目的：在推广护理标准预防操作流程(standard operation procedure，SOP)前后对护理人员进行操作情况和针刺伤职业暴露水平对比，探索护理SOP的实用性和有效性。方法：在中山大学中山眼科中心推广护理SOP前后，分别对14名责任护士进行操作考核，并对推广护理SOP前后收治的传染病患者数量和针刺伤职业暴露事件数量进行对比。结果：推行护理SOP前后操作考核平均分分别为82.31分、88.23分，差异有统计学意义(P<0.001)。初高级责任护士考核结果差异无统计学意义。推行护理SOP前后病房收治血液传染性疾病患者总数分别为32例、51例，针刺伤职业暴露事件分别为4例、0例，差异有统计学意义(χ2 =6.698，P=0.020)。结论：护理SOP的推广可使护理人员加强自我防护，减少针刺伤职业暴露，有效降低医源性感染率。
Objective: To compare the operation status and occupational exposure to needle stick injuries level of nursing staff before and after the promotion of nursing standard prevention operation procedure (SOP), and to explore the practicability and effectiveness of nursing SOP. Methods: Before and after the promotion of nursing SOPs at Zhongshan Ophthalmology Center of Sun Yat-sen University, 14 responsible nurses were assessed for operation,and the number of infectious diseases and occupational exposures to needle stick injuries before and after the promotion of nursing SOPs were compared. Results: The average scores of operation and evaluation before and after the implementation of nursing SOP were 82.31 points and 88.23 points, with significant statistical difference(P<0.001). There was no statistical difference in the results of the initial senior responsible nurses. The total number of patients with blood infectious diseases before and after the implementation of nursing SOP was 32 cases and 51 cases. The occupational exposure to needle stick injuries events were 4 cases and 0 and the difference was statistically significant (χ2 =6.698, P=0.020). Conclusion: The promotion of standard preventive procedures can enable caregivers to strengthen self-protection, reduce occupational exposure, and effectively reduce the rate of iatrogenic infection.
目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。
Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.
