肺功能检查导致医院感染的调查分析

目的分析引起肺功能检查医院感染的原因,为临床降低肺功能检查医院感染提供参考。方法选取2011年1月-2011年12月医院诊治行肺功能检查的患者作为研究对象,根据患者肺功能检查时间分为观察组154例和对照组146例;对照组肺功能检查按常规进行,观察组加强医院感染控制;对两组患者检查期间感染控制及医院感染发生情况进行观察,分析引起肺功能检查医院感染的原因。结果对照组患者发生医院感染21例,感染率14.4%,观察组患者无医院感染发生,两组感染率差异有统计学意义;导致医院感染的相关因素,主要为检测环境、规范操作、仪器设备清洗消毒和工作人员卫生等方面;观察组环境、设备表面、工作人员手部和防护服菌检分别为(3.6±1.7)CFU/m3、(5.6±2.7)CFU/cm2、(7.4±2.6)CFU/cm2和(27.8±12.8)CFU/cm2。结论加强肺功能检查医院感染控制,能够有效减少医院感染发生;对可能引起患者医院感染的各个环节加强控制,对于防止肺功能检查医院感染和保证医患健康有重要意义。     

持续质量改进对心导管室医院感染的影响

目的评价在医疗护理工作中实施持续质量改进,对心导管室医院感染发生率的影响。方法收集2011年1月-2012年12月医院心导管室行介入诊疗的患者共6 647例,将2011年手术患者3 175例作为改进前组,2012年手术患者3 472例为改进后组,比较两组患者感染率及物品表面菌落数,采用SPSS 17.0软件进行统计分析。结果医院感染率由改进前的4.8%降至改进后的2.4%,手卫生合格率由31.3%升至69.5%,物品表面菌落数由(4.74±1.34)CFU/cm2降至(3.29±1.36)CFU/cm2,差异均有统计学意义(P<0.05)。结论在医疗护理工作中实施持续质量改进,能显著降低心导管室医院感染的发生。     

口腔修复科交叉感染危险因素分析及预防对策

目的 探讨口腔修复科交叉感染的危险因素,总结预防对策,为控制医院感染提供依据.方法 回顾性分析医院口腔修复科2010年1月-2011年12月的120例患者,对其进行乙型肝炎病毒检测,比较乙型肝炎病毒感染组和未感染组治疗过程中的空气质量、器械消毒灭菌、废物处理和易感人群情况.结果 120例患者HBsAg阳性患者有42例,阳性率为35.0％;未感染组治疗过程中诊室空气中细菌平均数量为(2.3±0.2)CFU/m3,感染组(3.5±0.3)CFU/m3;器械表面的细菌数量,感染组(102±11) CFU/cm2,未感染组(62±13) CFU/cm2;感染组易感人员24例,未感染组25例,两组间比较差异有统计学意义(P＜0.05);诊疗过程中未感染组的废物处理要优于感染组.结论 空气质量、器械消毒灭菌、垃圾处理和易感人群等因素均与口腔修复科交叉感染密切相关,必须严格执行口腔修复科技术操作规程,健全管理制度,确保口腔器械消毒、灭菌质量,加强医疗废物管理,才能降低口腔修复科交叉感染发生率.     

消毒隔离措施的实施对重症监护病房金黄色葡萄球菌感染患者的影响

目的 探讨消毒隔离措施的实施对重症监护病房金黄色葡萄球菌感染患者的影响. 方法 对医院颅腩外科重症监护病房内金黄色葡萄球菌感染的6例患者,分析了可能引起的因素并采取了相应的消毒隔离措施. 结果 消毒措施实施后重症监护病房内的空气培养、物体表面、医务人员的双手细菌培养的菌落数分别为:(115.6±32.74)CFU/m3、(2.35±1.67)CFU/cm2、(5.6±1.38)CFU/cm2,均较消毒隔离措施实施前明显减少,两者比较差异有统计学意义(P<0.01);消毒隔离措施实施后患者的痰培养均无金黄色葡萄球菌. 结论 加强消毒隔离措施的实施能有效控制医院感染,防止今后类似情况发生.     

优质服务干预在预防手术室患者感染的效果研究

目的探讨优质服务干预在预防手术室患者感染的效果,以提高患者的满意度与获得良好的社会与经济效益。方法选取2012年6月-2013年6月医院收治的行手术患者180例,随机分为试验组和对照组各90例,两组患者在手术室均按照正常程序进行常规治疗,而试验组患者在常规治疗基础上给予优质干预措施,包括心理疏导、健康教育、手术相关干预与手术室环境管理等,观察和记录两组患者手术前后手术室空气菌落、刷手后护士手菌落数、术后患者感染率及对手术治疗的满意程度,数据均采用统计软件SPSS 19.0进行统计处理。结果试验组患者术后手术室空气菌落数(85.26±29.57)CFU/m3、护士手部菌落数(1.96±0.32)CFU/cm2均明显低于对照组的(388.10±92.25)CFU/m3、(8.36±2.08)CFU/cm2,差异有统计学意义(P<0.05);手术后试验组与对照组患者的感染率分别为5.56%、25.56%。结论手术室为医院感染高危科室,医疗工作各环节均相互地关联且互相影响,任何一个环节发生问题均可能引发手术室患者医院感染,医护人员应该增加职业道德教育与学习有关感染预防的知识,积极地采用现代化洁净手术室的护理干预新理念为患者提供服务,争取获得良好的社会与经济效益。     

手术室医院感染因素及控制措施

目的探讨手术室医院感染的因素,并采取有效地控制措施,为预防和控制手术室医院感染提供科学依据。方法选取2012年2月-2013年2月在医院手术的1 210例患者,随机分成两组,每组各605例,对照组患者仅进行常规护理,试验组在进行常规护理的同时,对其导致手术室医院感染的因素进行分析,并实施应对策略,观察两组患者感染发生率,并总结手术室医院感染的因素及应对策略。结果 1 210例手术患者共发生医院感染60例,其中对照组48例,感染率为7.93%;试验组12例,感染率为1.98%,两组差异有统计学意义(P<0.05);手术室医院感染的因素:手术室环境、手术室工作人员素质、手术室医疗器械的管理、侵入性操作、抗菌药物的不合理应用。结论手术室发生医院感染的危险因素较多,对手术室医院感染的危险因素进行分析并实施相应的应对策略,可有效降低手术室医院感染的发生率,值得在临床上推广使用。     

目标性监测及集束化干预对急诊患者呼吸道感染的预防效果分析

目的探讨呼吸道感染患者临床应用目标性检测手段配合集束化干预措施的预防效果,有效降低呼吸道感染的发生。方法调查医院2011年3月-2013年4月急诊患者120例,将2011年3月-2012年4月60例患者设为干预前组,以常规化护理模式进行呼吸道感染的预防治疗;2012年3月-2013年4月60例患者设为干预后组,采用集束化护理干预模式加以预防,对两组患者呼吸道感染及并发症发生率进行比较。结果干预前急诊患者发生呼吸道感染18例,感染率30.29%,干预后发生3例,感染率7.12%,两组患者感染率比较,差异有统计学意义(P<0.05);干预后急诊呼吸道感染患者并发症发生率18.33%,明显低于干预前的66.67%,差异有统计学意义(P<0.05)。结论采用集束化新型干预措施及目标性检测手段,可明显缩短感染持续时间,有效预防感染和并发症的发生。     

肺结核病区医院感染危险因素分析与预防对策研究

目的:研究肺结核病区医院感染危险因素,并且提出合理的预防措施.方法:选取我院自2014年4月至2015年4月期间收治的45例肺结核患者作为参照组,并且分析医院感染危险因素,制定合理的预防措施.选取2015年4月至2016年4月期间收治的实施预防措施的45例肺结核患者作为实验组,对比分析两组患者满意度以及感染率.结果:实验组患者感染率2.22%、护理满意度评分(98.14±5.24)分等指标显著优于参照组患者感染率15.56%、护理满意度评分(72.35±4.31)分,组间数据差异显著且P<0.05,统计学表示存在意义.结论:在肺结核病区对感染相关危险因素进行分析,依据感染管理等措施来控制以及预防,可以显著降低发生感染的可能性,值得临床上广泛应用.     

口腔科医院感染危险因素分析及防护对策

目的分析口腔科引起交叉感染的危险因素,提出有效的防护对策。方法对2010年1月-2012年12月的216例患者临床资料进行回顾性分析,均进行乙型肝炎病毒检测,按是否感染乙型肝炎分为感染组和未感染组,比较两组患者在治疗中的器械消毒灭菌、废物处理、空气质量及易感人群等情况。结果 216例患者中检测得出HBsAg阳性52例,阳性率24.07%,经研究发现,感染组52例患者中,治疗时器械表面检测出细菌数(103±12)CFU/cm2、空气中为(3.6±0.3)CFU/m3,易感人群有28例;未感染组164例患者中,治疗时器械表面检测出细菌数(63±11)CFU/cm2、空气中为(2.2±0.2)CFU/m3,易感人群有27例;在废物处理方面,未感染组显著优于感染组,两组在治疗时器械、空气细菌数、废物处理及易感人员数量方面差异有统计学意义(P<0.05)。结论空气、器械污染、废物处理不当、易感人群为口腔科交叉感染的危险因素,在治疗过程中,应采取有效的防护措施避免交叉感染。     

早期护理干预在控制重症监护病房医院感染中的作用

目的分析重症监护病房(ICU)医院感染的危险因素,探讨有效预防与控制ICU医院感染的护理措施。方法对2004年1月～2005年12月入住ICU的患者进行前瞻性监测,根据ICU医院感染的特点及危险因素,针对其高危因素和薄弱环节,实施早期护理干预。结果ICU医院感染发病率为27.20%,其中下呼吸道感染占51.82%,居首位,其次为泌尿道占23.36%,气管切开/插管患者发生下呼吸道感染占81.69%,使用呼吸机辅助呼吸发生下呼吸道感染占74.65%,泌尿道插管患者发生泌尿道感染占75.0%,说明侵入性操作是医院感染的主要危险因素。结论加强对侵入性操作的护理和管理,及时采取有效预防控制措施,是减少医院感染发生的关键。     

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.