加强医院消毒供应室集中管理与效果评价

目的 加强消毒供应室集中式管理,有效地控制医院感染.方法 消毒供应室对医院可复用的医疗器械进行统一回收、清洗消毒、检查包装、灭菌与发放的集中管理.结果 通过实施消毒供应室集中管理,器械清洗消毒、检查包装与灭菌有统一的操作流程,既保证质量,又节能降耗.结论 消毒供应室集中管理保证了可复用医疗器械的安全有效地使用,达到了控制医院感染、提高医疗护理水平的目的.     

消毒供应室的医院感染管理

目的 加强消毒供应室医院感染管理,提高医疗护理质量,预防与控制医院感染.方法 对消毒供应室医院感染管理过程中可能出现的危险因素和原因进行分析.结果 对消毒供应室的清洗、包装、灭菌、储存、发放等操作流程规范化管理,有效地控制了医院感染.结论 严格执行操作规程、规范管理是预防与控制医院感染的重要措施.     

消毒供应室包装质量缺陷分析及对策

消毒供应室消毒灭菌质量控制,是防止医院感染发生的重要措施之[1],包装质量直接影响灭菌质量,与医院感染的发生有密切的联系,它直接影响医院的医疗护理质量[2]。消毒供应室消毒灭菌物品种类多,数量大、周转快等特点,且各种操作流程中各个环节既独立又环环紧扣,工作人员稍有疏忽,就会导致灭菌失败的发生。现就我院消毒供应室20i2年全年中出现的包装质量缺陷问题进行分析,并提出相应防范对策：     

加强流程管理提高中心供应室的工作质量

目的 加强中心供应室流程管理,提高工作质量,预防与控制医院感染.方法 按照质量管理标准对中心供应室的建筑布局、工作流程及管理程序进行规范化.结果 对消毒供应室的清洗、包装、灭菌、储存、发放等操作流程规范化管理,有效地提高了工作质量,减少了医院感染危险.结论 中心供应室建立完善、合理的布局和工作流程、严格执行操作规程、规范管理是预防与控制医院感染的重要环节.     

加强消毒供应室管理控制医院感染

目的 探讨消毒供应室管理的有效方法,以控制医院感染,提高医疗护理质量.方法 建立布局合理的消毒供应室,加强回收医疗用品的清洗、包装、灭菌质量管理以及无菌物品的储存、发放和医务人员职业暴露防护管理,健伞医院与供应室医院感染管理组织,学习医院感染管理知识,提高控制医院感染意识.结果 提高了医疗护理安全,有效地控制了医院感染.结论 实施消毒供应室科学化管理是控制医院感染的重要途径.     

消毒供应室质量管理与控制

目的 提高消毒供应室的质量管理内涵,有效地控制医院感染的发生.方法 通过消毒供应室标准化建设、建立科学的质量控制体系、人员素质培训,供应室工作过程质量管理等方面,提高消毒供应室的质量管理内涵,有效地控制了医院感染的发生.结果 医院自2006年以来在基础和终末质量管理基础上加强对供应室工作各环节的过程质量监控,保证了无菌物品的质量,有效地控制医院感染的发生;在等级妇幼保健院评审中,得到评审专家的好评.结论 消毒供应室的每个工作流程紧密联结,医疗器械在工作流程中循环反复处理和使用,标准化的工作流程不仅能保证质量安全,还能不断地提高工作效率,只有全面提高供应室的质量管理,严把消毒供应关,才能有效控制医院感染.     

消毒供应室工作质量管理与流程环节控制

目的:加强供应室流程管理,提高工作质量,预防与控制医院感染.方法:按照质量管理标准对中心供应室的建筑布局、工作流程及管理程序进行规范化.结果:对消毒供应室的清洗、消毒、灭菌、储存、发放等操作流程规范化管理,有效地提高了工作质量,减少了医院感染危险.结论:供应室建立完善、合理的布局和工作流程、严格执行操作规程、规范管理是预防与控制医院感染的重要环节.     

加强消毒供应室管理控制医院感染

消毒供应室是医院中重要的组成部分,主要负责全院传染物品的回收、医疗设施以及有关器械的灭菌消毒,同时也是医院预防感染最为重要的部门.消毒供应室工作质量关系着临床医疗护理质量,对患者的生命安全以及院内感染率的发生有着十分重要的影响.由此可见,严控消毒供应室各个环节的工作质量,提高灭菌消毒质量,以确保消毒供应室有关人员的安全以及院内感染的预防控制,显得至关重要.对此,本文就消毒供应室工作提出了几点建议,旨在控制医院感染,提高临床医疗护理质量.     

严格消毒供应预防院内感染

医院消毒供应室是供应无菌器械,防止院内感染发生的"心脏"科室.医学技术发展要求加强消毒供应室的规范化、科学化建设与管理.消毒供应室工作质量的高低,直接影响着医疗、护理和科研的工作质量,同时关系到病人的生命安危.所以严格做好消毒供应工作对于促进医院医疗、护理工作的开展,控制医院内感染的发生处于至关重要的地位.随着医学科学事业的不断发展,人们逐步认识到了消毒供应室工作的重要性.消毒供应室不再是坐等服务的辅助科室,而是一个独立的有专科理论知识及技术操作的功能型医技科室.消毒供应室承担着全院医护工作所需要的消毒灭菌器械和物品,直接影响着病人的生命安危和医院医疗、护理质量.所以只有严格消毒供应室的消毒灭菌及发放等工作,才能有效控制院内感染发生,确保患者安全和医院信誉.     

应用品管圈降低灭菌物品闭合式包装缺陷发生率

目的分析品管圈在降低灭菌物品闭合式包装缺陷发生率中的应用效果。方法对东莞市人民医院2018年3-8月消毒供应室灭菌物品闭合式包装质量进行回顾性分析,进行品管圈管理,比较管理前(2018年3-4月)与管理后(2018年7-8月)灭菌物品闭合式包装缺陷发生率情况。结果应用品管圈管理后灭菌物品闭合式包装缺陷发生率明显低于管理前,差异有统计学意义(P0.05)。结论消毒供应室灭菌物品闭合式包装管理中采用品管圈管理,可明显降低手术器械闭合式包装缺陷发生率,减少器械重复包装灭菌次数,提高供应室人员工作效率,降低医院感染风险,值得推广。     

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 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.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.