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目的 收集卫生机构卫生保健工作者中关于注射的知识、态度和实践方面的定性和半定量信息 ,估计各种注射者实施的对患者、提供者和社区无害的注射的百分比。方法 采用SIGN提供的标准化工具对卫生保健工作者进行访谈。采用直接观察法 ,标准化问卷和焦点组访谈在处方者、注射者和处理医疗废弃物的后勤人员中收集定性和半定量信息。结果 每个处方者平均每周要接待 87 9名患者 ,其中 35 2 %会开出注射处方。在调查的 935份有效处方中 ,4 7 8%至少包括 1次注射。访问的 10 0名护士中 ,平均每人每周要实施 90 9次注射 ,其中 12 1%的注射是用于免疫的。在这 10 0名护士中 ,有 75 %报告在过去 1年中受到过尖锐物刺伤。每名护士平均每天要给 32名患者分配药物 ,其中 73 4 %的患者会接受注射。结论 即使在目前对AIDS的认识不断提高的情况下 ,注射在上海的使用程度仍然很高 ;一些因素提示卫生保健者对过度使用注射起到了一些作用 ;虽然在上海已经建立了一套有效的注射提供、管理、监督和废弃物处理体系 ,但是在注射者和医疗废弃物处理人员中仍时常发生尖锐物刺伤 ;一次性注射器和针头已经完全被医疗人员和患者所接受
Purpose To collect qualitative and semi-quantitative information on knowledge, attitudes and practices about injections among health-care workers in health facilities and to estimate the percentage of injections that are not harmful to patients, providers and communities by various injectors. Methods Interviews with health care workers using standardized tools provided by SIGN. Direct and standardized questionnaires and focus group interviews were used to collect qualitative and semi-quantitative information among the prescribers, injectors and logisticians who handle medical waste. As a result, each prescriber received an average of 87 9 patients per week, 35 of which 2% were prescribed injections. Of the 935 valid prescriptions investigated, 478% included at least 1 injection. Of the 10 nurses visited, an average of 909 injections were administered per person per week, of which 121% were injected for immunization. Of the 10 nurses, 75% reported being stabbed by sharp objects in the past year. On average, each nurse assigned 32 patients a day, of whom 73.4% received injections. Conclusions Injection use in Shanghai remains high even with the current rising awareness of AIDS; some factors suggest that health-care providers have had some effect on over-use injections; although an effective injection has been established in Shanghai Providing, managing, supervising and disposing of waste systems, sharp incidents of stabbing often occur among injectors and medical waste workers; disposable syringes and needles have been fully accepted by medical personnel and patients