医疗废物全过程管理在医院手术室的实施

目的 加强手术室医疗废物全过程管理,控制医院感染.方法 以国务院《医疗废物管理条例》及《军队医疗卫生机构医疗废物管理办法》为准则,建立全程无盲区管理方式,规范手术室医疗废物的分类收集、运送和暂时贮存的工作流程和要求,健全、完善各项规章制度.结果 手术室医疗废物的管理质量得到提高,各级人员环保意识加强,有效控制医院感染.结论 实施手术室医疗废物全过程管理,是控制医院感染的重要途径.     

胸外科手术患者医院感染控制的管理

目的 加强胸外科病房住院患者的护理管理,预防和控制医院感染的发生.方法 建立健全并落实各项规章制度,强化工作责任;加强宣传教育,提高感染控制意识;规范病区管理,包括护理人员、病区环境、医疗废物、患者及陪护人员的管理.结果病房环境得到改善,护理人员素质得到提升,医院感染的发生率有所降低.结论 建立健全并落实各项规章制度,强化工作责任,加强胸外科病房的护理管理能有效地预防和控制胸外科患者术后医院感染,从而确保患者的安全,提高医疗护理质量.     

医院感染管理与控制

目的了解医院感染管理现状,探讨医院感染管理的有效方法,提高医院感染质量管理与控制水平,切实抓好有关医院感染的各项工作,减少医院感染的发生率。方法加强领导,健全组织机构及管理网络,制定切实可行的制度计划、强化医院感染知识教育,提高全员参与管理的意识及医院感染专职人员的整体素质,加强医院感染知识培训,对医院感染及其相关因素进行督查、监测、分析和反馈,密切关注医院病原菌耐药及科室分布情况,有针对性提出控制措施并进行指导实施。结果通过过程管理,完善各项医院感染工作,提高了医务人员对医院感染管理的认识,使各项医院管理制度与措施得以顺利实施,控制了医院感染。结论加强医院感染管理,常规化、规范化监测,才能有效地控制医院感染。     

规范护理管理控制医院感染

目的 规范护理管理,控制医院感染,提高护理质量.方法 把医院感染管理纳入护理质量管理,在护理管理中建立健全各项质量管理体系,完善控制医院感染管理规章制度,加强护理人员医院感染知识教育和考核,提高护士医院感染管理意识,规范护理操作程序,定期检查督促各项制度的落实,持续进行质量改进.结果 护理人员自觉执行各项操作规程,医院感染管理形成了制度化、规范化,有效地降低医院感染率.结论 规范护理管理是控制医院感染的有效措施.     

医院感染管理与控制

目的了解医院感染管理现状,探讨医院感染管理的有效方法,提高医院感染质量管理与控制水平,切实抓好有关医院感染的各项工作,减少医院感染的发生率。方法加强领导,健全组织机构及管理网络,制定切实可行的制度计划、强化医院感染知识教育,提高全员参与管理的意识及医院感染专职人员的整体素质,加强医院感染知识培训,对医院感染及其相关因素进行督查、监测、分析和反馈,密切关注医院病原菌耐药及科室分布情况,有针对性提出控制措施并进行指导实施。结果通过过程管理,完善各项医院感染工作,提高了医务人员对医院感染管理的认识,使各项医院管理制度与措施得以顺利实施,控制了医院感染。结论加强医院感染管理,常规化、规范化监测,才能有效地控制医院感染。     

医疗集团管理模式运行机制下的医院感染管理

目的 探讨医疗集团管理模式运行机制下医院感染管理的有效措施,减少医院感染的发生.方法 建立健全医院感染管理组织各项制度,对全体人员采取系统化、规范化的感染知识培训,采用网格化的管理模式,完善药事管理组织和各项制度,建立有效的督导检查与激励机制.结果 医疗集团在感染控制方面资金投入加大,感染控制专职人员水平得到优化,全体员工遵从感染管理规范的自觉性提高,感染控制意识增强,抗菌药物的使用日趋合理,医院感染管理整体水平得到提高.结论 领导重视,加强感染基础设施和专业队伍建设,采取多种形式对全体员工进行感染知识培训,加强督导检查,科学管理,多措并举才能不断提高集团医院感染管理水平.     

现代医院感染质量管理与控制思路

目的提高医院感染(HAI)质量管理与控制水平,切实抓好有关HAI的各项工作,减少医院感染的发生率。方法加强领导,健全组织机构及管理网络,制定切实可行的制度计划、强化医院感染知识教育,提高全员参与管理的意识及医院感染专职人员的整体素质,加强HAI预防与控制,建立信息反馈制度。结果通过过程管理,完善各项医院感染工作,提高医务人员自觉参与医院感染管理的意识,保障消毒、灭菌效果水平。结论通过标准-考核-奖惩三位一体责任制管理体系,使各项医院感染制度落实到实处。     

产房医院感染的管理

我院在2000年进行ISO9001质量管理体系论证过程中,加强了医院感染的管理,完善了各项制度,增强了考核力度,提高了员工的感染管理意识,有效地控制了产房医院感染发病率,现将产房医院感染管理体会介绍如下.     

预防手术室医院感染之措施

医院手术室感染管理是预防和控制医院感染的极为重要环节,是手术室质量管理工作中不可缺少的一部分,对于提高医院管理水平和医疗质量有着十分重要的作用。多年来,我院建立健全感染管理规章制度,完善管理措施,规范护理管理,认真贯彻落实《医院感染管理规范》和《消毒技术规范》,在消毒灭菌、监督检测控制和预防医院感染工作中取得了一定成效。1强化医护人员的感染控制意识定期组织医护人员学习有关医院感染管理法律法规知识及各项感染管理规章制度,全面普及医院感染知识,不断地更新控制医院感染意识。并对手术室的监控人员进行岗位培训,加强…     

现代化手术消毒供应中心的感染控制与管理

目的 探讨大型医院现代化手术消毒供应中心感染管理的有效方法,以控制医院感染,提高医疗护理质量.方法 将手术室和供应室进行一体化设计和建设,健全管理组织、完善各项规章制度、做好灭菌效果监测及各项环节质量控制.结果 手术消毒供应中心感染管理质量得到规范和提高,控制措施得到落实,有效防范了手术期医院感染.结论 实施手术消毒供应中心科学化管理是控制感染的重要途径.     

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.