血液透析中心预防医院感染的护理措施探讨

目的 探讨血液透析室医院感染的危险因素,有效预防控制医院感染的发生.方法 加强医院感染的组织管理;坚持医院感染质量管理持续改进;医院感染知识培训,提高医院感染预防与控制意识;对重点环节如:建立消毒防护感染知识健康教育指导,帮助患者和家属掌握基本预防控制感染的技巧以及对操作过程的细微控制.结果 通过有效的管理与控制,提高了医疗质量,确保了医疗安全.有效提高了透析患者的生活质量和长期生存率.结论 加强血液透析室医院感染危险因素的管理与控制,是预防血液透析室医院感染发生的关键.     

麻醉恢复室护理工作交叉感染的控制与预防

目的以麻醉恢复室护理管理,分析其护理工作中医院感染类型、分布特点及原因,并从护理角度提出预防和控制措施。方法回顾性分析2014年5月-2016年4月在医院接受手术麻醉10 000例患者临床资料,对麻醉后恢复室护理期间发生医院感染患者感染特点、类型及原因等进行总结分析,对诱发麻醉恢复室医院感染的危险因素进行多元回归分析,并提出预防和控制对策。结果数字双盲法抽取PACU患者10 000例医院感染率4.1‰,其中以呼吸道感染和泌尿感染最多,分别31.7%和24.4%;年龄越低和年龄越高,PACU患者医院感染率越高,对比差异显著;PACU停留时间越长,医院感染率越高;护理人员执行PACU无菌操作不到位、PACU消毒隔离不严格是诱发医院感染的主要因素,分别到34.2%和29.3%。结论麻醉恢复室由于其特殊性容易发生医院感染,与消毒措施不到位、无菌操作不规范等有关。强化医院感染的认知,规范消毒隔离,切断传染途径,是解决麻醉恢复室医院感染的有效措施。为PACU针对性预防和控制医院感染提供借鉴。     

加强门诊输液室的管理降低医院感染风险

目的 加强门诊输液室的管理,避免或降低医院感染的发生.方法 针对医院门诊输液室的医院感染危险因素及管理现状进行分析,重新规划了门诊输液室的工作流程,对环境卫生、布局、优化工作流程、医疗废物处置、消毒隔离、培训等实施干预措施,进行管理.结果 门诊输液室的医院感染管理质量提高,有效预防医院感染的发生.结论 加强管理,严格落实消毒隔离措施是降低医院感染的有效方法.     

血液透析室医院感染危险因素的预防与控制

目的 探讨血液透析室医院感染的危险因素,有效预防控制医院感染的发生.方法 加强医院感染的组织管理、坚持医院感染质量管理持续改进、医院感染知识培训,提高医院感染预防与控制意识;对重点环节如:建立消毒防护感染知识健康教育指导,帮助患者和家属掌握基本预防控制感染的技巧以及对操作过程的细微控制.结果 通过有效的管理与控制,提高了医疗质量,确保了医疗安全,有效提高了透析患者的生活质量和长期生存率.结论 加强血液透析室医院感染危险因素的管理与控制,是预防血液透析室医院感染发生的关键.     

介人性超声的医院感染预防控制措施

目的 探讨介入性超声的医院感染控制管理措施,杜绝发生医院交叉感染.方法 健全组织、完善规章制度,专设独立的介入超声诊疗室,集中分类治疗,加强环境清洁消毒,加强器械的清洗灭菌,严格执行无菌操作原则进行临床诊疗工作.结果 2009年1月-2011年12月共实施超声介入治疗290例,成功率100.0％,无一例发生因介入治疗穿刺部位感染及交叉感染,取得良好效果.结论 超声引导介入穿刺治疗的临床应用越来越广泛,做好医院感染控制管理,杜绝医院感染发生十分必要.     

溧阳市2008年医院消毒质量监测情况分析

为进一步加强医疗机构消毒质量的监测、医院感染控制和管理工作,及时掌握各级医疗机构消毒质量和感染危险因素,不断提高消毒质量,减少医源性感染的发生,溧阳市疾病预防控制中心根据《全国疾病预防控制机构工作规范》、《医院感染管理规范》等要求,在2008年上半年对市级医院及各镇卫生院开展消毒质量监测工作,     

整形修复科手术室医院感染的控制与管理

目的 探讨整形修复科手术室医院感染的预防与管理方法,防止医院感染,确保医疗护理安全及质量.方法 针对整形修复科手术室的工作特点,加强医院感染控制管理,落实医院感染管理的规章制度和工作规范,严格执行有关技术操作规范和工作标准,有效预防和控制医院感染,防止医院感染对患者造成的危害,确保患者和工作人员的身体健康,创造合格的手术环境.结果 2009年3月-2011年6月共进行整形修复手术3026例,从未因手术室各环节因素造成的医院感染.结论 严格贯彻落实医院感染控制管理制度,可有效防止医院感染的发生,是整形手术医疗安全和质量的重要保障.     

血液透析感染因素及其控制措施浅析

目的:分析血透室医院感染因素,提出有效预防控制措施,降低医院感染发生率.方法:提高医护人员感染控制意识和患者健康保养知识,严格执行消毒隔离制度和监测制度,建立健全应急管理机制.结果:通过有效的预防控制措施,降低了感染率,有效提高了透析患者的生活质量,延长患者生存期.结论:加强人员管理,加强血液透析感染危险因素的管理与控制,是预防血液透析室医院感染发生的关键.     

门诊换药室患者医院感染危险因素分析与干预

目的 针对门诊换药室的特殊性分析患者发生医院感染的危险因素,制定并实施有效的感染干预措施.方法 分析患者医院感染各项因素,制定并加强制度管理,强化环境管理,规范各项操作,针对患者因素制定个性化干预措施.结果 忽视手卫生、环境污染、不规范伤口处理等,是感染的主要因素,加强制度与环境的管理、操作过程的管理等干预措施,有效防止了医院感染的发生.结论 换药室医院感染的危险因素多,从管理入手,重视环境管理,规范并强化各项操作及过程管理的干预,是预防治疗医院感染的有效方法.     

预防门诊输液室婴幼儿医院感染的护理对策

目的 探讨预防和控制门诊榆液室婴幼儿医院感染的措施,降低婴幼儿院内感染的发生率.方法 分析门诊输液室婴幼儿感染的主要易感因素,并提出相应的预防控制措施.结果 通过实施规范管理,避免了交叉感染,提高了医护质量,确保了患者与医护人员的安全.结论 严格执行各项医院感染管理及消毒隔离制度、加强人员及环境的管理对控制医院感染有非常重要的作用.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.