Implementation of a multimodal infection control strategy in the nursing home

The main cause of morbidity and mortality among residents of nursing homes (NHs) is healthcare-associated infections (HAIs). We conducted infection control intervention by applying the WHO multimodal strategy for one year from January to December 2018 in the one NH in South Korea. Healthcare workers (HCWs) in NH were observed by infection control nurse from February to December 2018. Hand hygiene (HH) compliance according WHO 5 moments and type of HH, glove use were measured as main outcomes. During the intervention period, a total of 1,461 cases were observed. HH compliance among HCWs increased from 12.6% to 55.2% after the intervention. According to WHO 5 moments, HH before touching a patient and after touching a patient saw significant improvements. Further, glove misuse decreased significantly from 45.9% to 25.4%. The multifaceted infection control program in the NH group significantly improved the HH compliance of HCWs.     

一起疑似鲍曼不动杆菌感染暴发的预防控制效果观察

目的评估一起疑似鲍曼不动杆菌肺部感染暴发疫情现场控制措施的效果。方法采取前瞻性和回顾性相结合的调查方法,对某医院胸外科一起疑似鲍曼不动杆菌感染暴发PDCA控制效果进行分析和评价。结果该医院胸外科在2013年6月份连续发生5例患者鲍曼不动杆菌肺部感染事件。依照持续质量改进原理,采取调查、现场分析、消毒隔离措施、追踪监测和总结验收等循环管理措施,使这起疑似鲍曼不动杆菌感染暴发疫情得到有效控制,其后无新的病例出现。结论应用持续质量改进措施,有效控制了该医院鲍曼不动杆菌感染暴发疫情,取得良好的效果。     

重症监护病房多重耐药鲍曼不动杆菌感染暴发调查与控制

目的对神经外科重症监护病房（ICU）下呼吸道多重耐药鲍曼不动杆菌感染暴发进行调查与分析,为控制医院内感染提供依据及对策。方法对我院ICU于2010年8月6～17日陆续发生的5例鲍曼不动杆菌下呼吸道感染开展流行病学调查,查找感染源、传播途径,采取干预措施控制感染。多重耐药鲍曼不动杆菌感染患者予以隔离,改用与中心供氧配套的蓝心管,湿化液使用小包装灭菌注射用水,加强医务人员手卫生,加强环境物表与医疗设备的清洁消毒并根据药敏结果选用抗菌药物治疗。结果经核实院内感染诊断,查找感染源、传播途径,取5例患者痰培养及进行环境卫生学监测,推断为暴发。5例患者分离的鲍曼不动杆菌对亚胺培南全部敏感,部分对氨曲南及环丙沙星中度敏感,余11种抗菌药物基本耐药。结论 感染患者未及时隔离,蓝心管与中心供氧出口不配套使用胶布固定增加污染机会,湿化液使用大包装灭菌蒸馏水24小时内未及时更换,医务人员手卫生依从性差,是造成此次多重耐药鲍曼不动杆菌感染暴发的原因。     

重症监护病房鲍曼不动杆菌爆发感染的分子流行病学调查研究

目的对重症监护病房(ICU)鲍曼不动杆菌(Ab)的爆发感染分子流行病学进行研究,并为临床防治Ab感染提供依据。方法对ICU集中检出的鲍曼不动杆菌的耐药情况耐药情况进行分析,收集流行病学资料,采用脉冲场凝胶电泳技术对收集菌株进行基因分型。结果 2011年10月从ICU患者连续检出鲍曼不动杆菌7株,同时从ICU呼吸机和床单上、床头柜检出鲍曼不动杆菌3株,有9株鲍曼不动杆菌的耐药表型和基因型基本一样。患者鲍曼不动杆菌检出标本来自呼吸道,对常用抗生素普遍耐药,耐药率达到90%。结论重症监护室由同一株鲍曼不动杆菌引起爆发感染,对临床常用抗菌药物普遍耐药,对碳氢霉烯类的耐药率有显著上升,应引起高度重视,同时采用必要措施切断传播流行。     

耐碳青霉烯类鲍曼不动杆菌医院感染暴发调查及危险因素分析

目的调查一起由耐碳青霉烯类鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)引起的医院感染暴发事件,为预防和控制医院感染暴发提供依据。方法对2017年12月24日-2018年2月12日入住ICU后发生肺部感染的患者进行环境卫生学及分子流行病学检测,分析各种危险因素并积极采取控制措施。结果先后共发生8例CRAB医院获得性下呼吸道感染,罹患率为9.0%(8/89),8例患者共分离出病原菌8株。第1、3、4、5号患者检出CRAB药敏结果相同;第2、6、7、8号患者检出CRAB药敏结果相同。环境微生物调查中,共采集46份环境表面和医务人员手标本,6份医务人员手标本菌落数超标,均不合格。CRAB检出率为10.9%(5/46)。8台监护仪CRAB检出率为2/8,医务人员手为1/6,输液泵按钮为1/6,治疗车为1/8,床头柜、床架、电脑键盘鼠标、呼吸机表面、医务人员鼻拭子均未检出CRAB。分子流行病学调查中脉冲场凝胶电泳(PFGE)提示患者和环境分离菌株为同一克隆,共有2个亚群。耐药基因检测提示所有菌株均携带OXA-23、OXA-51基因,未检测到KPC、IMP、NDM及其他OXA基因。单因素分析提示抗菌药物使用时间、机械通气、气管插管/切开、留置引流管、入住ICU天数、手术、混合感染可能是CRAB医院感染暴发的重要危险因素,但多因素分析未提示有独立危险因素。结论此次CRAB医院感染暴发原因可能是医务人员手卫生依从性不严,在侵袭性操作时通过医务人员手导致的水平传播。加强医务人员手卫生依从性、积极治疗患者和采取严格的消毒隔离措施对于预防和控制医院感染及暴发至关重要。     

Evaluation of infection control practices during an AE

The broadening global commitment of UK military personnel since the end of the Cold War has brought them into contact with a plethora of tropical diseases, some of which require isolation and air transfer to a UK medical facility. This presents a number of challenges to the safe repatriation of patients and attending medical and flight crews. During a recent repatriation of a patient with suspected Lassa fever from West Africa, the team's practices were evaluated and recommendations were made for improvements to future transfers by the deployable air isolator team. Valuable lessons were learned by the team, most notably the need to practice safe isolation procedures in a real working environment. In addition, the team should work on exercises together, thus aiding cohesion prior to deployment.     

一起诺如病毒引起的聚集性疫情的调查分析

本事件共有13名学生患病,均分布在三年级6班,罹患率为31.00%。疫情发生在6月4-7日期间,主要症状表现为呕吐(76.92%)、腹泻(46.15%)、发热(7.69%)。从11份粪便标本中检出7份GⅠ型诺如病毒核酸阳性。经回顾性队列分析,排除了食物和水源引起疫情的可能性,证明此次疫情是GⅠ型诺如病毒通过人传人的形式引起的。     

Implementing an infection control program for the community-based healthcare facility.

With the rampant increase in patients with communicable diseases, including AIDS and Hepatitis B, a sound infection control program is vital. Focusing on the needs of administrators in community healthcare agencies such as home health agencies, long-term care facilities, and public health departments, the authors discuss infection control concepts and the primary components of an infection control program.     

Implementation of an OR efficiency program

PERIOPERATIVE EFFICIENCY is considered a hallmark for physician and patient satisfaction.AN OR EFFICIENCY PROGRAM was implemented in a hospital in the northeastern United States in 2005. After one year, improvements were seen in OR schedule adherence, room turnover time, and staff member consistency across all shifts.A WELL-EXECUTED PERIOPERATIVE efficiency program may not only enhance physician and patient satisfaction, but also may improve staff satisfaction and patient safety. AORN J 88 (November 2008) 775-789. © AORN, Inc, 2008.     

MRSA感染暴发事件的调查与控制

目的 研究MRSA医院感染暴发的原因、流行病学特点和控制措施.方法 通过对神经外科短期内出现的7例MRSA感染病例进行流行病学调查,分析其相关危险因素及流行病学趋势.结果 加强医护人员的MRSA防控知识培训,提高其感染防控意识,充分运用MRSA感染暴发预警机制对MRSA感染患者进行有效的感染控制,可及时控制MRSA的暴发和流行.结论 MRSA感染的暴发是可防、可控的.     

新型冠状病毒肺炎疫情期间普通病房医护人员“零感染”标准预防措施实践

本文主要介绍了普通病房医护人员在新型冠状病毒肺炎疫情防控期间“零感染”的标准预防防护措施,包括上下班期间、病房工作期间、接触患者及家属时、休息进餐时、领取物资时等各时段的防护措施,旨在为临床非一线科室医护人员在疫情期间的防护提供参考。     

新冠肺炎期间超声科感染控制的实践与思考

2019年12月以来,新型冠状病毒引发的疾病已成为全国的突发公共卫生事件,对人民群众健康和生命构成严重威胁。中国医师协会超声医师分会、中华医学会超声医学分会等行业学会分别发布了有关新冠疫情下超声人员防护、超声仪器管理等多个建议案。但在实际工作中,由于受诊区固有设计、诊室固有布局、防护用品短缺等多种因素影响,学会的建议案在具体实施中遇到各种实际困难。本文从防护用品使用、设置合理的就诊流程、诊室与仪器管理,以及人员素质培养等方面,总结了我院在新冠肺炎期间超声科室感控管理的实践体会,提出思考建议,旨在为新冠肺炎期间做好超声科的感染控制提供思路。