, Yemen[J]. J Infect Public Health, 2013, 6(4):252-260.
16.	Omorogbe VE, Omuemu VO, Isara AR. Injection safety practices among nursing staff of mission hospitals in Benin City, Nigeria[J]. Ann Afr Med, 2011, 11(1):36-41.
17.	張友平, 鐘華蓀, 侯鐵英, 等. 廣東省39所醫院護士銳器傷調查與分析[J]. 中國護理管理, 2012, 12(4):72-74.
18.	陳惠清, 武迎宏, 劉坤, 等. 北京市醫務人員銳器傷的調查分析[J]. 中華醫院感染學雜志, 2013, 23(20):4976-4978.
19.	索瑤, 范珊紅, 高曉東. 陜西省11所醫院醫務人員銳器傷調查與分析[J]. 中華醫院感染學雜志, 2011, 21(12):2505-2507.
20.	劉桂芝, 李霞, 鄭曉鳳, 等. 醫務人員銳器傷基線調查與分析[J]. 中華醫院感染學雜志, 2014, 24(1):233-235.
21.	李衛光, 徐華, 朱其鳳, 等. 山東省28所醫院醫務人員銳器傷現狀調查[J]. 中華醫院感染學雜志, 2013, 23(7):1605-1607.
22.	Gyawali S, Rathore DS, Kc B, et al. Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal[J]. BMC Int Health Hum Rights, 2013, 13:3.
23.	李映蘭, 范學工, 周陽, 等. 基層醫院醫護人員安全注射知識、態度、行為調查分析[J]. 中國護理管理, 2011, 11(7):50-53.
24.	郭燕紅. 加強安全注射切實保障公眾健康[J]. 中國醫療器械信息, 2004, 10(4):18, 21.
25.	胡明霞, 趙科伕. 合肥市基層醫療機構安全注射的消毒與管理情況調查[J]. 中國農村衛生事業管理, 2015, 36(1):72-74.
26.	Wu Z, Cui F, Chen Y, et al. Evaluation of immunization injection safety in China, 2010:achievements, future sustainability[J]. Vaccine, 2013, 31(Suppl 9):J43-J48.
27.	張國增, 高園林, 史玉娟, 等. 自毀式注射器臨床應用影響因素的研究[J]. 中國衛生事業管理, 2015, 32(3):186-188.
28.	郭招治. 安全注射有效預防血源性疾病傳播[J]. 中華醫院感染學雜志, 2010, 20(24):3979.
29.	蔡艷陽. 基層醫療機構安全注射現狀的調查——以湖北省荊州市荊州區為例[J]. 醫學信息, 2013, 26(6):343.
30.	Pandit NB, Choudhary SK. Unsafe injection practices in Gujarat, India[J]. Singapore Med J, 2008, 49(11):936-939.
31.	李映蘭, 鄭悅平, 周陽. 醫護人員安全注射研究進展[J]. 中華醫院感染學雜志, 2009, 19(22):3148-3150.
32.	Gyawali S, Rathore DS, Shankar PR, et al. Injection practice in Kaski district, Western Nepal:a community perspective[J]. BMC Public Health, 2015, 15:435.
33.	Zhou Q, Zhu L, Li W, et al. Injection device-related risk management toward safe administration of medications:experience in a university teaching hospital in the People's Republic of China[J]. Therap Clin Risk Manag, 2014, 10:165-172.
34.	Levin Y, Kochba E, Hung I, et al. Intradermal vaccination using the novel microneedle device MicronJet600:past, present, and future[J]. Hum Vaccin Immunother, 2015, 11(4):991-997.
35.	關旭靜, 方剛. 預防接種用相關器材的現狀與發展動向[J]. 中國疫苗和免疫, 2010, 16(1):82-85, 91.
36.	俞學群. 加強我國預防接種中安全注射管理問題的探討[J]. 中國初級衛生保健, 2008, 22(1):60-61.
37.	薛菊蘭, 李曉琴, 陳松燕, 等. 社區損傷性醫療廢物的管理對策[J]. 中華醫院感染學雜志, 2012, 22(6):1212.
38.	鄧立鵬. 預防接種安全注射現狀和影響因素分析[J]. 醫學動物防制, 2009, 25(9):670-672.
39.	Garrett JH. A review of the CDC recommendations for prevention of HAIs in outpatient settings[J]. AORN J, 2015, 101(5):519-525; quiz 526-528.

1. 雷利霞, 吳曉蓮, 周繁華. 應用回縮自毀式一次性無菌注射器的必要性[J]. 中國實用醫藥, 2011, 6(16):269-270.
2. 李六億. 安全注射現狀及其管理對策[J]. 中國醫療器械信息, 2006, 12(3):2-3, 28.
3. Pépin J, Abou Chakra CN, Pépin E, et al. Evolution of the global burden of viral infections from unsafe medical injections, 2000-2010[J]. PLoS One, 2014, 9(6):e99677.
4. World Health Organization. WHO best practices for injections and related procedures toolkit[EB/OL]. (2010-04-14)[2015-12-01]. http://apps.who.int/iris/bitstream/10665/44298/1/9789241599252_eng.pdf.
5. Hutin YJ, Chen RT. Injection safety:a global challenge[J]. Bull World Health Organ, 1999, 77(10):787-788.
6. Yan YW, Yan J, Zhang GP, et al. Prevalence of injections and knowledge of safe injections among rural residents in Central China[J]. Singapore Med J, 2007, 48(8):769-774.
7. Hutin YJ, Hauri AM, Armstrong GL. Use of injections in healthcare settings worldwide, 2000:literature review and regional estimates[J]. BMJ, 2003, 327(7423):1075.
8. Ismail NA, Aboul Ftouh AM, El-Shoubary WH, et al. Safe injection practice among health-care workers in Gharbiya Governorate, Egypt[J]. East Mediterr Health J, 2007, 13(4):893-906.
9. Patel DA, Gupta PA, Kinariwala DM, et al. An investigation of an outbreak of viral hepatitis B in modasa town, gujarat, India[J]. J Glob Infect Dis, 2012, 4(1):55-59.
10. Eze JC, Ibeziako NS, Ikefuna AN, et al. Prevalence and risk factors for hepatitis C and human immunodeficiency virus coinfection among children in enugu, Nigeria[J]. Afr J Infect Dis, 2014, 8(1):5-8.
11. Gupta E, Bajpai M, Sharma P, et al. Unsafe injection practices:a potential weapon for the outbreak of blood borne viruses in the community[J]. Ann Med Health Sci Res, 2013, 3(2):177-181.
12. Kuehn BM. Unsafe injection practices plague US outpatient facilities, harm patients[J]. JAMA, 2012, 308(24):2551-2552.
13. Dolan SA, Felizardo G, Barnes S, et al. APIC position paper:safe injection, infusion, and medication vial practices in health care[J]. Am J Infect Control, 2010, 38(3):167-172.
14. Guh AY, Thompson ND, Schaefer MK, et al. Patient notification for bloodborne pathogen testing due to unsafe injection practices in the US health care settings, 2001-2011[J]. Med Care, 2012, 50(9):785-791.
15. Abkar MA, Wahdan IM, Sherif AA, et al. Unsafe injection practices in Hodeidah governorate, Yemen[J]. J Infect Public Health, 2013, 6(4):252-260.
16. Omorogbe VE, Omuemu VO, Isara AR. Injection safety practices among nursing staff of mission hospitals in Benin City, Nigeria[J]. Ann Afr Med, 2011, 11(1):36-41.
17. 張友平, 鐘華蓀, 侯鐵英, 等. 廣東省39所醫院護士銳器傷調查與分析[J]. 中國護理管理, 2012, 12(4):72-74.
18. 陳惠清, 武迎宏, 劉坤, 等. 北京市醫務人員銳器傷的調查分析[J]. 中華醫院感染學雜志, 2013, 23(20):4976-4978.
19. 索瑤, 范珊紅, 高曉東. 陜西省11所醫院醫務人員銳器傷調查與分析[J]. 中華醫院感染學雜志, 2011, 21(12):2505-2507.
20. 劉桂芝, 李霞, 鄭曉鳳, 等. 醫務人員銳器傷基線調查與分析[J]. 中華醫院感染學雜志, 2014, 24(1):233-235.
21. 李衛光, 徐華, 朱其鳳, 等. 山東省28所醫院醫務人員銳器傷現狀調查[J]. 中華醫院感染學雜志, 2013, 23(7):1605-1607.
22. Gyawali S, Rathore DS, Kc B, et al. Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal[J]. BMC Int Health Hum Rights, 2013, 13:3.
23. 李映蘭, 范學工, 周陽, 等. 基層醫院醫護人員安全注射知識、態度、行為調查分析[J]. 中國護理管理, 2011, 11(7):50-53.
24. 郭燕紅. 加強安全注射切實保障公眾健康[J]. 中國醫療器械信息, 2004, 10(4):18, 21.
25. 胡明霞, 趙科伕. 合肥市基層醫療機構安全注射的消毒與管理情況調查[J]. 中國農村衛生事業管理, 2015, 36(1):72-74.
26. Wu Z, Cui F, Chen Y, et al. Evaluation of immunization injection safety in China, 2010:achievements, future sustainability[J]. Vaccine, 2013, 31(Suppl 9):J43-J48.
27. 張國增, 高園林, 史玉娟, 等. 自毀式注射器臨床應用影響因素的研究[J]. 中國衛生事業管理, 2015, 32(3):186-188.
28. 郭招治. 安全注射有效預防血源性疾病傳播[J]. 中華醫院感染學雜志, 2010, 20(24):3979.
29. 蔡艷陽. 基層醫療機構安全注射現狀的調查——以湖北省荊州市荊州區為例[J]. 醫學信息, 2013, 26(6):343.
30. Pandit NB, Choudhary SK. Unsafe injection practices in Gujarat, India[J]. Singapore Med J, 2008, 49(11):936-939.
31. 李映蘭, 鄭悅平, 周陽. 醫護人員安全注射研究進展[J]. 中華醫院感染學雜志, 2009, 19(22):3148-3150.
32. Gyawali S, Rathore DS, Shankar PR, et al. Injection practice in Kaski district, Western Nepal:a community perspective[J]. BMC Public Health, 2015, 15:435.
33. Zhou Q, Zhu L, Li W, et al. Injection device-related risk management toward safe administration of medications:experience in a university teaching hospital in the People's Republic of China[J]. Therap Clin Risk Manag, 2014, 10:165-172.
34. Levin Y, Kochba E, Hung I, et al. Intradermal vaccination using the novel microneedle device MicronJet600:past, present, and future[J]. Hum Vaccin Immunother, 2015, 11(4):991-997.
35. 關旭靜, 方剛. 預防接種用相關器材的現狀與發展動向[J]. 中國疫苗和免疫, 2010, 16(1):82-85, 91.
36. 俞學群. 加強我國預防接種中安全注射管理問題的探討[J]. 中國初級衛生保健, 2008, 22(1):60-61.
37. 薛菊蘭, 李曉琴, 陳松燕, 等. 社區損傷性醫療廢物的管理對策[J]. 中華醫院感染學雜志, 2012, 22(6):1212.
38. 鄧立鵬. 預防接種安全注射現狀和影響因素分析[J]. 醫學動物防制, 2009, 25(9):670-672.
39. Garrett JH. A review of the CDC recommendations for prevention of HAIs in outpatient settings[J]. AORN J, 2015, 101(5):519-525; quiz 526-528.

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