医用口罩的正确选择与使用

目的探讨各种医用口罩的防护效果、适用范围和正确的使用方法。方法通过分析各类口罩的技术标准,了解各种医用口罩的防护效果,从而指导医务人员在临床工作中如何正确选择和使用医用口罩。结果医用外科口罩和医用防护口罩有国家技术标准,能起到有效阻挡病原体的防护作用,其他类型口罩没有统一的技术标准,仅有一定的机械阻挡作用,不能有效阻挡病原体通过呼吸道入侵。结论医师在临床工作中应根据实际情况和防护目的,正确选择与使用医用口罩,以达到防止呼吸道传播的感染性疾病和传染病在医院内的传播,做好有效的职业防护,减少医院感染的发生。     

医用防护口罩定性适合性检验在临床医务人员中的应用

目的 通过进行医用防护口罩3M FT-30定性适合性检验,以期为医务人员选择适合自己型号的口罩,降低被感染的风险,达到最佳的防护效果。方法 选取某院567名主要从事医技、护理及后勤岗位的工作人员于2022年4月1—22日在医院感染科组织下进行医用防护口罩的定性适合性检验。使用3M FT-30适合性检验设备,采用定性的方法检验受试者佩戴医用防护口罩的适合程度。结果 全院567名医务人员均对苦味剂敏感,敏感率为100%;共567名医务人员佩戴稳健医疗公司生产的医用防护口罩(折叠式)进行适合性检验,28名未通过检验,未通过率为4.94%;未通过测验人群中,脸型瘦小、胖大及面部局部五官特征突出的受测人员佩戴口罩与面部贴合不紧密,容易出现漏气,导致检验失败。未通过测验人员更换其他两种不同品牌口罩重新进行测验,其中11名佩戴振德医疗用品股份有限公司生产的医用防护口罩(头戴式)测验通过,16名脸型瘦小、下巴尖、鼻梁塌的医务人员佩戴思沃D920医用防护口罩通过测验,另外还有1名医务人员佩戴三种医用防护口罩均未通过测验。受试者佩戴同一种型号同一批次医用防护口罩做不同动作进行检验时未通过率比较,差异具有统...     

辽宁省2020年医用口罩应急检验情况分析

目的浅析辽宁省2020年医用口罩应急检验情况,为提升医用口罩质量及服务监管提供技术支持和参考。方法依据YY/T 0969-2013《一次性使用医用口罩》、YY 0469-2011《医用外科口罩》、GB 19083-2010《医用防护口罩技术要求》及相应的产品技术要求,对辽宁省2020年的3种医用口罩进行应急检验,整理结果数据,分析不合格项的产生原因。结果一次性使用医用口罩、医用外科口罩、医用防护口罩应急检验合格率分别为55.1%、65.0%、56.6%。结论3种医用口罩的应急检验合格率均较低,产品质量有待提高,应加强对此类产品的监督抽验及风险监测工作。     

医用防护口罩的定性适合性检验效果比较

目的 比较3MTM9132型与1860型N95颗粒物医用防护口罩的定性适合性检验效果,促进医务人员了解N95防护口罩的选择方法.方法 通过3M FT-30定性适合性检验设备,采用定性的方法,检验购自3M公司的3MTM 9132型和1860型N95微粒物医用防护口罩对医务人员的适合程度.结果 185名参加3MTM 9132型N95 颗粒物医用防护口罩测试的医务人员,敏感性检验级别均为1级,3人自述对口罩材料过敏,放弃适合性检验,182名接受定性适合性检验的医务人员中,有176名医务人员1次通过了定性适合性检验,其余6人经调整后均通过了定性适合性检验;637名参加3MTM 1860型N95颗粒物医用防护口罩测试的医务人员中,13人对苦味剂不敏感,敏感性级别为1、2、3级的人员分别占87.28％、7.69％、2.98％,通过敏感性检验的624名医务人员中,598人通过了定性适合性检验,佩戴两种不同型号口罩定性适合性检验通过率的差异有统计学意义(x2 =7.83,P＜0.05).结论 同一防护级别两种不同类型的医用防护口罩的定性适合性检验效果不同,医务人员应选择适合个人使用的防护口罩.     

新型冠状病毒肺炎隔离病房医务人员防护用品使用现况多中心调查分析

目的调查多中心新型冠状病毒肺炎(简称新冠肺炎)隔离病房中医务人员防护用品使用情况,了解其防护现状与特点。方法由经培训的医院感染管理专职人员随机抽取30所医院及院区的援鄂医疗队医务人员,记录被调查者基本情况和防护用品选择及穿戴的情况,并通过问卷星填报。结果此次调查发现参与新冠肺炎诊疗工作的医务人员在进入隔离病房前均接受防护用品使用及其穿脱流程的理论及实操培训,95.56%(2 433人)的医务人员在穿脱防护用品时有专人检查或督导。86.57%(2 204人)选择同时佩戴两层口罩,其中选择同时佩戴医用外科口罩及医用防护口罩的医务人员最多(1 621人,63.67%,);57.50%(1 464人)的医务人员使用护目镜或防护面屏,42.50%(1 082人)同时使用护目镜及防护面屏;95.25%(2 425人)的医务人员同时穿医用防护服及一次性隔离衣;96.62%(2 460人)的医务人员同时穿靴套及鞋套;戴两层帽子的医务人员比例最高,占70.54%;戴双层手套的医务人员比例亦最高,占57.31%。结论此次援鄂医疗队医务人员的个人防护有效地预防了新冠肺炎感染,实现了4.26万援鄂医疗队员的"零感染"。但部分防护用品仍存在叠穿或叠加使用的现象,如何适度使用个人防护用品有待规范和探索。     

医用口罩标准比对及医用口罩生产企业飞行检查常见问题浅析

近年来医用口罩产品质量受到持续关注。文章对国内医用口罩相关标准及技术指标进行比对,对医用口罩结构、原材料、生产工艺及省内行业现状进行介绍,结合2022年辽宁省医用口罩生产企业飞行检查情况,对生产管理、采购及文件管理部分出现问题进行分析,以供同类企业借鉴和参考。旨在帮助口罩生产企业提高质量意识,学习质量管理技能,持续产出符合预期用途和技术要求的口罩产品。     

3M~(TM)1860型N95颗粒物医用防护口罩的定性适合性检验

目的检验3MTM1860型N95颗粒物医用防护口罩在医务人员中的适合性,促进医务人员了解N95防护口罩正确的佩戴方法及调节方法。方法通过3MTMFT-30定性适合性检验设备,采用定性的方法,检验3MTM1860型N95颗粒物医用防护口罩对医务人员的适合程度。结果 637名参加测试的医务人员,有13人(2.04%)对苦味剂不敏感;其他人员敏感性级别分级为1级556人(87.28%)、2级49人(7.69%)、3级19人(2.98%)。637名医务人员中611人(95.92%)通过了定性适合性检验,26人(4.08%)未通过适合性检验。结论适合性检验能让医务人员了解正确的口罩佩戴方法,同时可以根据个人脸型等因素选择适合自己使用的防护口罩。     

医用外科口罩过滤效率检测

目的分析医用外科口罩常见的不合格项——过滤效率、压力差。方法参照YY0469-2011标准中规定的方法,对不同厂家生产的医用外科口罩过滤效率及压力差进行评价。结果厂家1、2、3生产的医用外科口罩符合标准要求,其他厂家生产的口罩未达标。结论选择合适的滤料是生产合格口罩的先决条件,建议生产企业选取滤料时,不但要考虑滤料的过滤效率,还应考虑其阻力性能。     

医院医用耗材中心化物流管理模式探讨

医院医用耗材的管理是医院的一项主要工作,贯穿了整个医疗服务的始终,涉及医用耗材的计划、采购、保管、发放及使用等.为了克服多头采购、耗材库房积压、大量过期报废、跑冒滴漏等问题,更好地为临床一线服务,我院利用中心化物流管理的方法,科学制定相应的医用耗材中心化物流管理方案,同时管理部门采用三权分立的办法,避免了采购权利过于集中,规避了风险[1].     

2020年湖北省医用口罩类产品监督抽检情况分析

目的：通过医用口罩类产品监督抽检情况,分析医用口罩类产品在生产、质量检测方面出现的问题,为提升医用口罩质量及监管服务提供技术支持和参考。方法：依据湖北省监督抽检方案,根据医用口罩类产品相应的强制性行业标准和企业制定技术要求,对湖北省内抽检口罩产品进行检测。结果：2020年4月～12月医用口罩共抽检104批次产品,占总批次的35%,共有20批次不合格,占医用口罩批次的19%,不合格项目主要集中在口罩带和细菌过滤效率上。结论：本省医用口罩类产品存在一定的问题,企业应加强对产品质量的控制以及完善质量体系的建设。     

Medical fitness evaluation for respirator users: results of a national survey of private sector employers

OBJECTIVE: To provide information on medical evaluation procedures for respirator use in private sector establishments. METHODS: In 2001, data on respirator use and practices were collected in a survey of private sector establishments. RESULTS: Of establishments where respirators were required, 46% did not evaluate employees' medical fitness. Evaluations for fitness increased with establishment size, ranging from 35% in small establishments (1-10 workers) to 95% in large establishments (>or=1000 workers). Questionnaire with a follow-up examination, as needed, was the most common method of evaluating medical fitness (48%). CONCLUSIONS: Results suggest that about half of all private sector establishments where respirators are required do not comply with Occupational Safety and Health Administration requirements for medical fitness evaluations. Improved awareness among employers and workers and identification of methods to increase medical evaluation practices, especially among smaller establishments, is needed.     

编制药械设备招标文件中技术参数的思考

目的:充分认识编写技术参数在药械设备政府采购活动中的重要性,探讨编写合法合理的招标文件的技术参数的方法,避免产生政府采购的不法行为。方法:根据政府采购相关行政规定和要求,结合当前国内药械设备政府采购存在的问题,分析编写招标文件中技术参数要求的利弊。结果:对实践中常见的问题,如何规范政府采购工作,编写合法合理的招标文件提出对策和建议。结论:招标文件中技术参数部分在整个采购过程中发挥着至关重要的作用。     

基于局域网的医院原生医学资源库构建与实现

为使院医院信息化顺应世界数字图书馆建设发展的要求,满足医务人员的多元化需求,基于局域网开发了医院图书馆医学原生资源数据库,并应用于医学原生资源的管理。旨在为医务人员提供系统的数字化医学原生文献查询检索,为用户提供方便的获取原生资源的渠道,从而促进医学学术的交流活动。     

Bonus systems in health insurance: a microeconomic analysis.

Faced with the cost explosion in the health care sector, policy-makers in most industrialized countries have been focusing on cost-sharing in health insurance as a possible solution. This is a sanction meted out to users of medical care; the alternative of creating positive incentives for non-users has not yet received nearly as much attention. This paper reports on the experiences made by German private health insurers with their plans offering rebates as well as experience-rated bonuses for no claims. It is argued that a rebate offer may be at least as attractive as conventional cost-sharing plans from the point of view of the consumer since these new options allow him to choose the time at which he is to bear the financial consequences of an illness. In the second part of the paper, predictions are derived concerning the incentives contained in the policies written by three particular insurers. Clear evidence of a decrease in demand for ambulatory medical care at the lower end of the billings distribution is found in rebate and bonus plans. The concluding section of the paper contains a discussion of the results with a view on the continuing debate about the reform of social health insurance.     

上海市社区卫生服务中心基本药物目录外用药需求分析

目的 ：分析上海市社区卫生服务中心基本药物目录外的实际用药需求。方法 ：通过分析上海市医疗机构药品集中招标采购数据库,针对社区卫生服务中心的工作人员和就诊患者开展问卷调查,从3个角度定量分析基本药物目录外用药需求。结果 ：基本药物目录外药品通用采购种类数占社区卫生服务中心药品通用名数的比例较高（66.6%）,但采购金额所占比例小（4.4%）;社区卫生服务中心工作人员对基本药物目录外药品的需求频次和紧缺程度上的反映略有差异;当社区患者配不到所需药品时,64%的被调查者会前往二、三级医院配药,12%的选择去药店购买,22%的选择替代药品,2%的选择自行停药。结论 ：社区基本药物目录之外的药品使用需求是普遍的,但集中度极低,多属于＂个性需求＂。     

Vaccine procurement and self-sufficiency in developing countries

This paper discusses the movement toward self-sufficiency in vaccine supply in developing countries (and countries in transition to new economic and political systems) and explains special supply concerns about vaccine as a product class. It traces some history of donor support and programmes aimed at self-financing, then continues with a discussion about self-sufficiency in terms of institutional capacity building. A number of deficiencies commonly found in vaccine procurement and supply in low- and middle-income countries are characterized, and institutional strengthening with procurement technical assistance is described. The paper also provides information about a vaccine procurement manual being developed by the United States Agency for International Development (USAID) and the World Health Organization (WHO) for use in this environment. Two brief case studies are included to illustrate the spectrum of existing capabilities and different approaches to technical assistance aimed at developing or improving vaccine procurement capability. In conclusion, the paper discusses the special nature of vaccine and issues surrounding potential integration and decentralization of vaccine supply systems as part of health sector reform.     

Analysis of the World Bank's pharmaceutical lending

This article analyzes the World Bank's lending activity on pharmaceuticals and medical products (PMP) during the fiscal years (FY) 1999-2001 by regions, borrower and supplier country, and procurement method. Data for the study derived from the World Bank Project and the Business Warehouse databases. The information included all Bank projects approved during the study period. Information for the PMP procurement contracts was extracted for the health sector components of all sector projects awarded. Contract dollar amount was aggregated by borrower and supplier countries. A total of 365 contracts of PMP for a value of US$ 364.5 million (2001 prices) were awarded. International competitive bidding was the most common procurement method used representing 46.0% of the total PMP contracts amount. Domestic providers supplied 52.5% of the PMP contracts managed by the borrower countries. Twenty-two countries accounted for 97.0% of the total PMP purchased during the period of analysis. Only a small fraction of the Bank activity was directed to the pharmaceutical sector. There is a need for more involvement of the World Bank to increase accessibility, affordability and rational use of pharmaceuticals and medical products. An evaluation of the different procurement methods and their implications on drug quality and prices should be performed.     

医院医学工程科技术管理规范专题一医疗器械采购技术管理规范探讨

结合当前医院医疗器械工作实际,围绕医疗器械采购工作规范化管理这一中心,就如何管理和怎样管理的问题进行了探讨。根据相关管理规范要求,同时紧密联系医院采购工作实际,从框架结构流程的角度,对医疗器械采购的基本要求、医疗仪器设备的采购流程、医疗耗材的采购流程及采购发票的管理等问题进行了分析,为进一步细化和全面规范化管理医院医疗器械采购、维护到日常的各项管理提供了行之有效的参考。     

Formaldehyde chamber disinfection: not suitable for respirators and anesthesia equipment

After formaldehyde-chamber-disinfection of respirators considerable quantities of formaldehyde deposit (presumably deep adsorption) within the devices. When the apparatuses are re-employed the respired air contains more than 1,000 (in individual cases more than 4,000) micrograms/m3. Thus all limits are exceeded by far. The liberation of the formaldehyde deposited in considerable amounts comes off according to an exponential equation dependent on the time of employment slowly, that with following chamber disinfections the quantities of formaldehyde in the apparatuses are still increased and still higher loadings of the respired gas occur. Even after employing them for a long time either non-stop or intermittently "saturated" respirators can not be used again. The disinfection according to the principle of the Aseptor-chamber or its imitations has to be refused for respirators and similar medical technical devices, e.g. incubators.