胃癌新辅助化疗日间病房医院感染的管理

目的探讨胃癌日间化疗患者医院感染的管理方法,制定管理措施,降低医院感染率,使化疗患者顺利渡过治疗周期。方法选取2014年1-11月在普通外科日间病房行胃癌新辅助化疗患者537例,加强对化疗间环境管理、加大对医护及后勤人员感染控制知识培训、患者及家属健康宣教培训力度,充分发挥科室感染控制联络护士职能,严格落实各项感染控制制度。结果 537例日间化疗患者均顺利完成化疗,未发生医院感染病例;胃癌新辅助化疗多采用日间化疗模式,使平均住院时间明显缩短,住院费用降低,既减轻患者经济负担,又使科室床位使用率得到提升。结论加强胃癌新辅助化疗日间病房医院感染的管理,提高防范意识是预防日间化疗患者发生医院感染、确保患者顺利渡过化疗周期的关键。     

儿科病房医院感染因素分析与控制措施

目的对儿科病房医院感染相关因素进行分析,制定相应的控制预防措施,以降低医院感染率。方法对儿科病房医院感染管理工作中存在的问题进行综合分析,并提出相应的有效措施与方案。结果目前儿科病房医院感染管理工作尚不够完善,在控制儿科病房医院感染的管理制度的制定与执行、面向患儿及家属的健康卫生知识的宣传与普及、病房人员流动控制、病房消毒工作的执行、医护人员的无菌操作、手卫生依从性及抗菌药物的合理使用等方面仍需加强。结论儿科病房医院感染管理工作需要规范化、病房消毒工作应更加彻底,加强医护人员手卫生依从性、正确合理的使用抗菌药物,才能更好地达到预防与控制儿科病房医院感染的目的。     

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.     

两种方法清洗消毒医用便器的效果监测与分析

目的 比较两种方法清洗消毒医用便器的效果.方法 选取呼吸科重症监护病房医用便器,随机分别使用便器清洗消毒机清洗及传统有效氯消毒液清洗,同时进行微生物学检测.结果 使用SAN24W便器清洗消毒机进行便器消毒,从消毒前的平均菌含量(1.86×105)±(6.42×104)CFU/cm2减少至消毒后的(52.67±36.50)CFU/cm2,与经普通清洗浸泡消毒的便器平均菌含量(8.27×102)±67.68 CFU/cm2相比明显减少,差异有统计学意义(P＜0.01),便器细菌的消亡率达99.97％,细菌减少的对数值均≥5,且未检测出致病菌.结论 便器消毒机清洗简便有效,能够明显降低便器含菌量,提高细菌消亡率.     

加强母婴同室管理 防止新生儿感染

为确保母婴健康,预防新生儿感染,我院妇产科加强了对母婴同室病房和新生儿感染的管理。 1 建立健全母婴同室管理制度 建立健全母婴同室管理制度,是加强母婴同室管理的重要一环。我院妇产科在落实医院各项规章制度的同时,又建立了母婴同室管理制度,如消毒隔离制度;减少探视制度;疾病感染隔离制;空气消毒监测制;母婴健康室教制度等。向病人及家属宣传有关健康方面的医学知识,医院感染、新生儿感染方面知识,使产妇及家属主动配合母婴同室病房的管理。     

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.     

超声乳化治疗白内障患者预防感染的措施

我院自2001年1月开展超声乳化治疗白内障以来,治愈白内障患者1537例。我们采取了一系列行之有效的控制感染措施,至今未发生一例感染病例,采取的措施是:1加强护理人员感染知识的培训强化护理人员预防感染意识,护士长每月组织医院感染知识讲座,每日利用晨会提问有关感染知识,每季度进行感染知识测试,使护理人员对医院感染知识了如指掌,也使护理人员认识到消毒隔离技术是预防医院感染的重中之重。科内设感染护士协助护士长监督护理人员消毒隔离技术,并定期监测科室内各种细菌指标。2加强病房消毒管理病房要求安静、舒适、光线柔和、空气清新。…     

儿科病房医院感染的危险因素分析及管理探讨

目的 探讨儿科病房发生医院感染的危险因素及预防管理措施.方法 回顾性分析医院小儿科2008年1月-2011年5月住院的4249例患儿的临床特征,同时对发生医院感染患儿的相关危险因素进行统计分析.结果 4249例住院患儿中发生医院感染162例,感染率为3.8％,10 d～2岁患儿发生医院感染率最高为68.5％;医院感染部位以呼吸道、消化道为主分别占46.3％、43.2％,季节与感染发生率相关,多发于夏、秋季节.结论 儿科病房中应注意空气的消毒,加强医院感染防治知识的培训,强化对患儿及家长的健康教育,预防医院感染的发生.     

混合科室的医院感染管理

目的 针对胸心外科与生物治疗科混合科室患者的疾病特点,总结胸心外科与生物治疗科的医院感染管理,预防与控制医院感染.方法 分析胸心外科与生物治疗科医院感染各个环节存在的问题,包括病房环境、重症监护病房消毒、患者和陪护人员、手卫生、中心静脉置管、呼吸机管路消毒管理以及白细胞下降患者的护理,采取针对性的规范管理,包括建筑布局合理、环境管理、重视医护人员手卫生消毒、加强中心静脉导管的护理知识培训和呼吸机管道消毒的管理以及对白细胞减少患者病房合理安置等针对性的护理工作.结果 实施医院感染控制后,降低了患者医院感染率,环境卫生学等各项监测指标合格率提高.结论 通过实施医院感染控制及医院感染的知识培训,加强胸心外科与生物治疗科混合科室的感染管理,使科室工作人员均能自觉执行手卫生,严格执行无菌操作规范及消毒隔离制度,切实有效控制和切断医院感染的各个环节,是医院感染管理工作的关键.     

护理管理与医院感染控制

医院护理人员是与患者接触时间最多的一线工作者,由于工作量大、岗位分布面广、所涉科室多,是造成医院感染的重要环节之一。因此加强护理管理对控制和预防医院感染的发生有着十分重要的作用。1护理管理1.1加强医院感染知识的培训医护人员在上岗前及以后的工作中经常系统地进行医院感染管理知识学习,使他们掌握医院感染的预防和管理方法,以便在工作中提高对医院感染的处理能力,并运用医院感染管理知识、预防医院感染的发生等。并通过她们教育工勤人员、患者及陪护、探视家属遵守消毒隔离制度预防医院感染。1.2加强职业道德培训要对医护人员进…     

不同病区医护手监测调查与分析

目的 了解医院手术室、重点感染病区、普通病区医务人员洗手效果，根据不同病区、不同特点，进一步加强和有针对性的对医务人员手的监督与监测。方法 回顾性分析我院手术室、妇产科、儿科、外科、门诊医护手监测资料。结果 医护手监测总合格率为89．7％，手术室护士手监测合格率96．8％；重点感染病区(妇产科、儿科)医护手监测合格率89．2％；普通病区(外科、门诊)医护手监测合格率88．4％。结论 医务人员对手的清洁与消毒，仍缺乏足够的认识，加强重点感染病区医务人员手的消毒管理、提高全院医务人员对手清洁与消毒意识，是预防医院感染的关键。     

医院工作人员SARS感染的原因及预防对策

目的 探讨医院工作人员在收治严重急性呼吸综合征(SARS)过程中受到感染的原因及预防对策，以减少医院感染的发生。方法 对我院从2003年2～4月约3个月收治SARS过程中受到感染的医院工作人员的临床特征及感染的原因及在此过程中所不断完善的预防对策做一回顾性分析。结果 我院感染SARS19名工作人员中11名护士、8名医生，通过近距离接触患者或接触患者的呼吸道分泌物等途径传播，在收治过程中，通过不断完善消毒隔离及个人防护措施、加强宣传教育，医院感染得到有效控制。结论完善医院感染管理监督机制、强调个人防护是减少SARS医院感染的关键。     

Nurses and hospital infection control: knowledge, attitudes and behaviour of Italian operating theatre staff.

This study examined the disinfection and sterilization practices used by hospital operating theatres and evaluated the knowledge, attitude and behaviour of nursing staff with regard to infection control. Of the 216 nurses responding, knowledge concerning such practices was not consistent since 10% did not believe that items should be rinsed in water after contact with glutaraldehyde and more than 25% thought that 10 min contact time provided sterilization. Almost all were aware that improper practices increased the risk of nosocomial infections in patients. Nurses in orthopaedic surgery had a significantly lower level of knowledge compared with others. The great majority of nurses agreed that guidelines for disinfection and sterilization practice should be maintained and applied. With regard to the use of surgical instruments, the majority used steam or dry heat sterilizers for the appropriate time and temperature. Glutaraldehyde was used by 95% to sterilize endoscopes, but at different temperatures and times of exposure. Similar procedures were reported as used for laryngoscopes, though a higher percentage used heat sterilization. Only 38% routinely used all barrier techniques (gloves, masks, and protective eye-wear). Predictors for the routine use of all barrier techniques included attendance at continuing education courses on nosocomial infections, and nurses who were male and those involved in orthopaedic operations. Data support the need for finding and implementing interventions related to the prevention of hospital infection activities, in order to motivate nurses to use the correct procedures as a routine.     

PDCA循环质量管理方法对提高患儿家属满意度的效果研究

目的在儿科病房中应用PDCA循环质量管理方法进行护理,观察该方法对患儿家属的影响。方法本次试验在2018年10月-2019年3月本院儿科住院部就诊的患儿中选取100例作为观察对象,根据管理模式的不同将其平均分为观察组与对照组两组,对照组接受常规病房护理,观察组接受PDCA循环质量管理,观察儿科患者家属对科室的满意度情况。结果观察组患儿家属对于儿科病房的服务态度、病房健康教育以及护患有效沟通的满意度显著高于对照组患儿家属,两组对比差异有统计学意义(P <0.05)。结论在儿科病房中应用PDCA循环质量管理方法对患儿进行护理,可有效缓解患儿的病情,提高生活质量,改善患儿预后,提升患儿及其家属的护理满意度。     

Economic aspects of day care after operations for hernia or varicose veins.

In a trial of 360 patients with hernia or varicose veins, day care surgery provided an economic alternative to the provision of surgical aftercare either in the surgical wards of a district hospital or in a convalescent hospital. There was only slightly more work for general practitioners. Most of the additional work for the community services was carried out by district nurses, with an average contact time in the postoperative period of 325 minutes for day care patients, compared with 186 minutes and 204 minutes respectively for patients admitted for 48 hours to the surgical or convalescent wards. Day care produced estimated savings of 30 pounds compared with the costs of a 48-hour stay in the surgical wards, and savings of 22 pounds compared with a 48-hour stay in the convalescent wards.     

Efficacy of nurses' on the job training to better advise cessation among hospitalized smokers

OBJECTIVES: The article describes the framework of an on-the-job training program for nurses that teaches them how to better advise hospitalized smokers to stop smoking. The purpose of the study was to evaluate the efficacy of the program. METHODS: We corducted an on-the-job training program for 4 years aimed at nurses who worked in 2 of 11 wards in our hospital (training wards). The aim of the training program that we developed was to improve nurses' self-efficacy in advising and supporting patients to stop smoking. An average of 40 nurses worked in the two wards at any time during the study period. A self-administered questionnaire was given to nurses working at our hospital before (in 1997) and after (in 2002) the program was undertaken. Changes in cognition and behavior with regard to advice to hospitalized smokers were also compared between nurses working at the training wards and nurses working in the other wards in question, whose number averaged 200 nurses during the period. RESULTS: There were no differences in age distribution, smoking habits and epidemiological knowledge of smoking between the two groups. Self-efficacy in advising and supporting patients to cease smoking was significantly increased among nurses working in the training wards (P=0.02), whereas no significant increase with time was found among nurses working in the other wards (P=0.14). After the program was undertaken, nurses working in the training wards had a significantly higher proportion who always advised hospital smokers to quit according to their predictable stage of change than their counter parts working in the other wards (adjusted odds ratio 2.93, 95% confidence interval 1.27-6.74). CONCLUSION: The study indicates the job training program to have improved the nurses' self-efficacy, appearing to change their behavior in advising and supporting patients to cease smoking.     

不同消毒方法对介入导管室环境的影响研究

目的 分析采取不同消毒方法对介入导管室环境的影响,为寻找合适的消毒方法对介入导管室进行消毒提供参考.方法 将介入导管室2010年1-12月收治患者作为对照组;2011年1-12月收治患者作为观察组;对照组治疗期间采取常规方式对介入导管室清洁卫生和紫外线消毒;观察组治疗期间采取常规方式对介入导管室清洁卫生和空气消毒机消毒;对两组研究期间介入导管室的环境进行监测和感染率进行统计分析.结果 观察组采取空气消毒机消毒,期间环境沉降菌静态和动态监测均值分别为(0.0±0.0) CFU/皿和(2.0±0.5) CFU/皿;对照组的静态和动态沉降菌均值分别为(2.0±0.5) CFU/皿和(20.0±10.5) CFU/皿;观察组医院治疗患者感染率为2.1％,明显低于对照组的5.3％,两组间差异均有统计学意义(P＜0.05).结论 介入导管室是医院感染的高危科室,也是医院预防感染与控制的重点对象,对其采取空气消毒机消毒可提高环境无菌控制,明显降低手术感染率,值得临床推广.     

肝胆外科病房深部真菌感染调查及其危险因素分析

目的 探讨肝胆外科病房真菌感染的临床特点与危险因素.方法 收集2005年1月-2010年6月肝胆外科病房深部真菌感染63例患者的临床资料,回顾性分析深部真菌感染的临床特点及危险因素.结果 63例患者留样标本共分离出76株真菌,深部真菌感染以白色假丝酵母菌为主,占47.4％,＞2种真菌混合感染者为13.1％;深部真菌感染的疾病主要有重症急性胰腺炎、肝胆胰恶性肿瘤、急性梗阻性胆管炎;长期广谱抗菌药物及皮质类固醇激素的使用、机械通气、中心静脉置管、静脉高营养的使用、肝功能障碍、高龄(≥60岁)等是肝胆外科病房深部真菌感染的高危因素.结论 深部真菌感染是肝胆外科病房常见的并发症;合理使用抗菌药物、减少侵入性操作、加强无菌观念和增强机体抵抗力是防止深部真菌感染的有效措施.     

耐药菌感染调查与管理对策

目的 对住院患者耐药菌感染情况进行调查,提出管理对策,防止耐药菌在医院内传播.方法 对医院2006年11月--2009年6月住院患者耐药菌感染情况进行现况调查.结果 同期住院患者耐药菌感染26例31例次,医院感染比例高达61.54%,死亡率占34.62%;感染部位下呼吸道感染发生率最高,占54.84%;感染危险因素包括:严重基础疾病、住院时间长、广谱抗菌药物使用、采用侵入性操作等;病区环境耐药菌的检出率为9.91%,诊疗用品的污染率为32.14%;多药耐药菌感染的聚集性发生,与诊疗器械污染密切相关.结论 加强对抗菌药物使用的管理,合理使用抗菌药物,防止细菌产生耐药性;积极开展感染病原菌及其耐药性监测,认真落实各项消毒隔离措施,规范诊疗操作,防止耐药菌在医院内的流行与传播;控制耐药菌医院感染,应成为当前医院感染监管的重点.     

Comparison of two methods for assessing the removal of total organisms and pathogens from the skin.

A standard hand-wash sampling technique was compared with a simple finger-streak sampling method in assessing the relative effectiveness of a number of alternative preparations used for disinfecting the surgeon''s hands (alcoholic 0.5% chlorhexidine, alcoholic 0.1% tetrabrom-o-methyl phenol, a 4% chlorhexidine detergent solution, aqueous 0.5% chlorhexidine, 2% ''Irgasan'' detergent solution and, as control, bar soap). There was a fairly good correlation between the results of assessment by the two methods after a single disinfection and after six disinfections, three on one day and three on the next. Significant differences were shown in 21 comparisons between treatments when the hand-wash sampling test was used, and 16 of these comparisons also showed a significant difference by the finger-streak test. Staphylococcus aureus was found in hand samplings from 5 out of 8 nurses in the Burns Unit of Birmingham Accident Hospital by the hand-wash sampling method and from 2 of the same 8 nurses by the finger-streak method; the numbers were small, and no Staph. aureus were isolated from the same hands after 1 min. wash in 70% ethyl alcohol. Similar sampling on 29 nurses in other wards showed Staph. aureus on 3 nurses (one in large numbers) by the hand-wash technique and on 1 nurse by the finger-streak test; in only 1 nurse whose hands showed Staph. aureus before disinfection was the organism found, by hand-wash sampling, after disinfection. Parallel sampling of nurses'' hands after washing with soap and water and after disinfection with 95% ethanol showed larger numbers of Staph. aureus in a hospital for skin diseases than in a general hospital, and a lower incidence and somewhat lower density of Staph. aureus after ethanol treatment than after washing with soap and water; Gram-negative bacilli, on the other hand, were commoner on hands in the general than in the skin hospital, and present in much smaller numbers after disinfection with ethanol than after washing with soap and water. Antibiotic sensitivity tests showed the frequent recurrence on the hands of some nurses of multi-resistant Staph. aureus with resistance patterns similar to those found in infective lesions in some of the patients; different sensitivity patterns were usually found in staphylococci isolated from the nose. Even in wards where many patients were infected, carriage by nurses'' hands of a particular strain of Staph. aureus did not seem to last for more than a few days.