發(fā)布時間：2018-05-10 08:33

  本文選題：流感暴發(fā)期 + 小兒輸液室　； 參考：《青島大學》2012年碩士論文

【摘要】：背景流感暴發(fā)期門診小兒輸液室患兒數量驟增,病人及家屬等眾多的人員流動帶動氣流,加速空氣中病原微生物的播散,對病人和醫(yī)護人員呼吸道感染形成威脅。因此,測定小兒輸液室空氣中的細菌含量并采取有效的預防控制措施對改善醫(yī)院環(huán)境控制醫(yī)院獲得性呼吸系統感染有重要意義。 目的本研究通過采集動態(tài)環(huán)境下小兒輸液室空氣和護士手部樣品,培養(yǎng)后計數細菌菌落,并從增加動態(tài)環(huán)境下空氣消毒的時間和強化護士手衛(wèi)生兩方面干預,使流感暴發(fā)期小兒輸液室環(huán)境監(jiān)測符合《醫(yī)院消毒衛(wèi)生標準》的要求。 方法1.在流感暴發(fā)期,監(jiān)測動、靜態(tài)環(huán)境下小兒輸液室空氣質量,并增加動態(tài)環(huán)境下的空氣消毒,即除常規(guī)夜間消毒2小時外(靜態(tài)環(huán)境下消毒),另增加上午持續(xù)消毒4小時、下午持續(xù)消毒4小時(動態(tài)環(huán)境下消毒)。然后在每種環(huán)境下分別采樣、送檢。2.隨機監(jiān)測護士手衛(wèi)生情況,強制護士按WHO規(guī)定的5個重要的手衛(wèi)生時刻：即在接觸患者前、進行清潔(無菌)操作前、接觸患者后、接觸患者體液后、接觸患者周圍環(huán)境后都要按照六步洗手法的步驟洗手或使用速干手消毒劑行衛(wèi)生手消毒。分別觀察兩種情況下護士手衛(wèi)生的依從性、正確率和手部細菌情況。 結果1.常規(guī)消毒后動態(tài)環(huán)境下小兒輸液室的細菌含量明顯高于靜態(tài)環(huán)境下,持續(xù)消毒后空氣中動態(tài)環(huán)境下細菌含量明顯減少,甚至達到消毒后靜態(tài)環(huán)境下的效果,符合《醫(yī)院消毒衛(wèi)生標準》的要求。隨機所測140株細菌中,革蘭氏陰性菌占71.8%,革蘭氏陽性菌15.4%,真菌9.8%。其中葡萄球菌和埃希桿菌屬是主要菌群,占空氣中細菌數的68.82%-78.57%；革蘭氏陰性桿菌中大腸桿菌的含量明顯高于其它陰性桿菌含量。2.強制情況下護士手衛(wèi)生依從性、正確率和隨機情況下相比明顯提高,手部菌落數降低未檢測出致病菌。 結論 1.靜態(tài)環(huán)境下的空氣監(jiān)測,不能反映工作狀態(tài)下的空氣質量；增加動態(tài)環(huán)境下的持續(xù)空氣消毒,能有效的提高空氣潔凈度。 2.加強對醫(yī)務人員的督導培訓,做好手衛(wèi)生和衛(wèi)生手的消毒是防止院內感染的重要措施之一
[Abstract]:Background during the influenza outbreak, the number of children in the infantile transfusion room of the outpatient clinic has increased sharply, and many people, such as the patients and their families, are moving through the airflow, which accelerates the spread of pathogenic microorganisms in the air and threatens the respiratory tract infection of the patients and medical staff. Therefore, it is important to measure the bacterial content in the air of infantile transfusion room and take effective prevention and control measures to improve the hospital environment and control nosocomial respiratory system infection. Objective to collect air samples from infantile infusion room and hand samples of nurses in dynamic environment, count bacterial colonies after culture, and intervene in two aspects: increasing the time of air disinfection in dynamic environment and strengthening the hand hygiene of nurses. The environmental monitoring of infantile infusion room during influenza outbreak is in accordance with the requirements of hospital disinfection and hygiene standard. Method 1. During influenza outbreak, air quality of infantile infusion room was monitored in dynamic and static environment, and air disinfection in dynamic environment was increased, that is, in addition to routine nocturnal disinfection for 2 hours (disinfection in static environment, and continuous disinfection for 4 hours in morning), Disinfection lasted 4 hours in the afternoon. Then in each kind of environment, sample separately, submit to check. 2. According to the five important hand hygiene times stipulated by the WHO, the nurses were randomly monitored for hand hygiene: before contact with the patient, before cleaning (sterile) operation, after contact with the patient, and after contact with the patient's body fluid. After contact with the patient's surroundings, wash hands with the six-step hand-washing method or use a quick-drying hand disinfectant for hand sanitization. The compliance, accuracy and bacteria of hand hygiene of nurses were observed. Result 1. The bacterial content in the infantile infusion room after routine disinfection was significantly higher than that in the static environment, and the bacterial content in the air under the dynamic environment after continuous disinfection was significantly reduced, and even reached the effect under the static environment after disinfection. Meet the requirements of Hospital Disinfection and Sanitation Standard. Gram-negative bacteria accounted for 71.8, Gram-positive bacteria 15.4and fungi 9.8. Among them, Staphylococcus and Escherichia coli are the main flora, accounting for 68.82-78.57 in the number of bacteria in air, and the content of Escherichia coli in Gram-negative bacilli is obviously higher than that of other negative bacilli. The nurses' hand hygiene compliance and accuracy were significantly higher than those under random conditions, and no pathogenic bacteria were detected in the decrease of hand colony number. Conclusion 1. Air monitoring under the static environment can not reflect the air quality in the working state, and increasing the continuous air disinfection in the dynamic environment can effectively improve the air cleanliness. 2. One of the important measures to prevent nosocomial infection is to strengthen the supervision and training of medical personnel and to do hand hygiene and hand disinfection well.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R183

【參考文獻】

相關期刊論文 前10條

1 陶成玉,何強,王洪飛,陳宏平;醫(yī)院感染的管理與控制[J];中國公共衛(wèi)生管理;2000年05期

2 尚惠英;尚磊;江遜;;醫(yī)院內感染的調查與分析[J];中國醫(yī)院統計;2006年02期

3 孫敬;陳會;陳麗霞;蘭玉娟;;醫(yī)院內環(huán)境空氣細菌監(jiān)測方法學探討[J];江西醫(yī)學檢驗;2006年05期

4 沈燕君,毛亞倫,周惟,瞿月霞,呂佩君;2000年寧波市醫(yī)院感染調查分析[J];現代實用醫(yī)學;2001年12期

5 于璽華;;紫外線照射消毒技術的特性及應用解析[J];暖通空調;2010年07期

6 于璽華;;空氣凈化是除去懸浮菌的主要手段[J];暖通空調;2011年02期

7 馬瑞華,柴同杰,郭冬梅,陸寅,孫愛芹;應用ANDERSEN-6級撞擊式采樣器檢測病室腸桿菌氣溶膠含量的研究[J];中國實用護理雜志;2005年04期

8 王豫林,陳代鴻;空氣中微生物采樣方法的比較[J];微生物學通報;1989年05期

9 陳清;吳嫻波;云雪霞;柯雪梅;;醫(yī)院感染的流行病學進展[J];新醫(yī)學;2006年07期

10 李新霞;高鳳娥;唐艷紅;;醫(yī)院Ⅱ類環(huán)境空氣消毒現狀[J];中國消毒學雜志;2006年03期

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