Paper Keywords: operating room, nurses, occupation, hazards, factors

Operating room nurses are a group of people who are engaged in special nursing work in a special working environment. The special environment of the operating room often exposes the nurses in the operating room to some dangerous factors, thus threatening their own health. Therefore, as a nurse working in the operating room, we must first correctly understand the possible risk factors in the operating room, constantly improve our awareness of self-protection and strengthen our own protection work, so as to ensure our own safety and smooth daily work.

1 analysis of occupational hazard factors of nurses in operating room

1. 1 physical hazards

1. 1. 1 Hazards of rays: It has been proved that rays can excite the ionization of gases in the air and produce nitrides, ozone,

Harmful substances such as free radicals, a small amount of repeated exposure to radiation can cause cancer or teratogenesis.

1. 1.2 Harm of ultraviolet ray and ozone: ultraviolet ray is a common disinfection method for air disinfection in operating room. Ultraviolet rays can decompose oxygen molecules in the air into ozone, which is a strong oxidant and has strong irritation to skin mucosa and lung tissue. Long-term exposure can cause keratitis, conjunctivitis, erythema, emphysema and pulmonary fibrosis.

1. 1.3 noise hazard: noise has obvious damage to people's hearing: hearing loss; Damage to cardiovascular system: the sensitivity of vascular smooth muscle to vasoconstrictive substances is increased. Blood vessels contract, leading to an increase in blood pressure; It will also affect the endocrine system: irritability, poor judgment, long-lasting memory and reduced flexibility, leading to distraction and error-prone work. Noise exceeding 50 decibels will affect people's rest and sleep, and the sound level will reach 7090 decibels, which will make people feel bored and affect the efficiency of study and work. Long-term noise stimulation can cause deafness, autonomic nervous disorder and endocrine dysfunction. The average noise in the operating room should be 60-65 decibels, which is the highest level allowed by the body within 8 hours, but it often reaches 90 decibels. Therefore, the operating room belongs to the department with serious noise pollution. The noise in the operating room mainly comes from monitors, high-frequency electrotome, ultrasonic cleaning machines, etc.

1.2 chemical hazard factors

1.2. 1 Hazards of various chemical disinfectants: such as formaldehyde, ethylene oxide, glutaraldehyde, chlorine-containing disinfectants, etc. Long-term exposure to various chemical disinfectants will irritate the skin and cause contact dermatitis, rhinitis and asthma. Acute exposure can lead to pulmonary edema, cell mutation, carcinogenesis and teratogenesis.

1.2.2 Harm of anesthetic gas: A small amount of anesthetic waste can affect the hearing, memory, comprehension, digital reading ability and operation ability of operating room staff. Long-term exposure to the environment polluted by trace anesthetic gas may cause spontaneous abortion, fetal malformation and fertility decline.

1.2.3 Harm of antineoplastic drugs: It is very common for patients with malignant tumors to use antineoplastic drugs in surgery. Antitumor drugs can enter the human body through the skin and respiratory tract, damage normal cells, and appear leukopenia, alopecia, irregular menstruation and so on. In addition, anti-tumor drugs can also move through the placenta, causing teratoma and so on.

1.3 biological hazards and accidental injuries: nurses in operating rooms inevitably come into contact with patients' blood, body fluids, excreta and other diseases in their daily work; Improper operation of sharp instruments and needles. Will lead to blood-borne infection. Common are human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and spirochete virus. It can spread directly through sharp instrument stab wounds. Research shows that 80.6% of medical staff's occupational infections are caused by sharp instrument stab wounds. The risk of hepatitis B and hepatitis C infection is 2% ~ 40% and 3% ~ 10% respectively. Electrical injury: The widespread use of high-frequency electrotome, electric drill and other equipment has greatly increased the probability of electrical injury and burn of nursing staff.

1.4 Physiological and psychological factors: Nurses in the operating room are highly nervous, highly focused and work fast, and the work they face is high-risk, high-risk, high-intensity and irregular. Being in this environment for a long time has caused many threats to nurses in the operating room. The heavy work in the operating room will greatly increase the probability of cervical spondylosis and low back pain among the operating room staff; At the same time, the operating room has a fast pace of work and requires high concentration. High-intensity work pressure often makes people feel tired and affects the quality of surgical cooperation. Long-term continuous work, fasting, irregular diet, etc. Nurses in operating room are easy to cause gastric ulcer and migraine; Long-term standing work leads to varicose veins of lower limbs.

2 protective measures

2. 1 formulate occupational exposure management system: according to the problems existing in occupational protection, formulate and improve occupational exposure treatment process and emergency plan, improve disinfection and isolation system, formulate protection process, improve protection facilities, and establish management system, treatment and reporting system for sharp instrument injuries of medical personnel.

2.2 Strengthen the occupational safety protection knowledge education of medical staff: The hospital should take occupational safety education as the content of on-the-job training, organize medical staff to carry out occupational safety related knowledge training and assessment regularly, and strengthen their occupational safety knowledge.

2.3 Implement strict self-protection measures: (1) Prevent physical hazards: The operating room should be equipped with a special X-ray operating room. When X-rays are used during the operation, nurses in the operating room should temporarily avoid them on the premise of ensuring the safety of patients. If they can't avoid it, they should put on lead clothes in advance. Nurses involved in the operation should be rotated regularly to avoid short-term high-dose radiation exposure. Nurses in pregnant operating rooms should avoid exposure to radiation; Nurses in operating room should avoid ultraviolet disinfection in operating room; Restrict unnecessary conversations in the operating room and do four things lightly: speak lightly, walk lightly, operate lightly and close the door lightly. Medical instruments in the operating room should be inspected and maintained regularly, obsolete equipment should be eliminated in time, and equipment with good performance and low noise should be introduced. (2) Prevention of chemical hazards: chemicals should be properly stored in a cool and ventilated place, and volatile toxic reagents should be sealed. Disinfectants are available now, the dosage should be accurate, avoid using large doses, and take protective measures when using them; The operating room should be ventilated regularly, so that harmful gases such as anesthetic waste gas can be discharged in time; When contacting with anti-tumor drugs, you should strictly abide by the operating rules, take protective measures, and burn the used items in time.

(3) Prevention of biological hazards and accidental injuries: For surgical patients, preoperative examinations such as triple hepatitis B detection and HIV determination should be done well, and patients who are found to be positive should be noted on the operation notice so that the operating room staff can know as soon as possible and take corresponding protective measures; Nurses in the operating room should check themselves regularly, find the damaged skin and mucosa in time, deal with it in time and take measures in time; Use needles and trocar with protective design; When doing venipuncture or directly or indirectly contacting with patients' blood, the staff should wear gloves as much as possible. If you don't wear gloves, wash your hands in time after the operation. Simple and effective hand washing can remove more than 90% microorganisms on hands, and important links can be soaked with disinfectants such as 75% alcohol or 0.5% iodophor. All personnel involved in the operation should wear gloves, preferably double gloves. Studies have shown that if a steel needle contaminated with blood pierces a layer of latex gloves or polyethylene gloves, the amount of blood contacted by medical staff may be reduced by 50% compared with that without gloves. According to foreign reports, the perforation rate of double gloves is 4.7%, of which the outer layer and

2.4 Appropriate adjustment of nurses' work intensity and psychological pressure: At work, appropriate adjustment of the working times of hand-washing nurses and itinerant nurses should not only ensure the continuity of work, but also pay attention to alleviating nurses' physical and mental fatigue and tension caused by work. Let the nurses in the operating room pay attention to saving physical strength and energy and reducing ineffective labor. Managers should design the process reasonably to ensure the high efficiency of the operating room. Light music can be played in the operating room to relax the nurses in the operating room and create a relaxed and happy working environment for them. At the same time, after work, operating room nurses can learn to adjust themselves and actively maintain their mental health.

3 abstract

The development of medicine has promoted the progress of nursing. Nursing plays a very important role in medical work. Therefore, ensuring the occupational safety of nursing staff is an important issue in medical and health work today. Because of the special working environment in the operating room, nurses in the operating room are facing many threats of occupational injuries due to various occupational factors and working environment. Although many hospitals have taken some measures to reduce the occurrence of injuries, as nurses working in operating rooms, they should strengthen their awareness of protection. Only in this way can the occurrence of injuries be reduced.

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