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。     

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、…     

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…     

加强供应室质量管理控制医院感染

目的 加强医院消毒供应室工作各环节的质量管理，控制医院感染。方法 重视再生物品清洗、包装质量，严格灭菌物品装放，正确选择灭菌方法，加强无菌物品储存和发放管理，完善各项监测措施。结果 加深了供应室工作重要性的认识，确保了无菌物品质量，有效地防止了医院感染的发生。结论 通过落实一系列管理措施，使供应室工作达到科学化、规范化、标准化。     

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.     

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.