品管圈在消毒供应中心清洗消毒环节质量控制中的应用研究

目的探讨品管圈应用于清洗消毒环节质量控制的重要性。方法对比2015年1月-2015年8月品管圈应用前为对照组,2015年9月-2016年4月品管圈应用后为实验组,计算医疗器械回收、分类、清洗、消毒、干燥、包装、灭菌、储存和发放的合格率及医院感染的发生率。结果对照组医疗器械回收、分类、清洗、消毒、干燥、包装、灭菌、储存和发放的合格率分别为94.50%、93.86%、94.93%、94.43%、95.07%、95.14%、94.43%、93.71%、94.50%,均低实验组98.21%、97.79%、99.29%、98.86%、99.14%、99.36%、98.14%、96.79%、97.71%,差异均有统计学意义(P<0.05);两组齿类轴节器械、非齿类无轴节器械、组合器械等各类器械合格率的差异均有统计学意义(P<0.05);除其他类型器械外,两组各类器械合格率的差异均有统计学意义(P<0.05);实验组医院感染率为1.30%显著低于对照组4.10%(P<0.05)。结论品管圈应用于消毒供应中心的清洗消毒环节质量控制,医疗器械回收、分类、清洗、消毒、干燥、包装、灭菌、储存和发放合格率提高,可有效降低医院感染率。     

组长负责制在消毒供应中心管理中的应用效果评价

目的探讨组长负责制在消毒供应中心管理中对工作质量及效率的影响。方法在消毒供应中心各环节设立组长岗位,实施组长负责制,通过质控检查与临床满意度问卷调查,比较组长负责制实施前后的工作质量、效率和临床满意度变化。结果实施组长负责制后,消毒供应中心清洗合格率由之前的92.00%（460/500）上升至98.60%（493/500）,包装合格率由90.00%（270/300）上升至98.00%（294/300）;临床科室对消毒供应中心的满意度由85.00%（408/480）上升至97.08%（466/480）,上述指标在实施组长负责制前后比较,差异均有统计学意义（均P＜0.05）。结论实施组长负责制,激发了各级护理人员的潜能,提高了工作效率和质量,使护士长工作回归到管理层面,临床服务满意度得到提升。     

无线射频识别器械包追溯管理系统在消毒供应中心控制感染中的应用

目的通过应用无线射频识别(RPID)器械包追溯管理系统,提高消毒供应工作质量,减少感染发生。方法应用RPID器械包追溯管理系统平台,在消毒供应中心建立手术器械回收、清洗、包装、灭菌、储存、发放系统,实现各环节管理信息化、规范化管理。结果该系统的应用提高供应物品质量,保证诊疗效果;消毒供应中心管理模式由单纯的经验管理向基于数据事实分析的科学管理转变;过期预警,落实感染控制;无菌物品追踪到使用患者;消毒供应中心举证依据;数字统计精确,便于成本管理。结论 RPID器械包追溯管理系统在消毒供应中心的应用,有效地控制消毒供应中心医院感染的发生。     

循证护理管理对消毒供应中心中器械消毒质量效果分析

目的:分析循证护理管理对消毒供应中心中器械消毒质量效果。方法:选2017年5月-2018年5月本科65件待消毒灭菌的器械,随机分两组,对照组26件常规护理管理,研究组39件循证护理管理,比较两组消毒质量及各科室满意度。结果:研究组清洗(95.43±2.19)分、灭菌(91.87±2.81)分、包装(91.20±2.29)分均比对照组高(P0.05),且研究组满意度98.00%比对照组高(P0.05)。结论:循证护理管理可提高消毒供应中心中器械消毒质量,提高工作人员工作效率与科室间的满意度,在临床上具有一定应用价值。     

消毒供应中心集中管理的实施与效果评价

目的 通过医院消毒供应中心集中管理模式实施的各流程环节,评价集中管理模式实施取得的效果.方法 消毒供应中心对医院所有重复使用的诊疗器械、器具和物品进行统一的回收,集中清洗、消毒、灭菌、储存和发放.结果 有效控制重复使用诊疗器械因处理不当造成医院医源性感染的发生,消毒供应中心专业技能有效发挥,专业人做专业事,使物品处理程序进入规范化,质量管理标准化.结论 消毒供应中心集中管理模式的实施,是控制医院医源性感染和促进消毒供应中心专业化管理的有效措施,杜绝重复使用诊疗器械处理过程的不规范,无菌物品质量安全得到保证.     

精细化质控管理对消毒供应中心手术器械消毒灭菌合格率影响分析

目的：探讨精细化质控管理对消毒供应手术器械消毒灭菌合格率及风险事件发生率的影响。方法：选取本院消毒供应中心20名护理人员作为研究对象，将未实施精细化质控管理前作为对照组（2020年1月～2020年12月），将实施精细化质控管理后作为观察组（2021年1月～2021年12月）。对比消毒供应中心在实施精细化质控管理前后的工作质量，对比两组器械回收、器械清洁消毒、器械包装、器械发放合格率；对比两组工作满意度。结果：各抽取300件器械作为调查对象，观察组器械回收、器械清洁消毒、器械包装、器械发放合格率均高于对照组，差异显著（P<0.05）。随访40名医护人员，对观察组的工作满意度为95.00%(38/40)，对对照组的工作满意度为70.00%(28/40)，对观察组的工作满意度更高（P<0.05）。消毒供应中心观察组时期工作满意度为100.00%(20/20)，对照组时期工作满意度为80.00%(16/20)，观察组高于对照组（P<0.05）。结论：消毒供应中心实施精细化质控管理后器械供应质量显著提升，能够为医院各个科室及时供应质量合格的可复用器械，其工作质量也得到各个科室及...     

手术室器械纳入消毒供应中心全程质量追溯管理的探讨

目的探讨手术室器械纳入消毒供应中心进行全程质量追溯管理,确保器械安全使用,提高手术质量,加强医院感染控制。方法手术室器械纳入消毒供应中心集中管理,消毒供应中心按标准化流程进行器械回收、分类、清洗、消毒、检查包装、灭菌、监测、发放,完善质量控制过程的相关记录,实施全程质量追溯管理。结果 2008年5月-2009年7月集中处置手术室器械包27 500余个,施行相应手术13 500余例,手术器械清洗、消毒、灭菌质量合格,记录具有可追溯性,器械装配符合要求。结论将手术室器械纳入消毒供应中心实行全程质量追溯管理,有效地保障了器械使用安全,预防与控制医院感染,是举证的重要依据。     

图章标识卡在口腔诊疗器械消毒供应流程中的应用

目的探讨图章、标识卡在口腔诊疗器械消毒供应流程的应用与效果。方法根据临床科室对诊疗器械的管理要求,以及医生对器械的使用习惯,设计一套图章标识卡,应用在诊疗器械回收清洗消毒打包灭菌供应的整个流程中,对使用后的诊疗器械分科室、分诊位进行清洗消毒打包灭菌,再发放回原诊位使用。结果图章在器械的消毒供应流程中应用,发放回原诊位的正确率由原来81%上升到99%;医生对包装灭菌后使用器械的使用习惯及发放正确率的满意度由78%提高到97%。结论图章标识的应用,有助于口腔诊疗器械消毒的规范有效实施。     

消毒供应中心物品质量控制与实施

目的 实施医院消毒供应中心各环节物品的质量控制,控制医院感染的发生.方法 通过严格的下收下送环节质量控制,清洗、包装、灭菌过程的质量控制,以及灭菌后物品和一次性无菌物品正确储存和发放管理,完善各项监测措施.结果 确保了医院消毒供应中心无菌物品质量,有效地防止了医院感染的发生.结论 通过各环节质量控制与实施,使消毒供应中心的工作逐渐走向科学化、规范化、标准化.     

分层管理对消毒供应室管理质量、器械清洗灭菌合格情况的影响

目的 探讨分层管理对消毒供应室管理质量、器械清洗灭菌合格情况的影响。方法 纳入2020年1月至2022年12月本院消毒供应室管理人员22名,其中2020年1月至2021年6月实施常规管理,2021年7月至2022年12月实施分层管理,对比分层管理实施前后管理质量、器械清洗灭菌合格情况、满意度情况。结果 分层管理实施后器械管理、包装质量、器械灭菌、环境管理评分高于实施前（P <0.05）;分层管理实施后器械清洗、消毒液浓度、器械灭菌合格率高于实施前（P <0.05）;分层管理实施后各科室器械发放、包装、器械回收、器械消毒满意度评分高于实施前（P <0.05）。结论 分层管理可提升消毒供应室管理质量及医疗器械清洗灭菌合格率,提高各科室满意度。     

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.     

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.