洁净手术部控制医院感染流程优化管理

目的 探讨洁净手术部控制医院感染流程优化管理的方法.方法 从医院洁净手术部的建筑布局入手,按照洁净手术部的设计标准,从洁净手术部的日常环境管理,控制人流、物流等综合措施.结果 优化了医院洁净手术部的感染控制体系,促进手术室工作次序最佳化达到流程次序最佳化,有效控制医院感染.结论 坚持按照洁净手术部的设计标准,使预防感染的措施具有可操作性、可控制性,达到医院洁净手术部控制医院感染流程的优化管理.     

洁净手术部的医院感染管理

目的 探讨提高洁净手术部医院感染管理工作水平的方法.方法 从洁净手术部的建设标准入手,运用空气和物体表面微生物的理论,论述了洁净手术部医院感染管理的艰巨性、复杂性、专业性和法规性.结果 严格规范洁净手术部的建设标准,是做好医院感染管理工作的坚实基础;坚持介入洁净手术部的工程质量验收,是做好医院感染管理工作不可缺少的重要环节;全面开展洁净手术部的日常监控,是做好医院感染管理工作的有效手段;努力创新洁净手术部现代管理模式是做好医院感染管理工作的精髓.结论 洁净手术部的医院感染管理,必须要强调全方位控制细菌的综合措施,要规范净化空调保障体系,实施全过程监控.     

口腔专科洁净手术部的感染控制及管理

作者通过临床实践,探讨了符合口腔专科手术部安全、有效、实用要求的感染管理方法。分析了洁净手术部的使用情况,对手术部感染监控工作提出了相应的管理措施,即口腔专科洁净手术部为专科手术提供安全的无菌环境,通过合理有效的管理,预防专科手术院内感染。而先进的洁净设备是创造无菌环境的条件,合理有效的感染管理是实现无菌环境的保证。     

洁净手术部的建设与管理(四)--洁净手术部平面布局设计

手术部布局是医院整体设计的重要组成部分。手术部平面布局设计包括手术部整体布局、手术室平面布局、手术室设备布局。布局设计是手术部关键设计,它直接影响手术部的使用效果,可变性差,一旦建成,就难以修改变动。由于各医院手术部规模不一样,各医院管理模式、工作习惯存在差异,造成手术部布局差异很大,难以从学术的角度总结成几类标准的模式。平面布局最基本原则是保证人流、物流、气流的合理性,使人、物分流,污、洁分流,提高手术室洁净度,减少感染的发生,并使医护人员操作管理舒适、高效、安全、节能。1手术部整体布局洁净手术部主要有洁…     

医院洁净手术部的运行管理与日常监测(续)

合理的设计,优质的施工是洁净手术部实现无菌环境的前提。科学的运行管理,规范的日常监测的运行状态则是实现全方位、全过程控制污染的保证。本文阐述洁净手术部动态管理的理念,旨在提高洁净手术部运行管理水平,实施更有效的控制“二次污染”,全方位地实现“无菌保障体系”之最终目的。(本文分二部分阐述:第一部分运行管理;第二部分日常监测)     

洁净手术部全环境监测与制度化管理

严格洁净手术室管理、规范制度、措施到位、全员参与，是达到预期实施效果的重要保证。北京武警总医院自启用洁净手术部后，采取本底调查，坚持日常全环境监测与制度化管理。完善了硬件、软件建设的实践研究，使洁净手术部整体管理水平飞跃发展，充分发挥了其洁净质量的效能。达到了制度约束医疗行为，措施提升质量的有利效果。     

医院层流洁净手术部原理及功能特点

1层流洁净手术部原理 随着医院的现代化发展,对医疗质量和医疗环境都产生更高的要求,洁净手术部是近年来快速发展的医疗项目,它的出现有效地降低了术后的患者感染率,改善手术环境,提高了手术的整体质量。为医护人员创造出有利于工作的舒服环境,满足手术过程对空气的温度、湿度、风速、清新洁净度、噪声及空气中的菌落数等各项指标的严格要求。洁净手术部的核心部分是净化空调系统,该系统运行的质量直接影响着整个洁净手术部的使用效果。因此,提高净化空调系统的可操作性及可维护性,会在很大程度上提高整个净化手术部的性能。     

北京大学所属医院洁净手术部质量管理监测结果分析

目的通过对医院洁净手术部综合性能和管理现状监测结果的分析,发现质量管理中存在的问题,促进医院加强管理．保障洁净手术部有效运行。方珐回顾性分析洁净手术部检查资料,了解质量管理中存在的问题及薄弱环节,提出有效的改进措施。结果洁净手术部的管理还存在着一定的缺陷,应进一步加强管理力度,定期监测。结论洁净手术部的管理涉及多专业,多学科,多部门,是对医院感染管理工作的挑战。需要制定与此相适硬的、科学合理的运行和管理的措施．以保障洁净手术部的安全运行。     

医院洁净手术部的感染控制与管理

目的 探讨洁净手术室的科学管理方法 ,为手术患者提供高度洁净、安全的手术环境,预防感染.方法 根据洁净手术室的特点,实行了人、物净化及严格的分区管理,采取无菌,净化运行、清洁管理措施,加强洁净手术部的流程管理的方法 .结果使洁净手术室控制工作做到"人尽其责,物尽其用",有效地控制了污染源,避免了交叉感染,保证手术和患者的医疗护理安全.结论 洁净手术室的启用和完善的管理措施,对于提高手术室洁净度确实、有效,降低了手术感染率,提高手术质量.     

医院洁净手术部的运行管理与日常监测

合理的设计,优质的施工是洁净手术部实现无菌环境的前提。科学的运行管理,规范的日常监测的运行状态则是实现全方位、全过程控制污染的保证。本文阐述洁净手术部动态管理的理念,旨在提高洁净手术部运行管理水平,实施更有效的控制“二次污染”,全方位地实现“无菌保障体系”之最终目的。     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

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.     

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.