目的:探讨眼科病房收治地震伤员期间如何进行医院内感染的预防及控制。方法：对2008年5月12日至5月27日眼科病房收治伤员期间对医院感染存在的高危因素进行分析，从人员、物品、病区环境、伤员的卫生处置等方面加强管理。结果：在收治伤员期间，眼科手术同步开展，无1例院内感染发生。结论：加强预防和控制管理是防治医院感染的关键。
During the medical rescue of Wenchuan earthquake, the Nursing Department of West China Hospital of Sichuan University immediately initiated the emergency response plan, reasonably dispatched nurses of the medical teams from West China Hospital, other provinces and foreign countries. Meanwhile, the Nursing Department set up the medical team for emergency treatment, provided the basic information of the wounded, established the flow of rapid registration and rapid preview, formulated and optimized the flow of the admission of the wounded, and improved the flow of information-collecting. What’s more, the nursing department adjusted the current work according to the situation of hospitalization of the wounded in different stages to ensure the efficient running of medical rescue. Moreover, the routine nursing practice was also maintained and none of the inpatients other than those from the disaster area got involved in any unexpected accident.
【摘要】 目的 了解学生对医院感染职业防护的基础知识的认知程度和学习需求。 方法 2010年3月采用自行设计问卷，对参加《医院感染与职业防护》课程学习的医学学生进行摸底调查。 结果 92.73%不知道标准预防措施和锐器伤后的正确处理方法及补救措施；27.27%不知道抽血时应戴手套；25.45%不清楚医务人员“六步洗手法”；90.91%不知晓工作服应交医院统一洗涤。 结论 学生防护知识薄弱，防护行为不全面、不规范。教学应重点帮助学生树立标准预防观念，掌握正确职业防护知识，在临床工作中以避免和减少各种危险因素的侵袭。【Abstract】 Objective To examine and evaluate the students’ knowledge and needs in studying hospital infection control and occupational protection. Methods Using a self-designed questionnaire in March 2010, we did a survey on students who attended the course of hospital infection control and occupational protection. Results Among all the students, 92.73% did not know standard prevention measures, and the correct treatment and remedial measures for sharp injuries; 27.27% did not know gloves should be worn at the time of blood drawing; 25.45% did not know the "six-step" hand-washing; and less than one out of ten students used hospital laundry to wash their uniform. Conclusions The students have a low level of relevant knowledge on occupational protection, and their protection behaviors were not complete or standard. Therefore, the teaching should help and support students to have a concept of standard prevention, and acquire sound knowledge and behavior of occupational protection in order to avoid and reduce the risk factors from their future clinical practices.
ObjectiveTo explore the efficacy of reforming head nurse inspection and supervision outside the eight-hour administration, in order to ensure seamless quality management. MethodsFrom January 2014, reform was carried out on the name, form, content, and standard of head nurse inspection and supervision, including the combination of casual and work wear, seamless management outside the eight-hour administration, complete management with key emphasis, fine evaluation with objectives and emphasis, the combination of feedback and summarizing, and the combination of written and oral report. ResultsAfter the implementation of 6-month reformation, the head nurses involved in inspection increased from 102 in January 2014 to 124 in June 2014, the departments involved in inspection increased from 276 to 332. After the implementation, the ward environment management and nurses' working state were improved. Adverse events (pressure ulcer, fall/drop from bed) were decreased. The qualified rate of patient identification arose. Patients and their relatives had a higher rate of medication and disease knowledge, and nurses had a higher rate of knowledge on the responsibility for diagnosis and major nursing points. The differences before and after the reform were significant (P<0.05). ConclusionThe elaborating reform can promote the efficiency of head nurse inspection and supervision, and ensure the nursing quality and safety outside the eight-hour administration.
ObjectiveTo investigate the incidence and trendency of healthcare-associated infections (HAIs) in a pediatric intensive care unit (ICU) of a hospital, identify the main objectives of infection control, and formulate corresponding preventive and control measures.MethodsA prospective targeted monitoring method was adopted to investigate HAIs in the pediatric ICU of a hospital from January 2013 to December 2018.ResultsFrom January 2013 to December 2018, the number of target ICU patients was 11 898, the number of patient-days was 55 159; 226 HAIs occurred, the HAI case rate was 1.90%, the incidence of HAI per 1 000 patient-days was 4.10‰, and the adjusted incidence of HAI per 1 000 patient-days was 1.21‰. The main infection site was respiratory tract [83 cases (36.7%)], with ventilator-associated pneumonia in 73 cases (32.3%); secondly, 69 patients (30.5%) had bloodstream infection, among which 48 (21.2%) had non-catheter-related bloodstream infection.ConclusionHospital targeted monitoring is helpful to grasp the situation and trend of HAIs, define the main target of infection control, and formulate corresponding preventive and control measures, which can effectively reduce the incidence of HAIs.
ObjectiveTo explore the changes of intraoperative temperature and influencing factors of the short-term prognosis of patients undergoing clipping of posterior communicating artery aneurysms.MethodsThe basic clinic data and intraoperative temperature of patients undergoing elective clipping of posterior communicating artery aneurysms between October 2018 and July 2019 were collected, and the minimum intraoperative temperature was categorized into ≥36.0 and <37.5℃, ≥35.0 and <36.0℃, and <35.0℃. According to the Glasgow outcome scale (GOS) at discharge, the patients were divided into good prognosis group (GOS 4-5) and bad prognosis group (GOS 1-3). Multiple logistic regression analysis was used to obtain the risk factors of short-term prognosis.ResultsA total of 127 cases were involved, and intraoperative hypothermia (<36.0℃) occurred in 64 cases (50.4%). The intraoperative temperature presented classical three-phrase changes, i.e. it dropped rapidly at 1 hour after anesthesia introduction, decreased slowly during 2-3 hours after anesthesia introduction, and then entered the plateau. In the 127 cases, 93 (73.2%) had good prognosis, with an intraoperative hypothermia proportion of 44.1% (41/93); and 34 (26.8%) had bad prognosis, with an intraoperative hypothermia proportion of 67.6% (23/34). Univariate analysis showed that Hunt-Hess grade (χ2=18.999, P<0.001), intraoperative bleeding (χ2=7.074, P=0.008), minimum intraoperative temperature (Z=−3.473, P=0.001), and postoperative complications (χ2=43.060, P<0.001) were related to the short-term prognosis of patients undergoing clipping of posterior communicating artery aneurysms. Multiple logistic regression analysis presented that high Hunt-Hess grade (Ⅳ, Ⅴ) [odds ratio (OR)=6.456, 95% confidence interval (CI) (1.141, 36.532), P=0.035], the minimum intraoperative temperature <35.0℃ [OR=7.552, 95%CI (1.450, 39.345), P=0.016], and postoperative complications [OR=22.866, 95%CI (6.778, 77.142), P<0.001] were independent risk factors of the short-term prognosis. The difference in short-term prognosis between patients with the minimum intraoperative temperature ≥35.0 and <36.0℃ and the ones with the minimum intraoperative temperature ≥36.0 and <37.5℃ was not statistically significant (P>0.05).ConclusionsThe minimum intraoperative temperature<35.0℃ and postoperative complications were changeable factors to effect progonosis of patients undergoing elective clipping of posterior communicating artery aneurysms. Clinical staff should set medical intervention measures based on the individual conditions of patients to improve patients’ quality of life.