Chasing Zero: Our Journey to Preventing Surgical Site Infection

After an increase in methicillin-resistant Staphylococcus aureus infections was discovered at a health care facility in Arizona, a multidisciplinary team convened to investigate the underlying problem and work toward eliminating surgical site infections. The team investigated environmental factors, held inservice sessions to reinforce sterile technique, and made important changes to the facility culture in efforts to eliminate surgical site infections. The team's efforts were put into practice on October 30, 2008, and only one surgical site infection was identified in the following seven months.     

层流手术室两种空气质量检测方法的比较

目的比较《医药工业洁净室（区）沉降菌的测试方法》（A法）和《医院消毒卫生分区域多点布控法》（B法）两种空气质量检测方法对层流手术室的检测效果。方法采用A与B两种方法对层流手术室进行空气质量检测，比较其检测合格率、复检合格率及两种方法的灵敏度。结果B法比A法检测合格率高，差异有统计学意义（P〈0.05）；对于检测不合格的手术室采用两种方法复检所得合格率的差异无统计学意义（P〉0．05）。结论分区域多点布控法是较为合理和科学的手术室空气质量检测方法，但仍存在一定的问题，有待于进一步改进。     

Nasal CPAP in the delivery room for newborns with extremely low birth weight in a hospital in a developing country

The objective of this study was to determine the feasibility of the use of continuous positive airway pressure installed prophylactically in the delivery room (DR-CPAP), for infants with a birth weight between 500 and 1000 g in settings with limited resources. During 23 months, infants with a birth weight between 500 and 1000 g consecutively received DR-CPAP. A total of 33 infants with low birth weight were enrolled, 16 (48.5%) were females. Only 14 (42.4%) received antenatal corticosteroids and only 2 of those 14 (14.3%) infants weighing 500-750 g were not intubated in the delivery room, and apnea was given as the reason for intubation of these patients. Of the 19 infants in the 751-1000 g weight range, 9 (47.4%) were intubated in the delivery room, 6 due to apnea and 3 due to respiratory discomfort. For DR-CPAP to be successful, it is probably necessary for preterm babies to be more prepared at birth to withstand the respiratory effort without the need for intubation. Antenatal corticosteroids and better prenatal monitoring are fundamental for success of DR-CPAP.     

PET-CT中心医用回旋加速器及机房设计简介

本文介绍了PET-CT中心医用回旋加速器结构及原理,根据国家法律法规及设备场地安装要求分析了机房设计建设时应考虑的原则等,提出具体机房建设要求。     

食管癌患者手术室BPD护理路径效果研究

目的探讨BPD手术室护理路径对食管癌患者的护理效果。方法将本院手术治疗的80例食管癌患者随机分为对照组（常规护理）和观察组（BPD护理），比较两组疗效。结果观察组的治愈率、患者和医师满意率高于对照组，差异无统计学意义（P〉0．05）；手术并发症及住院天数低于对照组，均P〈0．05。结论BPD手术室护理路径在食管癌患者中的护理效果较好，值得临床广泛推广。     

洁净手术部工程设计的几点思考

在现代手术部建设工程项目中，设计和设计管理工作是十分重要的环节。在设计上，不仅应从理论上满足洁净手术部的标准，还应从人性化、个性化、智能化等方面系统考虑。在设计管理上，应收集与医院手术部相关的原始资料，以保证建筑、主体结构设计满足深化设计的要求。     

加强供应室下收下送车辆的消毒与管理

目的控制医院供应室运输环节感染的发生，加强供应室下收下送车辆消毒的管理，确保无菌物品的灭菌有效、使用安全。方法洁车使用后内面使用500mg/L的有效氯制剂擦拭消毒，洁车外面使用1000mg/L的有效氯制剂擦拭消毒，使用前用紫外线灯照射1h；污车使用后，内、外面均使用1000mg／L的有效氯制剂擦拭消毒，并使用紫外线灯照射1h；车轮用清水冲洗后用1000mg／L的有效氯制剂擦拭消毒；车辆分别标明“洁”或“污”字样，严格分类使用，分类储存；车辆外以防水套覆盖，也标明“洁”或“污”字样。结果消毒后洁车细菌菌落≤5cfu／m^2，污车细菌菌落≤15cfu／m^2。结论有效氯消毒，加以紫外线灯照射车辆能够达到国家卫生部规定的无菌区、清洁区、污染区卫生标准。此方法简便、易行、经济、有效，是控制医院供应室运输环节的有效方法。     

门诊注射室空气消毒方法的探讨

目的:探讨艾条熏蒸对门诊注射室空气消毒的效果.方法:用平板自然沉降法进行空气采样分析,比较艾条和紫外线对门诊注射室空气自然菌的杀菌效果.结果:艾条熏蒸对门诊注射室空气自然菌的效果等同于紫外线.结论:艾条熏蒸完全能代替紫外线进行门诊注射室的空气消毒.     

DRINKING IN THE INJURY EVENT: A COMPARISON OF MEXICAN-AMERICAN MALE ER PATIENTS IN THE UNITED STATES AND IN MEXICO

Probability samples of 66 Mexican-American injured male emergency room (ER) patients in Santa Clara County, CA, and 457 injured male ER patients in Pachuca, Mexico are compared on a number of drinking-in-the-event variables. While those in Pachuca were more likely to be positive on the breathalyzer than those in Santa Clara, they were less likely to attribute a causal association of their drinking with the event. Site (Santa Clara) was found to be a significant (positive) predictor of drinking prior to injury.     

Audit of the utilization of time in an orthopaedic trauma theatre

Background: The efficient use of operating theatres is important to ensure optimum cost–benefit for the hospital and to clear waiting lists. This audit uses the orthopaedic trauma theatre as a model to assess the theatre efficiency at our institution. Methods: We performed a retrospective audit using data gathered from the operating theatre database at our institution. We considered each component of the operating theatre process and integrated them to give a combined value for surgical and anaesthetic time (end utilization) and total theatre efficiency (operating theatre utilization). Results: Results showed that relative to the standards set, changeover time and start times were sub‐standard, with consistently prolonged changeovers and late starts. End utilization and operating theatre utilization were 78.8 and 81%, against a standard of 77 and 85–90%, respectively. However, these figures may be misleading due to sub‐standard performance in changeover time and other variables. Conclusions: We have highlighted inefficiency in the orthopaedic trauma theatre at our institution and suggest various strategies to improve this that may be applied universally.