张红 高欢玲 李红梅

[摘要]目的 了解護理实习生的职业状态及其发生锐器伤的相关因素，为制定有效的预防和干预措施提供依据。方法 采用方便抽样的方法，将人口学资料、锐器伤情况制成问卷，并采用《护士职业态度量表》于2017年6月～2018年6月对山西医科大学汾阳学院接收的217名护理实习生进行回顾性调查。结果 护理实习生的职业态度平均得分为（2.17±0.76）分。单因素分析结果显示，不同性别、年龄（≥20岁、<20岁）、生源地（城市、乡镇和农村）护理实习生的锐器伤发生率比较，差异均无统计学意义（P>0.05）。专科护理实习生的锐器伤发生率高于本科，差异有统计学意义（P<0.05）；家人志愿和调剂护理实习生的锐器伤发生率高于自愿报考者，差异有统计学意义（P<0.05）；性格偏外向护理实习生的锐器伤发生率高于偏内向者，差异有统计学意义（P<0.05）；职业态度得分<4.5分护理实习生的锐器伤发生率高于职业态度得分≥4.5分者，差异有统计学意义（P<0.05）。多因素分析结果显示，学历层次、报考志愿情况、护理实习生性格、职业态度得分是护生锐器伤暴露情况的显著影响因素（P<0.05）。结论 护理实习生的职业态度较低，职业暴露风险高，锐器伤发生率较高，应在日常学习和工作中加强对护理实习生锐器伤的防护培训，并加强心理干预，重建职业信心。

[关键词]护理实习生；锐器伤；职业态度；相关因素

[中图分类号] R47 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0160-04

[Abstract] Objective To understand the professional attitude of nursing interns and the related factors of sharp injury， and to provide basis for formulating effective prevention and intervention measures. Methods Convenient sampling method was used， and the demographic data and sharp injuries were made into questionnaires. A total of 217 nursing interns accepted by Fenyang College of Shanxi Medical University from June 2017 to June 2018 were investigated retrospectively with Nurse professional attitude scale. Results The average score of nursing interns′ professional attitude was （2.17±0.76） points. Univariate analysis reaults showed that there were no significant difference in the incidences of sharp injury among nursing interns of different sex， age （≥20 years old， < 20 years old） and places of origin （cities， towns and rural areas） （P>0.05）. The incidence of sharp injury among specialty nursing interns was higher than that of undergraduate nursing students （P<0.05）； the incidence of sharp injury among family volunteer and dispensing nursing interns were higher than those of voluntary applicants （P<0.05）； the incidence of sharp injury among extroverted nursing interns was higher than that of introverted nursing interns （P<0.05）. The incidence of sharp injury in nursing interns with occupational attitude score <4.5 points was higher than that with occupational attitude score ≥4.5 points （P<0.05）. Multivariate analysis results showed that education level， volunteer status， nursing students′personality and professional attitude were the significant influencing factors （P<0.05）. Conclusion Nursing interns have lower occupational attitude， higher risk of occupational exposure and higher incidence of sharp injury， and it is necessary to strengthen training on sharp injury prevention， strengthen psychological intervention and rebuild professional confidence.

[Key words] Nursing interns； Sharp injury； Professional attitude； Related factors

护理学是一门综合型应用型学科，临床实习是护生从学校走向临床、由学生转变成护士的中转阶段，将理论与实践相结合，提髙综合能力。而临床工作中存在很多潜在性危险，尤以锐器伤最易发生[1]。锐器伤主要是医护工作者在医疗活动中被玻璃制品、针头、手术器械等锐利物品割伤和刺伤所引起的存在有被病原微生物感染风险的意外事件[2]。有资料显示，美国每年发生锐器伤达60多万人次[3]，欧洲的针刺伤发生每年达100万人次[4]。大量研究证实，锐器伤可以传播20多种病原体。因此，对于锐器伤的防护是医疗活动中的重中之重[5]。护理实习生由于职业防护意识淡薄、操作技术不熟练、临床经验不足等原因更容易发生锐器伤。在国外，关于锐器伤的职业暴露的研究较多，相应的防护和管理机制也较为完善。但是，国内对于锐器伤研究大多处于进展阶段，致护理实习生的锐器伤发生率居高不下。……