安全注射的现状及管理对策_West China Medical Journal

Authors：

 张慧 ¹ , 尹维佳 ¹ , 乔甫 ¹ , 朱仕超 ¹ , 李婧闻 ¹ , 黄静 ¹ ,  宗志勇 ^1,2

1. ;
2. ;

Corresponding author：

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

Keywords：

安全注射; 现状; 管理

DOI：

10.7507/1002-0179.20150681

Video：

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注射是医疗、预防、保健服务中最常使用的技术手段，而不安全注射已成为严重的公共卫生安全问题，在发展中国家尤为突出。不安全注射主要与缺乏安全注射的意识和知识、缺乏有效的方法和设备、经济利益趋势导致注射滥用以及缺乏安全注射监管体系等密切相关。安全注射不仅是医院感染防控和医务人员职业安全保障的基本措施，也体现了医疗卫生保健机构的整体管理水平和医疗质量。安全注射的管理是系统工程，涉及到国家政策和法规、教育培训、产品和技术改进及监督管理等方面，应积极采取有效措施推动和促进我国安全注射质量的持续改进，保障注射安全。

Citation： 张慧, 尹维佳, 乔甫, 朱仕超, 李婧闻, 黄静, 宗志勇. 安全注射的现状及管理对策. West China Medical Journal, 2015, 30(12): 2377-2380. doi: 10.7507/1002-0179.20150681 Copy

1.	雷利霞, 吴晓莲, 周繁华. 应用回缩自毁式一次性无菌注射器的必要性[J]. 中国实用医药, 2011, 6(16):269-270.
2.	李六亿. 安全注射现状及其管理对策[J]. 中国医疗器械信息, 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.	张友平, 钟华荪, 侯铁英, 等. 广东省39所医院护士锐器伤调查与分析[J]. 中国护理管理, 2012, 12(4):72-74.
18.	陈惠清, 武迎宏, 刘坤, 等. 北京市医务人员锐器伤的调查分析[J]. 中华医院感染学杂志, 2013, 23(20):4976-4978.
19.	索瑶, 范珊红, 高晓东. 陕西省11所医院医务人员锐器伤调查与分析[J]. 中华医院感染学杂志, 2011, 21(12):2505-2507.
20.	刘桂芝, 李霞, 郑晓凤, 等. 医务人员锐器伤基线调查与分析[J]. 中华医院感染学杂志, 2014, 24(1):233-235.
21.	李卫光, 徐华, 朱其凤, 等. 山东省28所医院医务人员锐器伤现状调查[J]. 中华医院感染学杂志, 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.	李映兰, 范学工, 周阳, 等. 基层医院医护人员安全注射知识、态度、行为调查分析[J]. 中国护理管理, 2011, 11(7):50-53.
24.	郭燕红. 加强安全注射切实保障公众健康[J]. 中国医疗器械信息, 2004, 10(4):18, 21.
25.	胡明霞, 赵科伕. 合肥市基层医疗机构安全注射的消毒与管理情况调查[J]. 中国农村卫生事业管理, 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.	张国增, 高园林, 史玉娟, 等. 自毁式注射器临床应用影响因素的研究[J]. 中国卫生事业管理, 2015, 32(3):186-188.
28.	郭招治. 安全注射有效预防血源性疾病传播[J]. 中华医院感染学杂志, 2010, 20(24):3979.
29.	蔡艳阳. 基层医疗机构安全注射现状的调查——以湖北省荆州市荆州区为例[J]. 医学信息, 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.	李映兰, 郑悦平, 周阳. 医护人员安全注射研究进展[J]. 中华医院感染学杂志, 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.	关旭静, 方刚. 预防接种用相关器材的现状与发展动向[J]. 中国疫苗和免疫, 2010, 16(1):82-85, 91.
36.	俞学群. 加强我国预防接种中安全注射管理问题的探讨[J]. 中国初级卫生保健, 2008, 22(1):60-61.
37.	薛菊兰, 李晓琴, 陈松燕, 等. 社区损伤性医疗废物的管理对策[J]. 中华医院感染学杂志, 2012, 22(6):1212.
38.	邓立鹏. 预防接种安全注射现状和影响因素分析[J]. 医学动物防制, 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, 吴晓莲, 周繁华. 应用回缩自毁式一次性无菌注射器的必要性[J]. 中国实用医药, 2011, 6(16):269-270.
2. 李六亿. 安全注射现状及其管理对策[J]. 中国医疗器械信息, 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. 张友平, 钟华荪, 侯铁英, 等. 广东省39所医院护士锐器伤调查与分析[J]. 中国护理管理, 2012, 12(4):72-74.
18. 陈惠清, 武迎宏, 刘坤, 等. 北京市医务人员锐器伤的调查分析[J]. 中华医院感染学杂志, 2013, 23(20):4976-4978.
19. 索瑶, 范珊红, 高晓东. 陕西省11所医院医务人员锐器伤调查与分析[J]. 中华医院感染学杂志, 2011, 21(12):2505-2507.
20. 刘桂芝, 李霞, 郑晓凤, 等. 医务人员锐器伤基线调查与分析[J]. 中华医院感染学杂志, 2014, 24(1):233-235.
21. 李卫光, 徐华, 朱其凤, 等. 山东省28所医院医务人员锐器伤现状调查[J]. 中华医院感染学杂志, 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. 李映兰, 范学工, 周阳, 等. 基层医院医护人员安全注射知识、态度、行为调查分析[J]. 中国护理管理, 2011, 11(7):50-53.
24. 郭燕红. 加强安全注射切实保障公众健康[J]. 中国医疗器械信息, 2004, 10(4):18, 21.
25. 胡明霞, 赵科伕. 合肥市基层医疗机构安全注射的消毒与管理情况调查[J]. 中国农村卫生事业管理, 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. 张国增, 高园林, 史玉娟, 等. 自毁式注射器临床应用影响因素的研究[J]. 中国卫生事业管理, 2015, 32(3):186-188.
28. 郭招治. 安全注射有效预防血源性疾病传播[J]. 中华医院感染学杂志, 2010, 20(24):3979.
29. 蔡艳阳. 基层医疗机构安全注射现状的调查——以湖北省荆州市荆州区为例[J]. 医学信息, 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. 李映兰, 郑悦平, 周阳. 医护人员安全注射研究进展[J]. 中华医院感染学杂志, 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. 关旭静, 方刚. 预防接种用相关器材的现状与发展动向[J]. 中国疫苗和免疫, 2010, 16(1):82-85, 91.
36. 俞学群. 加强我国预防接种中安全注射管理问题的探讨[J]. 中国初级卫生保健, 2008, 22(1):60-61.
37. 薛菊兰, 李晓琴, 陈松燕, 等. 社区损伤性医疗废物的管理对策[J]. 中华医院感染学杂志, 2012, 22(6):1212.
38. 邓立鹏. 预防接种安全注射现状和影响因素分析[J]. 医学动物防制, 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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