清洗消毒质量监测记录单的设计与应用

消毒供应中心承担医院内可重复使用的医疗器械、器具和物品清洗、消毒、灭菌工作。由于以往对清洗、消毒质量没有监测和记录,常致器械清洗消毒不彻底,无法保障灭菌质量。鉴此,笔者设计清洗、消毒质量检测记录单,并将其应用于消毒供应中心,取     

信息系统在消毒供应中心无菌物品管理中的应用

通过多方合作,开发符合规范的医院消毒供应中心信息系统,对供应中心无菌物品各项流程进行实时监测与追踪,实现无菌包物流管理。结果医院消毒供应中心信息系统能提供重复使用物品在回收、清洗、消毒、灭菌和使用过程的完整实时的数据电子档案,实现消毒供应中心电子化物流管理,优化配送工作流程,减少过期包现象发生,并能实现无菌物品质量追溯。     

加强消毒供应中心管理预防和控制院内感染

目的:加强消毒供应中心管理,达到预防和控制院内感染.方法:狠抓硬件建设,营造良好的工作环境,加强消毒供应中心人员的素质管理,健全并落实各项规章制度,严格执行各项操作流程,加强各项监测及再生物品的各环节质量管理.结论:提高供应中心工作质量,控制院内感染,并保证为临床提供合格的灭菌物品.     

消毒供应中心参与医学美容科医疗器械清洗包装质量管理的效果

研究消毒供应中心参与医学美容科医疗器械清洗包装质量管理的效果。方法 选择蒙阴县人 民医院2022年6月-2023年6月的15名消毒供应中心工作人员，按照随机数字表法分为基础组（7名）和科研 组（8名）。基础组采取常规管理，科研组采取医疗器械清洗包装质量管理，比较两组消毒灭菌质量、不 良事件及工作人员满意度。结果 科研组管理后器械拆装、消毒质量、清洗质量、包装质量评分均高于基 础组（P ＜0.05）；科研组不良事件发生率低于基础组（P ＜0.05）；科研组满意率为100.00%，高于基础组 的57.14%（P ＜0.05）。结论 消毒供应中心参与医学美容科医疗器械清洗包装质量管理可提高消毒灭菌质 量，保证器械消毒合格并避免发生不良事件。     

消毒供应室无菌物品的监测

目的:探讨如何确保医院消毒供应室无菌物品的灭菌效果及性能良好.方法:通过医院感染管理科对消毒供应室工作的指导,加强相关知识的培训,规范物品清洗,灭菌流程,进行灭菌效果监测和质控.结果:对消毒供应室无菌物品采用102件进行监测,合格率达100％.结论:医院感染管理科对消毒供应室无菌物品监测结果满意.     

浅谈影响再生医疗器械清洗消毒的因素及处理方法

目的:讨论影响再生医疗器械清洗消毒的因素及处理方法.方法:依据国家卫生部法规性文件<医院感染管理规范>、<医院消毒技术规范>为标准,规范清洗、强化清洗质量以减少医院感染.结果:进一步完善了消毒供应中心管理制度.结论做好清洗消毒第一关,是预防医院感染管理工作中的重要环节,防止交叉感染,确保灭菌物品的无菌供应及全院医疗安全.     

无菌物品质量追溯系统中物品过期预警报告模块的设计与应用

目的降低无菌物品过期返消毒率,并杜绝给患者使用过期无菌物品,保障医疗安全。方法利用条码技术和计算机编程开发消毒供应中心无菌物品质量追溯系统,在该系统中设立过期预警报告模块,在无菌物品过期前发出预警提示,进行相应处理。结果2008～2011年无菌包过期未用率下降,4年的数据比较,差异有统计学意义(P<0.01)。结论无菌物品过期预警报告模块的运用减少了无菌器械包过期再灭菌的资源浪费,保证无菌物品质量、保障医疗安全。     

环节控制减少消毒供应中心复用器械包信息追溯错误

目的探讨降低无菌物品质量追溯系统中器械包信息追溯错误发生率。方法对2012年5月至2013年3月发生器械包追溯错误128件进行回顾性分析,找出发生错误的环节,分析原因,针对性制定改进措施并贯彻落实环节控制。结果环节控制后器械包信息追溯错误发生率由环节控制前4.4%降至1.3%,差异有统计学意义(P0.01)。结论对消毒供应中心无菌物品质量追溯过程进行环节控制能有效降低复用诊疗器械包信息追溯错误发生率。     

多种类正压式动力送风过滤式呼吸器清洗消毒实践

目的 探讨被新型冠状病毒污染的正压式动力送风过滤式呼吸器在消毒供应中心的清洗消毒方法.方法 消毒供应中心人员根据说明书以及国家发布的相关文件和指南,针对正压式动力送风过滤式呼吸器材质、结构特点及时制订正压式动力送风过滤式呼吸器清洗消毒流程.结果 清洗消毒正压式动力送风过滤式呼吸器144套,功能完好,使用者反馈无问题,医院感染管理科监测消毒效果符合标准要求,未发生使用者医院感染情况.结论 正压式动力送风过滤式呼吸器科学规范的清洗消毒方法能有效地杀灭新型冠状病毒,并保证呼吸器功能完好性,为医护人员提供合格的无菌物品.     

口腔科再生医疗器械的感染控制对策

目的:了解口腔科发生医源性感染的关键点,探讨预防控制对策。方法:采用诊疗后再生医疗器械的清洗、消毒、灭菌、无菌物品的储存等控制点的管理,制定控制感染程序,并落实执行。结果:供给口腔医师质量可靠的无菌物品,清洗彻底是保证消毒灭菌成功的关键;正确包装,保证无菌物品建立无菌屏障的完整有效性;消毒灭菌合格,有效控制医院感染;正确的无菌物品储存,确保无菌物品使用前不被污染。结论:做好口腔科再生医疗器械感染控制要点,可保证口腔科的医疗安全,确保无医源性感染的发生。     

Clinical audit,quality improvement and data quality

Clinical audit and quality improvement are essential processes that help to ensure that patients receive safe, effective, and high-quality care. By participating in clinical audit and quality improvement initiatives, anaesthetists can gain a deeper understanding of the care provided to patients and identify areas for improvement. Ensuring good data quality is crucial for these processes, and can be achieved by following a systematic approach to data management, including training on data collection and management techniques, strict data validation procedures and regular data quality checks. Additionally, involving patients, staff, and other stakeholders in the process can help to ensure that changes are well received and implemented effectively. By participating in these processes, we can contribute to the ongoing efforts to improve the quality of care provided by the NHS, and develop the skills and knowledge necessary for continuing professional development.     

绝经后女性骨密度和生活质量、睡眠质量及疲劳之间相关性研究

目的 本研究旨在探讨绝经后妇女的生活质量(quality of life,QOL)、睡眠质量和疲劳水平与骨密度(bone mineral density,BMD)之间的关系。方法 本研究纳入113例无骨折的绝经后骨质疏松症(postmenopausal osteoporosis,PMO）患者,172例骨量减少患者和102例BMD正常的患者。疼痛、生活质量、睡眠质量和疲劳的严重程度使用视觉模拟量表(VAS)、欧洲骨质疏松症基金会QOL问卷(QUALEFFO-41)、匹兹堡睡眠质量指数(PSQI)和个人力量(CIS)问卷检查表评估。结果 在VAS和QUALEFFO-41总分方面,三组间差异无统计学意义 (P＞0.05)。另一方面,与BMD正常组相比,PMQ和骨量减少组的PSQI和CIS总分比较差异具有统计学意义(分别为P = 0.015和0.007)。结论 QOL、睡眠质量和疲劳对PMO或骨量减少的女性影响显著。     

精子质量与胚胎质量

衡量男性的生殖能力一般采用WHO的精液分析标准,包括精子的活力、密度、畸形率等,然后结合女方的一些相关检查,为夫妇选择适应的妊娠方式.对于婚后1年规律性生活仍未怀孕者,则认为是不孕,应选择合适的助孕治疗.随着卵胞浆内单精子注射(ICSI)的发展,男性不育得到了有效的治疗,但ICSI却使精子的自然选择作用消失,操作过程中有可能选择了质量差的精子进行受精,其胚胎的发育和质量、妊娠率及妊娠结局不能达到期望的水平.     

Health status,health-related quality of life,and quality of life following ankle fractures: A systematic review

Introduction

The number of disabling short- and long-term consequences after ankle fracture (AF) is high. Therefore, it is important to consider the health status (HS), health-related quality of life (HRQOL), and quality of life (QOL) of these patients. The aim of this study was to provide a systematic overview of studies on HS, HRQOL, and QOL in patients with AF. In addition, the conceptualisation of HS, HRQOL, and QOL in these studies was evaluated.

Methods

A systematic literature search was conducted in Pubmed, Embase, The Cochrane Library, and PsycINFO (January 1976 to April 2012).

Results

Twenty-three studies were included of which almost half had a cross-sectional design. The assessment of HRQOL or QOL was an explicit objective in 17.4% of the studies. The SF-36 and SMFA were the instruments most often used and measure respectively HS and a combination of HS and HRQOL. However, they had been labelled as functional status. Inconclusive results were reported regarding the predictive value of age, sex, education level, alcohol use, smoking, fracture type, and the role of syndesmotic reduction with regard to HS and HRQOL. Also, inconclusive results were found comparing HS and HRQOL scores of patients with AF with norm population scores and regarding the course of HS and HRQOL over time. The additional value of early mobilisation after AF was not confirmed.

Conclusions

There are few quality studies on HS and HRQOL following AF and results are inconclusive. Future studies should measure these important patient-reported outcomes, including QOL. The concepts HS and HRQOL are not applied in agreement with the content of the instruments and instruments are downgraded to assess functional status. The correct terminology should be used to warrant clear communication in the field.     

Evaluation of semen quality in 1808 university students,from Wuhan,Central China

The aim of this study was to evaluate the semen quality of university students in Wuhan, the largest city in the world in terms of the number of university students. All student sperm donors recorded in the Hubei Province Human Sperm Bank from 1 March 2010 to 31 December 2013 were screened. At last, a total of 3616 semen samples from 1808 university student sperm donors were eligible and retrospectively analyzed. Each donor''s semen parameters were averaged over two samples and compared with the World Health Organization criteria, and a generalized linear regression model was used to examine several determinants of semen quality. We found that the mean and median values were 3.0 ml and 2.8 ml for semen volume, 50.2 × 10⁶ ml⁻¹ and 50.0 × 10⁶ ml⁻¹ for sperm concentration, 148.1 × 10⁶ and 142.1 × 10⁶ for total sperm count, and 58.6% and 60.0% for total sperm motility. About 85.0% of donors had parameters that were all normal. Season and duration of abstinence were critical factors affecting semen quality. We also found a decrease in sperm concentration during the 4 years observation; however, this may not be a strong evidence to confirm the declining trend of semen quality. In conclusion, semen quality of university students in Wuhan was not optimal and should be paid high attention, long-term observation and further study should be carried out to confirm the present situation.     

Cure, continence and quality of life after treatment for fistula-in-ano

Background: The best operation for high anal fistulas is difficult to nominate because they have varying cure and incontinence rates. The objective of this study was to quantify the relative importance of the outcomes of cure, continence and other quality‐of‐life (QOL) factors. Methods: A questionnaire was sent in October 2006 to patients with anal fistulas and to colorectal surgeons. Participants were asked to nominate up to five QOL domains. They were also asked to choose between two treatment options (with different cure and continence rates). Results: Seventy‐five of 134 (56%) surgeons and 28 of 199 (14%) patients replied. Comparing draining and cutting setons, surgeons (57 of 71, six neutral) favoured the former and patients (15 of 27, four neutral) preferred the latter. Comparing mucosal advancement flap with cutting seton, both surgeons (71 of 75, four neutral) and patients (13 of 26, two neutral) preferred the former. There was greater uncertainty among surgeons when comparing draining seton (23) and mucosal advancement flap (33), with 18 neutral. Patients preferred the mucosal advancement flap (19) to draining seton (three) and four were neutral. In direct questioning of objectives, surgeons nominated continence, leakage, pain, cure and sepsis as the five most important QOL factors. Patients nominated independent activity, pain, continence, psychological health and leakage as their five factors. Conclusion: Functional impairment and QOL do not necessarily correlate. The development of a validated specific QOL scale for patients with anal fistulas would be important to compare the results of different treatment options. This scale should include social and psychological factors in addition to the physical outcomes.     

Radical prostatectomy: Time trends, morbidity and quality of life

In recent years, increased screening for prostate cancer, primarily with prostate-specific antigen testing, has led to an apparent increase in the incidence of prostate cancer and resulted in a shift to an earlier patient age and tumor stage at diagnosis. From the early 1980s, there have been great advances in surgical technique. In the 1990s, radical prostatectomy gained popularity among Japanese urologists. Time trends and morbidity of contemporary anatomical radical prostatectomy in Japan are reported here. In addition, the quality of life in men undergoing radical prostatectomy is discussed.     

Public policy and quality of healthcare

Anaesthesiologists have long been interested in improving the quality of clinical care. However, clinical care is but one contributor to healthcare quality, which is influenced by a wide range of factors including health policy, health system funding, and organization. It is the interaction between these drivers and a nation's social and economic conditions (such as education and personal income) that determines the population's health. Whereas public debate has focused on healthcare funding, health systems face similar problems in achieving the best outcomes most affordably. The ability to measure outcome is limited in most jurisdictions, mainly by the lack of information systems. Nevertheless, public reporting of quality indicators has increased. Affordability is threatened by new technologies, population growth and ageing. This threat is creating renewed interest in prevention and population health, particularly through the use of leading indicators. With this interest in population health, the role and education of physicians may need to change.     

设立质量敏感指标推进普外科优质护理持续改进

目的探讨护理质量敏感指标在普外科优质护理持续改进中的应用效果。方法采用德尔菲法设立普外科护理质量敏感指标9项,将其应用于普外科手术患者优质护理中,收集每月监测数据进行动态分析,针对分析结果进行护理质量持续改进。观察比较护理质量敏感指标应用前后护理质量评分、患者对护理工作满意度及护理不良事件发生率。结果护理质量敏感指标应用后护理质量各项评分、患者对护理工作满意度显著高于应用前,护理不良事件发生率显著低于应用前(P0.05,P0.01)。结论护理质量敏感指标能有效提高普外科优质护理质量,降低护理不良事件发生率。