消毒供应中心护理质量控制在预防院内感染中的作用

目的:探讨消毒供应中心护理质量控制在预防院内感染中的作用。方法:选取我院消毒供应中心的20名工作人员作为研究对象,参考随机数字表法将其分为对照组与观察组,各10例。对照组实施常规管理,观察组在对照组基础上进行护理质量控制管理,比较两组工作人员器械清洗消毒灭菌合格率以及质量控制评分。结果:观察组管理后器械清洗消毒灭菌合格率高于对照组,P<0.05;观察组管理后无菌区灭菌质量、环境质量、消毒灭菌质量、物品质量评分均高于对照组,P<0.05。结论:消毒供应中心内实施护理质量控制的效果良好,能有效提升工作人员对医疗器械清洗、消毒、灭菌的合格率以及质量控制评分,起到预防院内感染的作用。     

消毒供应中心消毒效果评价及质量管理对策分析

目的通过对医疗机构消毒供应中心的高压锅灭菌效果、无菌区空气及医务人员手的卫生学监测,进行消毒效果评价,探讨加强消毒供应中心管理在医院感染控制中的作用,分析管理对策,最终达到控制预防医院感染发生的目的。方法依据《医院消毒卫生标准》GB15982-2012,选取包头市19所二级以上综合医院,于2012年1月~2013年6月每月对消毒供应中心的高压锅灭菌效果、无菌区空气及医务人员手进行卫生学监测和消毒效果评价。结果对消毒供应中心高压锅共采样342份,合格342份,合格率100%;对无菌区空气共采样342份,合格334份,合格率97.66%;对医务人员手共采样342份,合格330份,合格率96.49%。结论为巩固消毒供应中心高压锅灭菌效果,进一步提高无菌区空气和工作人员手消毒合格率,应严格执行医院《消毒供应中心管理规范》、《清洗消毒及灭菌技术操作规范》,通过加强供应室规范化管理,有效控制医院感染的发生。     

消毒供应中心质控管理的持续质量改进效果分析

目的评估消毒供应中心质量控制管理的改进效果。方法通过统计分析消毒供应中心2012年医疗器械及其他医疗用品的清洗、灭菌、包装及发放的质控指标,评估质控管理的持续质量改进。结果2012年消毒供应中心医疗器械的清洗不合格率为3．2％,比2011年下降12％。医疗器械消毒灭菌合格率为100％。压力蒸汽灭菌湿包发生数、包装不合格率、无菌物品发放错误例数较2011年分别下降47．4％、52．1％及34．3％,且1-12月份的数据呈现逐渐下降的趋势。结论2012年消毒供应中心的质控指标逐月上升,并且显著优于2011年,持续质量改进为医疗安全和医院感染防控提供了保障。     

二级医院区域化消毒供应中心医院感染管理的实践

目的:探讨二级医院区域化消毒供应中心对基层医疗机构实行集中供应,在实践过程中控制医院感染的措施?方法:通过合理的布局和设备资源管理,严格实施清洗质量和灭菌效果监测,通过增加信息追溯系统?加强科室质控等方法,提升无菌物品供应质量,加强医院感染管理?结果:加强医院感染管理后,区域化消毒供应中心的消毒无菌物品和可重复使用器械等灭菌合格率达99%,强化了专业规范执行?结论:加强区域化消毒供应中心实践过程中的感染环节控制,对提高物品灭菌质量?控制医院感染十分重要?     

区域化消毒供应中心运行过程中的医院感染管理

目的探讨区域化消毒供应中心运行过程各环节中医院感染控制措施。方法通过合理的布局流程,优质的设备资源,严格的清洗质量控制,规范的灭菌效果监测,先进的质量追溯系统,专业的工作团队,加强消毒无菌物品和可重复使用器械在收送过程各环节中的严格把关,加强医院感染管理。结果加强医院感染管理后,区域化消毒供应中心的消毒无菌物品和可重复使用器械等灭菌合格率达100%。结论加强区域化消毒供应中心运行过程中的感染管理,对控制医院感染十分重要。     

医院消毒物品集中式管理效果分析

目的 探讨一种经济、实用、安全、有效的医院临床科室消毒物品的管理方法,以控制医院感染,确保医疗安全.方法 将医院临床科室的消毒物品分为两组各600件,其中试验组消毒物品由消毒供应中心集中处理;对照组消毒物品由临床护士自行处理,比较两组的清洗消毒质量.结果 试验组由消毒供应中心集中管理,清洗消毒合格率为100.0％,对照组消毒物品由临床护士分散式处理,合格率为80.0％,试验组消毒合格率明显高于对照组.结论 采取消毒供应中心集中式管理,既能保证消毒物品清洗消毒质量,规范消毒物品管理,控制医院感染,确保医疗安全,同时又减轻了临床护士工作量,减少了环境污染,有利于职业安全防护.     

前馈控制对骨科手术患者消毒供应中心相关医院感染的影响

目的研究前馈控制对骨科手术患者消毒供应中心相关医院感染的影响,为临床医院感染的控制提供理论依据。方法选择2015年1月-12月住院骨科手术患者1184例作为对照组,另选择2016年1月-12月住院骨科手术患者1204例作为研究组,对照组采用常规方式防控医院感染,研究组在其基础上采用前馈控制,记录院内感染发生情况,对两组患者的住院时间、住院费用进行比较,对消毒物品清洗、包装、发放进行采样,并计算合格率,统计物品丢失率。结果研究组的清洗合格率、包装合格率及发放合格率为97.00%、97.80%、96.53%明显高于对照组的87.00%、92.80%、89.53%,且研究组消毒物品丢失率为0.80%低于对照组的3.20%,差异有统计学意义(P<0.05);研究组患者医院感染率为1.83%,其中消毒供应中心相关性医院感染率为0.42%,对照组患者感染率为4.73%,其中消毒供应中心相关性医院感染为1.94%,差异有统计学意义(P<0.05),研究组患者住院时间(14.34±4.59)d和住院费用(5859.44±384.58)元均显著低于对照组(20.39±4.45d,8573.84±558.39元),差异有统计学意义(P<0.05),两组患者共发生医院感染78例,检出病原菌138株。结论前馈控制能够显著提高消毒供应中心相关工作质量,降低消毒供应中心相关医院感染率,值得临床推广应用。     

“生命网”健康管理联合个体化有氧抗阻运动护理干预冠心病效果观察

目的　探究消毒供应中心按照敏感指标要求进行质量控制对医疗器械灭菌质量管控的意义。方法　将南京医科大学附属南京医院（南京市第一医院）消毒供应中心2017年1—12月间处理的医疗器械随机抽取500件作为对照组，此期间采用常规质量管理方法对医疗器械的清洗、灭菌质量进行控制；将2018年1—12月间处理的医疗器械随机抽取500件作为研究组，此期间按照敏感指标的要求对医疗器械的清洗、灭菌质量进行控制。应用SPSS软件，对2组间的清洗质量合格率、湿包发生率、包装质量合格率进行比较。结果　对照组的清洗、包装合格率分别为87.8%（439/500）、89.2%（446/500），研究组的清洗、包装合格率均为95.0%（475/500）。与对照组相比，研究组的清洗、包装合格率均明显提高（P均＜0.05）。研究组的湿包发生率为1.0%明显低于对照组的8.0%（P＜0.05）。结论　消毒供应中心按照敏感指标的要求对医疗器械灭菌质量进行管控，可有效提高医疗器械清洗消毒质量和包装质量的合格率，是实现医疗器械灭菌质量的重要保障，对降低院内感染，保证患者安全有重要意义。     

消毒供应中心物品质量控制与实施

目的 实施医院消毒供应中心各环节物品的质量控制,控制医院感染的发生.方法 通过严格的下收下送环节质量控制,清洗、包装、灭菌过程的质量控制,以及灭菌后物品和一次性无菌物品正确储存和发放管理,完善各项监测措施.结果 确保了医院消毒供应中心无菌物品质量,有效地防止了医院感染的发生.结论 通过各环节质量控制与实施,使消毒供应中心的工作逐渐走向科学化、规范化、标准化.     

加强消毒供应中心环节质量监控预防医院感染

目的控制医院感染和交叉感染。方法加强对消毒供应中心人员进行专业知识培训及素质培养,加强下收、下送及再生医疗器械的回收、清洗管理,成立质控小组,对清洗、包装、灭菌的各环节进行督导检查;执行标准化、制度化、科学化及普遍干预的管理体制。结果医疗器械的清洗、消毒、灭菌质量明显提高,无菌物品监测合格率为100.0%,保障了医疗安全。结论通过加强消毒供应中心各环节的质量监控,可有效预防和控制医院感染。     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.