重庆市14家医院护理人员对胰岛素注射相关针刺伤风险感知现状

目的了解护士胰岛素注射相关针刺伤暴露现状及对暴露后预防血源性疾病知识掌握情况。方法采用方便抽样法于2016年10—11月选择重庆市14家医院共计2 220名护士进行问卷调查。结果 718(32.3%)名护士发生过胰岛素注射相关针刺伤,28名护士针刺伤后感染血源性疾病。护士乙型肝炎预防用药知晓率为30.4%,艾滋病预防用药知晓率为4.1%,梅毒预防用药知晓率为1.4%;不同职称、工作年限的护士对针刺伤暴露后预防用药知识掌握程度不同(P0.05)。护士对针刺伤暴露后乙型肝炎血清学随访次数知晓率为34.8%,丙型肝炎血清学随访次数知晓率为46.6%,艾滋病血清学随访次数知晓率为16.6%,梅毒血清学随访次数知晓率为12.8%。结论重庆市14家医院护士对胰岛素注射相关针刺伤暴露率高,护士对针刺伤暴露后预防血源性疾病知识掌握程度低,特别是艾滋病和梅毒相关知识。各级医院应加强胰岛素注射相关安全培训,提升护士职业风险感知力。     

某二级甲等综合性医院护士预防患者静脉血栓栓塞症的知信行现状调查

目的调查某二级甲等综合性医院护士预防静脉血栓栓塞症(Venous Thromboembolism,VTE)的知信行现状及相关影响因素,为促进护士预防VTE行为的转变和形成提供有力依据。方法于2018年3月,采用横断面调查的方法选取某二级甲等综合性医院197名护士进行问卷调查。结果 197名护士对预防VTE的认知得分为(26. 26±3. 70)分,态度得分为(28. 87±8. 11)分,行为得分为(20. 9±5. 41)分。Logistic多元逐步回归显示,护士预防VTE知识与所在科室为其他科室差异有统计学意义(P=0. 000),与工作年限为11～20年的有统计学意义(P=0. 01);护士预防VTE行为与所在科室为外科、妇产科比较差异有统计学意义(P=0. 022,P=0. 047);态度与行为得分呈正相关(P <0. 05,r=0. 45),行为与知识得分呈正相关(P <0. 05,r=0. 35)。结论护士对于VTE的预防及行为均处于较低水平;提升护士预防VTE的行为水平须提升其知识和态度,同时也要加强医院、科室预防VTE的意识,构建住院患者静脉血栓栓塞症防治管理体系。     

护士标准预防知识现状及影响因素分析

[目的]了解临床护士标准预防知识掌握情况,防止医院感染的发生.[方法]采用分层随机抽样的方法,用一般资料问卷,标准预防知识问卷,对1 000名临床护士进行调查.[结果]共收回有效问卷831分,护士标准预防知识平均得分(35.81±4.69)分.得分率71.62%.是否具有乙肝抗体、培训次数、工作年限、学历、所在医院是否是艾滋病培训基地5个影响因素影响护士标准预防知识的得分.[结论]护士标准预防知识掌握尚未达到良好水平.存在很多不足和认识误区,对护士进行标准预防知识进行有效的培训、提高掌握程度十分必要.     

县级医院护士手卫生依从性调查分析

目的了解县级医院护士洗手依从性现状,分析影响护士洗手依从性的相关因素。方法采用分层抽样方法,抽取XX县医院、县妇幼医院、县中医医院、县骨科医院300名护士进行调查。采用自制手卫生知识问卷、洗手依从性问卷、洗手健康信念问卷,并进行统计分析。结果共回收有效问卷288份,护士洗手依从性得分为61.73±22.62),得分率为74.66%。影响因素为洗手行动障碍,是否接受过预防知识的培训,所在的医院和科室环境等。结论县级医院护士洗手的依从性低,存在医院感染隐患,需要从各方面进行改进以提高护士洗手依从性。     

实习护生对标准预防认知和掌握情况的调查分析

目的了解护生实习初期与实习末期对标准预防知识及相关措施的掌握情况，有针对性地加强防护教育，减少院内感染。方法采用自行设计问卷，随机72名护生实习前期与实习末期标准预防知识掌握情况调查与对比，进行统计分析。结果实习前期与实习末期标准预防知识掌握情况差异有显著性。结论实习初期应加强护生标准预防教育，提高双向防护知识，做好医院感染控制工作。     

武汉市综合医院护士标准预防依从信念评估及其影响因素

目的研究武汉市综合医院护士标准预防依从信念及相关影响因素,以期为提高护士依从信念,降低职业暴露风险提供理论依据。方法采用方便整群抽样法抽取武汉市320名护士作为研究对象,采用一般资料问卷调查以及护士标准预防依从信念量表评估受试对象依从信念水平,并采用logistic回归分析其相关影响因素。结果 320名护士整体标准依从信念总均分为(89.52±11.49)分,有益性得分为(8.37±2.45)分,阻碍性得分(20.19±5.96)分,易感性得分(10.20±3.15)分,自我效能得分(13.35±4.12)分,促发因素得分(18.47±3.26)分,严重性得分(18.94±3.18)分;多因素回归分析中,学历、人际关系、工作年限、科室、医院等级、标准预防知识是对护理人员依从信念得分差异有显著性影响的变量(P0.05)。其中,标准预防知识对依从信念得分影响最大,回归系数B=5.15,P0.05。结论护士整体标准预防知识信念水平有待提高,护理管理者可从人际关系、科室环境、基础设施、标准预防知识等多方面积极采取措施,提高护士标准预防依从信念,降低护士职业暴露的风险。     

社区护士糖尿病知识掌握情况分析

目的了解大连社区护士糖尿病知识的掌握情况,为更好地实施糖尿病健康教育提供依据。方法采用随机抽样的方法,在2009年2月对大连市108名社区护士发放糖尿病相关知识问卷,其中有效问卷100份。统计每位护士的得分及答对率和答错率最高的5道题目。结果本次调查的100名护士糖尿病相关知识测试总分最高为47分,最低为22分,平均为(38.66±4.37)分。良好12名、一般64名、差24名。结论社区护士糖尿病知识掌握情况不理想,应采取切实有效的培训方式加强对社区护士糖尿病知识的教育。     

手术室护士血源性病原体职业危害相关因素调查分析

目的了解手术室护士职业危害现状,为采取针对性的职业教育和防护措施,降低手术室护士血源性病原体职业危害提供科学依据。方法采用问卷方法调查2008-2009年医院手术室38名护士血源性病原体职业危害因素及相关知识掌握情况测评。结果 38名护士中接触血性传播性疾病达68.42%;受伤率78.9%,缝合针居首位;护龄<5年的低年资护士锐器伤占76.67%;大多数损伤发生在整理或清洗器械占36.67%;职业危害相关知识测评中,主要问题是对职业暴露的危害认识不清,不了解、不遵从标准的行为仍普遍存在。结论手术室护士接触血源性病原体概率高,锐器损伤概率大,血源性疾病传播危害性大,手术室护士预防血源性病原体感染迫在眉睫,应采取积极有效的措施加以防护。     

医疗机构护理人员艾滋病防护知识认知的调查

目的了解医疗机构护士对艾滋病知识的掌握情况,为对其进行防治艾滋病知识培训提供依据。方法采用自拟问卷,对医疗机构407名护士进行调查。结果医疗机构护理人员较好地掌握了艾滋病防护知识,但不同级别医院的护理人员,不同学历、不同护龄的护士对艾滋病防护知识掌握情况存在显著差异。结论分层次、有针对性地对医疗机构护理人员进行艾滋病防护知识专业培训能起到事半功倍的促进作用。     

医院感染基本知识培训对带状疱疹感染患者护理工作的影响分析

目的 探讨医院感染基本知识培训对带状疱疹感染患者护理工作的影响,为减少与控制带状疱疹感染提供参考.方法 随机抽取2011年1月-2012年7月258例带状疱疹感染住院患者进行回顾性调查,对护理人员进行面对面的医院感染基本知识培训,培训结束后随机选取79名护士进行带状疱疹感染医院感染基本知识知晓率问卷调查.结果 带状疱疹感染患者护理工作影响相关因素包括治疗与护理持续时间、患者住院时间、抗菌药物使用种类等;79名护士在医院感染基本知识培训前后对疾病相关知识知晓率发生了显著的变化,护士对带状疱疹病因知识、感染因素、患者临床表现、感染危害、护理措施和医院感染防治知晓率教育前分别为46.8％、44.3％、51.9％、31.6％、44.3％和40.5％,教育后分别为86.1％、81.0％、89.9％、81.0％、87.3％和73.4％,差异有统计学意义(P＜0.01).结论 规范的护理操作可最大程度的减少或消除带状疱疹感染.     

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.