医院消毒供应室实行集中式管理对策与效果

针对污染医疗器械分散式管理的突出质量问题,将全院所有科室需消毒灭菌的物品回收至消毒供应室,采取集中管理. 1管理对策 1.1布局管理 我院消毒供应室布局流程相对合理,通道各自独立,不逆行,空气流向由洁到污,物品传递窗口由污到洁,去污区空气保持负压,检查包装区及无菌物品存放区空气相对保持正压.     

护理新理念在消毒供应中心管理中的应用探讨

目的：研究分析在消毒供应中心管理中采用护理新理念的应用措施和应用效果。方法回顾性分析2010年1月---2012年1月期间,对我院消毒供应中心工作人员进行护理新理念教育、推广的情况,分析护理新理念实施前后的各项指标变化。结果经护理新理念的实施中,消毒供应中心的无菌灭菌合格率、包装合格率以及洗涤合格率均明显高于实施前,与实施前比较存在明显差异,差异具有统计学意义,（P＜0．05）。且消毒供应中心的无菌物品发放合格率以及服务满意度较之新理念实施前有明显改善,前后比较差异存在明显统计学意义,（P＜0．05）。结论在消毒供应室的日常管理中应用护理新理念能够有效改善消毒供应中心的工作质量,提高服务满意度,有助于消毒供应中心的发展与员工凝聚力的提高。     

消毒供应室无菌物品存放间的管理

目的探讨消毒供应室无菌物品存放间的管理办法,目的是控制医院感染,提高医疗护理质量。采取的主要方法是重视消毒供应室无菌物品存放间工作人员的素质培养,加强无菌物品的质量管理,完善各项监测措施。这样才能为临床科室提供合格的灭菌物品,有效防止医院感染的发生,使消毒供应室无菌物品存放间的管理逐步达到科学化、规范化、标准化。     

运用PDCA循环促进基层医院消毒供应质量持续改进

目的探索和总结医院消毒供应质量管理的有效方法,保证消毒供应的质量。方法运用PDCA循环管理法对消毒供应室实施标准化、科学化质量管理。结果自2010年开始运用PDCA循环管理法以来,消毒供应室的建筑布局、基本配置及工作流程得以规范,消毒供应室人员对清洁、消毒、灭菌的标准化意识得以加强,在管理的过程中倡导集中化、专业化,加强了对无菌物品消毒灭菌的规范化、科学化管理,形成了管理的良性循环体系,使医院消毒供应质量得到持续改进,实现了全院医疗物品消毒供应集中化处理,保证了物品消毒灭菌质量。结论领导重视,全力推进消毒供应室一体化建设是关键;推行PDCA循环管理法,坚持计划(P)、实施(D)、检查(C)、处理(A)循序渐进,促进了医院消毒供应室的规范化管理,使医院消毒供应质量在不断循环往复中提高,达到了质量持续改进的目的。     

供应室消毒隔离管理

供应室的主要职责就是清洗、灭菌、供应无菌物品。保证无菌物品的质量,是降低医院感染发生和保证医疗质量的重要环节。因此,必须加强供应室的消毒隔离管理。1供应室的管理供应室制定严格消毒隔离制度,成立质量控制小组,每月按要求进行检查指导。严格划分污染区、清洁区、无菌区,各类物品按规定放置。供应室工作人员应有严格的消毒隔离意识、无菌观念和高度的责任心,认真执行各项技术操作规程,熟悉各种器械物品性能、消毒方法及洗涤操作技术,定期进行考核。消毒员必须经培训后持证上岗,严格按照操作规程进行操作。进入无菌室时,要穿工作服、…     

供应室消毒在医院感染控制方面的管理和策略分析

目的：探讨供应室消毒在医院感染控制方面的管理方法和策略。方法：自2012年3月开始对本院供应室实施科学管理，对供应室进行合理布局，并调整工作流程，建立相应的规章制度并严格落实，加强对工作人员的管理和培训，对于重复使用的器械进行质量监督。结果：实施科学管理后，物品消毒合格率明显高于实施科学管理之前，护理人员理论知识以及规范操作考核得分均有所提高，护理人员工作积极性得到明显改善，与实施前比较差异均有统计学意义（P〈O．05）。结论：通过对供应室进行科学管理可以有效提高器械消毒质量，确保患者在就诊的过程中使用到无菌器械，减少医院感染的发生。     

做好供应室质量管理控制的几点建议

消毒供应室在医院质量管理中,占据重要的地位。通过供应室能够为医疗实践活动提供无菌器材、敷料以及其他无菌物品等等,从而提高医院的工作质量以及患者的就医安全。为此,强化供应室质量管理工作,对于控制医院感染,提高患者的就医安全性等方面具有非常重要的意义。该文从工作人员素质、工作质量、灭菌效果检测以及无菌物品管理等角度人手,对提高供应室质量管理控制措施提出一些建议。     

加强无菌物品质量管理

根据卫生部2002年《消毒技术规范》对无菌物品质量管理标准,近年来我院护理部、医院感染科制定了严格的管理措施,对无菌物品的打包、发放、存储等环节质量实行4个统一管理措施,使无菌物品的管理更科学、更实用,提高了管理及工作效率,保证患者医疗安全。1管理措施1.1统一物品打包护理人员认真落实消毒供应室质量考核标准,充分利用卫生资源,主动承担全院灭菌物品打包工作。所有物品进入消毒供应室打包间打包。取消了分娩室、手术室打包间及临床科室打包。1.2统一规范操作流程规范消毒供应室器械清洗包装操作程序。器械使用多酶清洗、除锈、润…     

供应室消毒隔离的管理

保证无菌物品的质量是供应室工作的核心,是降低医院感染发生和保证医疗质量的重要环节。因此,必须加强供应室消毒隔离的管理。1供应室路线及人员的管理严格划分污染区、清洁区、无菌区,各类物品按规定放置。供应室工作人员应有严格的无菌观念和高度的责任心。认真执行各项技术操作规程,熟悉各种器械物品性能、消毒方法及洗涤操作技术,定期进行考核。消毒员必须经培训后持证上岗。医务人员进入无菌室时要穿工作服,戴口罩、帽子,换鞋;污染区工作人员不得随意进入清洁区和无菌区;工作人员手每月抽样做细菌培养。2各种器械、物品的处理各类污染…     

医院供应室在控制医院感染中的作用探讨

医院供应室是医院感染管理的重要部门,它集中了全院的医疗器具的回收、清洗、消毒、灭菌和一次性无菌物品的供应,其工作质量优劣直接影响医院医疗质量和病人的安危,在控制医院内感染中有着重要作用。供应室的工作质量则是由供应室建筑布局、供应室人员素质及设备条件等一系列     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.