疫苗冷链网络实时监测系统与人工监测效果比较

摘要:目的　“北京市顺义区疫苗冷链网络实时监测系统”与以往人工冷链设备监测效果比较。方法　采用Excel2010对资料进行统计分析。结果　疫苗冷链网络实时监测系统从温度监测频率、温度数据连续性、直观性方面,在发现温度异常的能力方面,在冷链系统管理水平方面,在群众满意度方面均优于人工监测系统。结论　疫苗冷链网络实时监测系统的监测效果远远高于人工监测系统,极大的提高了冷链系统管理水平,提升了群众对接种疫苗的信心和对预防接种单位的满意度,为评价疫苗冷链系统运行状况提供了客观的依据。     

物联网技术在疫苗冷链监测系统中的应用

为了达到对疫苗冷链设备温度实时监管目标,北京市顺义区将最新的物联网、云计算等技术应用于疫苗冷链监测工作,建成了"北京市顺义区疫苗冷链实时监管系统",现对该系统建设背景、功能和实时监测效果进行介绍。该系统是北京市第一家实现区疾控中心与基层预防接种单位全覆盖的疫苗冷链网络实时监测平台,开创了全市疫苗冷链系统管理的新模式,更大程度上保证了疫苗安全。     

江苏省冷链温湿度定点实时监测网络平台系统在疫苗储存、运输中的应用效果分析

为进一步落实《疫苗流通和预防接种管理条例》,加强对疫苗储存、运输温湿度的监测与管理,保障预防接种的安全性和有效性,2012年江苏省各疾控中心安装部署冷链温湿度定点实时监测网络平台系统,实现冷链温湿度数据平台实时监测记录、冷链数据异常时及时发送短息告知冷链管理人员及数据查询统计等功能.我省冷链系统自动化温度监控网络的成功建立,实现了冷链系统全程自动化管理,使我省冷链系统管理达到了一个新的水平.     

冷链设备无线温度监控系统的实践与探讨

药品、疫苗、血液制品等温度敏感性医用产品在冷链储运过程中,为了保证质量、减少损耗需要对温度进行实时监测。本文介绍了一种准确有效快捷的冷链监测方式,从而实现冷链温度的实时监测和分析预警。     

区域疫苗冷链温度实时监控系统的建立与应用研究

目的建立覆盖全区预防接种单位的冷链温度远程实时监控系统,实现疫苗冷链温度全程实时监控、预警处理,消除预防接种安全隐患。方法各接种单位统一配置医用冷藏冰箱,安装GPRS无线温度监测仪,自动记录和实时监测冷链温度,根据实际情况设置3种预警模型并即时自动启动,系统能够通过短信预警平台向预设管理人员发送报警短信,实现无人值守。结果冷链温度远程实时监控系统能够完成冰箱内温度实时采集、数据上传及报警等功能,使用医用冷藏冰箱贮存疫苗,系统运行更稳定,温度数据准确可靠。结论采用物联网技术对基层预防接种单位实施疫苗冷链温度全程监控技术可靠,监管势在必行。     

疫苗冷链温度自动监测系统与人工监测效果评价

目的了解预防接种门诊冷链运转情况,评价疫苗冷链温度自动监测系统使用效果。比较疫苗冷链温度自动监测系统与人工监测效能,为进一步推广和优化冷链温度自动监测系统提供科学依据。方法从全市随机选取8个预防接种门诊,对所选取门诊的所有常温冰箱和低温冰箱进行自动监测和人工监测温度及异常事件发生情况进行分析比较。结果疫苗冷链温度自动监测系统冷藏温度高于人工监测,配对t检验显示二者差异有统计学意义(P0.01)。疫苗冷链温度自动监测系统冷冻温度与人工监测冷冻温度差异无统计学意义(P0.05)。疫苗冷链温度自动监测系统超温率为0.256 8%,高于人工监测超温率为0.006 8%(P0.01)。研究期间疫苗冷链自动监测系统统计电源断电共为186次,人工监测记录为118次,人工监测数据低于疫苗冷链温度自动监测系统。疫苗冷链温度自动监测系统监测设备故障数量为6次,人工监测数量为17次,人工监测数据高于疫苗冷链温度自动监测系统。结论疫苗冷链温度自动监测系统可以对整个冷链全程、持续、高效监测,温度监测灵敏度高,但在设备故障监测报警、温度校准、智能化等方面还有待进一步优化。     

窄带物联网技术在疫苗冷链运输中的应用研究

利用窄带物联网(NB-IoT)技术研制一种温度监测系统,系统控制单元通过串口发送通信注意(AT)指令,控制NBIo T模块将传感器采集的数据发送至物联网云平台,以实现疫苗冷链运输全流程实时温度监测,相比传统监测方式具有功耗低、成本低以及信号稳定等优点,可有效避免疫苗因冷链“断链”等问题而失效,保障疫苗使用有效性与安全性,具有较高的应用价值。     

疫苗冷链网络实时监测系统应用1年后效果评价

目的分析和评价北京市顺义区疫苗冷链网络实时监测系统运行状况,以提高监督管理水平。方法收集物联网技术引入疫苗冷链管理后的数据采用Microsoft Excel 2010软件,对资料进行统计分析。结果共监测33家接种单位136台疫苗冷链设备,监测到报警53 779次;94.33%的告警时间持续在30 min以内,告警时间持续2 h以上的仅占1.11%;98%以上的告警温度小于1℃;54.71%的告警发生在非正常上班时间;共发送告警和告警恢复短信19 219条;药剂科冰箱报警率高于其他冰箱。结论该系统对全区疫苗冷链设备做到了实时监测,及时发现了告警并发送短信,特别是对非上班时间的监测,有效地减少了疫苗冷链事故的发生,是疫苗安全的有效保障之一。     

疫苗冷链温度实时监管系统应用效果评价

目的分析评价宁波市鄞州区接种门诊运行疫苗冷链温度实时监管系统4年后的应用效果。方法通过区域疫苗监控B/S平台追溯疫苗冷链日最高温度、日最低温度及预警短信,评价和分析冰箱温度稳定性和冷链异常原因,并对所有冷链监管人员就疫苗冷链温度实时监管系统运行效果方面问题进行个人访谈。结果医用常温冰箱温度稳定性优于家用常温冰箱,医用低温冰箱温度稳定性优于家用低温冰箱,差异均具有统计学意义(P0.001)。工作时间冰箱温度异常预警占92.17%,预警有效率为10.85%,非工作时间占7.83%,预警有效率为16.67%,冰箱开启时间过长为温度超标的主要原因,占有效预警的50.00%;24位冷链监管人员均认为系统应用效果良好且冷链监管质量得到很大提高,普遍认为冷链监管便捷性有所提高。结论接种门诊疫苗冷链温度实时监管系统应用效果良好,值得在疫苗监管领域推广。建议接种门诊加强疫苗冷链温度稳定性评价与冰箱日常使用和维护管理,并以医用冰箱作为疫苗储存首选设备;建立疫苗冷链应急管理机制,核查预警信息,避免疫苗冷链运转异常而导致疫苗报废的经济损失。     

基于信息云平台的疾控机构冷链设备温度监控研究

目的：探索疾控机构冷链设备的温度监控信息化管理模式,提高检测试剂、耗材、质控样品、标准菌株和疫苗等产品的存储和运输安全。方法：基于信息云平台的4G无线传输技术,对冷链设备的温度进行实时监测、上传、储存、预警、统计和分析,并监测比较冷链设备的性能状态。结果：通过使用温度传感器并设置监控指标,实现温度数据的自动实时监控、实时采集,实时上传。疾控中心仓储和车载冷链设备实现24小时温度监控和预警,克服了传统模式温度监控的不足,降低了温度管理的工作量,减少了产品“失温”带来的风险。结论：信息云平台满足了疾控中心对冷链设备温度监控的需求,改变了传统温度监控模式,保障了冷藏冷冻产品的安全,但仍存在进一步完善的空间。     

基于移动互联技术的预防接种门诊冷链监测系统设计与实现

目的：设计一种适合基层预防接种门诊使用的冷链设备监测系统。方法：通过部署于各预防接种门诊的监测终端．利用GPRS移动网络将监测数据提交到市冷链设备监测管理平台,各级主管部门和预防接种门诊通过互联网访问该平台进行日常查询与管理。结果：通过监测终端结合管理平台的方式对冷链设备的温度、电源以及终端自身状态进行监测．对异常情况进行现场、短信、色标、邮件等多重报警,为预防接种门诊的冷链设备建立了一个多层级监测保障体系。结论：本系统性能稳定、监测全面,实现了预防接种门诊冷链设备监测的自动化和智能化,且系统具有投入小、安装便捷、不受空间距离限制、维护简单等特点,十分适合类似预防接种门诊的基层医疗机构。     

冷链设备无线监控系统在我院血液管理中的应用

本文介绍了我院输血科冷链设备温度无线监控系统的实施,实现了冷链设备温度自动化的集中监测、记录和预警等功能,确保温控数据的完整和可靠性,保证临床用血安全。     

智能手机在预防接种工作管理中的国内外应用现状

尽管预防接种工作取得了巨大的成就,部分地区仍面临着接种率低和接种不及时、常规免疫接种报告数据质量不高、疫苗管理不规范、疫苗温度监测不到位、人员能力不足等挑战。针对上述问题,文章综述了智能手机用于预防接种提醒、预防接种信息管理、疫苗管理、冷链设备温度监测预警和手机预防接种应用软件五个方面的国内外应用现状,提出了运用智能手机支持预防接种管理工作的初步设想。     

Application of the remaining vaccine vial monitor life calculation to field temperature monitoring data to improve visibility into cold chain equipment performance

Vaccine Vial Monitors (VVM) are used to estimate if a vaccine has been exposed to excessive hot temperatures. This endpoint measurement is useful in determining if a vaccine is safe to be administered to a patient, but it does not pinpoint where in the cold chain a vaccine was exposed to excessive heat. With the expansion and technological advancement of cold chain equipment temperature monitoring, it is now possible to remotely estimate VVM status as a vaccine moves through the cold chain. In the present study, we examine the application of the mathematical principles backing VVMs on real, continuous, temperature monitoring data in Africa. Results suggest that exposure to short bursts of hot temperature or long power outages may still allow for safe distribution of affected vaccines. The remaining VVM life calculation could improve managerial visibility into cold chain equipment performance allowing for better data-driven planning and maintenance decisions.     

冷链管理与预防接种效果的相关性研究

目的:探究冷链管理与预防接种效果的相关性。方法:对本院的冷链自动监测系统使用前后6个月的情况做数据信息统计,其中,手工监测的时间为2018年7月1日~2018年12月31日。自动监测的时间为2019年1月1日~2019年6月30日。共选取本院的13台疫苗储存冰箱作为本次研究活动的监测对象,对自动监测及手工监测所出现的机械故障及自动监测预警产生的原因进行分析。结果:自动监测组储苗冰箱机械故障发生率低于手工监测组,差异明显(P<0.05)。通过对自动监测预警的产生原因进行分析可知,包括提前预警、冰箱门关闭不严、冰箱断电、冰箱出现故障、冰箱门开启时间过长。结论:在预防接种中应用冷链管理方法,取得了良好的接种效果,为疫苗质量的提升奠定了坚实的基础。     

Is freezing in the vaccine cold chain an ongoing issue? A literature review

Vaccine exposure to temperatures below recommended ranges in the cold chain may decrease vaccine potency of freeze-sensitive vaccines leading to a loss of vaccine investments and potentially places children at risk of contracting vaccine preventable illnesses.This literature review is an update to one previously published in 2007 (Matthias et al., 2007), analyzing the prevalence of vaccine exposure to temperatures below recommendations throughout various segments of the cold chain. Overall, 45 studies included in this review assess temperature monitoring, of which 29 specifically assess ‘too cold’ temperatures. The storage segments alone were evaluated in 41 articles, 15 articles examined the transport segment and 4 studied outreach sessions. The sample size of the studies varied, ranging from one to 103 shipments and from three to 440 storage units. Among reviewed articles, the percentage of vaccine exposure to temperatures below recommended ranges during storage was 33% in wealthier countries and 37.1% in lower income countries. Vaccine exposure to temperatures below recommended ranges occurred during shipments in 38% of studies from higher income countries and 19.3% in lower income countries.This review highlights continuing issues of vaccine exposure to temperatures below recommended ranges during various segments of the cold chain. Studies monitoring the number of events vaccines are exposed to ‘too cold’ temperatures as well as the duration of these events are needed. Many reviewed studies emphasize the lack of knowledge of health workers regarding freeze damage of vaccines and how this has an effect on temperature monitoring. It is important to address this issue by educating vaccinators and cold chain staff to improve temperature maintenance and supply chain management, which will facilitate the distribution of potent vaccines to children.     

A vaccine cold chain temperature monitoring study in the United Mexican States

Vacine cold chain assessments conducted in various parts of the world indicate that maintaining equipment at the temperature range recommended by the World Health Organization (WHO) is not always observed. It has been also the case that staff rather prioritize protecting vaccine from heat damage, thus often exposing vaccines to freezing temperatures. As a result, inadvertent freezing of vaccines is a largely overlooked problem all over the world. In a recent systematic review, comparison of the occurrence of freezing temperatures during storage and transport were found to be a global problem occurring both in the resource-rich as well as the resource-limited settings. A vaccine cold chain temperature monitoring study was conducted using standard WHO study protocol with the objective to document potential problems and to identify appropriate control measures. Multiple temperature monitoring devices were used in the study to evaluate user friendliness of these devices and staff attitudes towards them. In general, majority of the time, temperatures were kept between recommended temperature range of 2–8 °C. Temperature variation got wider when products moved from 3PL Laboratory to service points. The wider variation is found at the service points. High temperature excursions were observed or short periods of time while exposures to freezing temperatures were more both higher in number and duration, however, shake test with these vaccines indicated no freeze damage. 91% of staff believed that they did not have the necessary tools to detect if a vaccine had been damaged by a temperature excursion outside the 2–8 °C range, and all staff believed that inclusion of such devices (e.g. vaccine vial monitor) in the system would improve cold chain operations as they have became aware of problematic areas through this study.     

Evaluating the value proposition for improving vaccine thermostability to increase vaccine impact in low and middle-income countries

The need to keep vaccines cold in the face of high ambient temperatures and unreliable access to electricity is a challenge that limits vaccine coverage in low and middle-income countries (LMICs). Greater vaccine thermostability is generally touted as the obvious solution. Despite conventional wisdom, comprehensive analysis of the value proposition for increasing vaccine thermostability has been lacking. Further, while significant investments have been made in increasing vaccine thermostability in recent years, no vaccine products have been commercialized as a result. We analyzed the value proposition for increasing vaccine thermostability, grounding the analysis in specific vaccine use cases (e.g., use in routine immunization [RI] programs, or in campaigns) and in the broader context of cold chain technology and country level supply chain system design. The results were often surprising. For example, cold chain costs actually represent a relatively small fraction of total vaccine delivery system costs. Further, there are critical, vaccine use case-specific temporal thresholds that need to be overcome for significant benefits to be reaped from increasing vaccine thermostability. We present a number of recommendations deriving from this analysis that suggest a rational path toward unlocking the value (maximizing coverage, minimizing total system costs) of increased vaccine thermostability, including: (1) the full range of thermostability of existing vaccines should be defined and included in their labels; (2) for new vaccines, thermostability goals should be addressed up-front at the level of the target product profile; (3) improving cold chain infrastructure and supply chain system design is likely to have the largest impact on total system costs and coverage in the short term—and will influence the degree of thermostability required in the future; (4) in the long term, there remains value in monitoring the emergence of disruptive technologies that could remove the entire RI portfolio out of the cold chain.