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Hospital sense of hand hygiene knowledge

Hospital sense of hand hygiene knowledge

1. What is hand hygiene: the general term for hand-washing, disinfection of hand hygiene and surgical disinfection.

2. Handwashing: washing hands with soap or soap and mobile water to remove dirt, debris and some pathogenic bacteria from the hands.

3. Sanitary hand disinfection: refers to hand sanitizer hand-wiping process.

4. Surgical hand disinfection: refers to the hand disinfectant to eliminate or kill hand temporary bacteria and reduce the habit of bacteria in the process.

5. Habitat bacteria: also known as indigenous bacteria, from the skin of most people isolated from microorganisms. This microorganism is an inherent permanent resident on the skin and is not easily removed by mechanical friction. Such as coagulase-negative staphylococcus, corynebacterium, propionic acid bacteria, Acinetobacter and so on.

6. Temporary bacteria: also known as contaminated bacteria or passenger bacteria, residing in the skin surface, regular hand-washing is easy to be removed by microorganisms. Available when in contact with the surface of a patient or contaminated object, ready to be transmitted by hand.

7. A survey shows that the use of solid waste soap in China's ICU bacterial contamination up to 100 cfu / g.

8. If applied solid soap should be kept clean and dry.

9. Requirements for the hand washing facilities in the clinic area

① mobile wash basin ② non-touch switch ③ liquid soap ④ appropriate dry hands measures

10. Medical staff should wash their hands in the following cases:

① direct contact with the patient before and after;

② contact with blood, body fluids, secretions, excrement, wound dressing and after the treatment of dirt;

③ wear clothes before and after isolation, after picking gloves;

④ before and after aseptic operation;

⑤ leave the hospital, clinic, ward.

11. Wash your hands when rubbing steps and time requirements

Wash hands with soap hands rub time not less than 15 seconds, rubbing steps:

① palm relative, fingers close together, rub each other;

② palmar opponents along the back of the fingers rub each other, exchange;

③ palm relative, hands and fingers rub each other;

④ right thumb holding his left hand rotating rub, exchange;

⑤ bending fingers to rotate the joints in the other hand rubbing, exchange;

⑥ the five fingertips close together on the other palm rotation rub, exchange; if necessary, increase the wrist cleaning.

12. Strict implementation of the correct hand washing rules can reduce nosocomial infections by 30%.

13. Medical staff should carry out the isolation and protection measures during the operation of oral cavity:

① wear masks, hats, the patient's blood may appear, body fluids splashing, should wear goggles.

② Before each operation and after the operation should be strictly hand-washing or hand disinfection.

③ medical staff wearing gloves operation, each treatment of a patient should be replaced by a pair of gloves and hand-washing or hand disinfection.

14. Gloves should also be washed before operation, the use of gloves and can not replace hand or hand lotion to clean the hands.

15. Isolation divided into four categories: spray isolated air isolation contact isolation protective isolation

16. Sterilizing bags dropped on the ground or misplaced unclean, should be regarded as contaminated, to be reprocessed.

17 disinfection and sterilization principles: medical supplies into human tissues or sterile organs must be sterilized; contact with skin and mucous membranes of appliances and supplies must be disinfected.

18. Microbial disinfection factor sensitivity in descending order is: lipophilic virus, bacterial propagules, fungi, hydrophilic viruses, bacterial spores, prions.

19. Pre-vacuum pressure steam sterilization sterilization package requirements: the volume does not exceed 30cm × 30cm × 50cm; metal package weight does not exceed 7kg, dressing package does not exceed 5kg.

20. Treatment rooms, dressing room on the time limit for the use of sterile goods requirements: the withdrawal of liquid medicine, open the intravenous use of sterile liquid to be specified time, more than 2 hours after the use of unsealed pumping more than the various solvents 24 hours can not be used. Sterile storage tank placed in a sterile items (cotton balls, gauze, etc.) once opened, the use of the longest no more than 24 hours. Sterile plate does not exceed 4 hours.

21. Anesthetic apparatus cleaning and disinfection requirements: should be regularly cleaned and disinfected, contact with the patient's supplies one by one disinfection; strict compliance with the principles of disposable medical supplies management.

22. Three levels of hospital infection management network organizations: Hospital Infectious Diseases Committee, Hospital Feeling Section, the hospital infection control team.

23. Medical staff hospital infection duties:

① strictly enforce the aseptic technique and other hospital infection management rules and regulations;

② grasp the principle of clinical rational use of anti-infective drugs, so that a reasonable application;

③ grasp the diagnostic criteria of nosocomial infection, timely diagnosis of nosocomial infections;

④ found cases of hospital infections, timely delivery of pathogen test and drug susceptibility testing, find the source of infection, the route of infection, control of spread, and actively treat patients, truthfully fill out the report; found that the prevalence of nosocomial infection, Assist in the investigation. Found that the legal infectious disease, according to "infectious disease prevention and control law" provisions of the report;

⑤ attend the hospital to organize a variety of prevention, control of hospital infection knowledge training;

⑥ master self-protection knowledge, the correct conduct of technical operations, prevention of sharp injuries.

24. Clinical infection monitoring team responsibilities:

Responsible for the management of infection in undergraduate hospitals, according to the characteristics of undergraduate hospital infection, develop the relevant management system and disinfection and isolation measures, and organize the implementation of;

② supervise undergraduate staff to implement aseptic technique procedures and disinfection and isolation system;

(3) To monitor hospital infection cases and infection and take effective measures to reduce the incidence of undergraduate hospital infection. In case of epidemic tendency of nosocomial infection, promptly report to SENS and actively assist in the investigation;

④ supervise the rational use of anti-infective drugs in undergraduate room;

⑤ organize undergraduate staff to prevent and control the training of knowledge of hospital infection, hospital infection should be related to knowledge included in the contents of the study business.

25. Hospital of our hospital key departments:

Surgery room, neonatal ward, hemodialysis room, DSA, various intensive care unit, stomatology, laboratory, endoscopy room, disinfection supply room, hematology, infectious diseases and so on.

26. Hospital infection control indicators are: the incidence of hospital infection rate ≤ 10%, sterile surgical incision (Ⅰ) infection rate ≤ 0.5%, false negative rate ≤ 20%.

27. Nosocomial infections: In-hospital infections acquired by inpatients, including infections that occur during hospitalization and those that occur after they have been discharged from the hospital but do not include an infection that has started before admission or is already in an incubation period at admission. Hospital staff also received hospital infection infection.

28. "Diagnostic criteria of nosocomial infection (Trial)" provides the following conditions are nosocomial infections

Infection without a definite incubation period prescribes an infection that occurs 48 hours after admission, with a clear latent infection, an infection that has passed the average incubation period since admission,

② The infection was directly related to the last hospitalization;

③ In addition to the original infection on the other parts of the new infection (except for sepsis migratory foci), or infection in the hospital so that pathogens based on the separation of new pathogens (excluding contamination and the original mixed infection) infection;

④ newborns in childbirth and postpartum acquired infection;

⑤ As a result of treatment and access to potential infections, such as herpes virus, Mycobacterium tuberculosis and other infections;

⑥ medical staff acquired during the hospital infection.

29. "Diagnostic criteria of hospital infection (Trial)" provides the following conditions do not belong to nosocomial infection

① skin mucosa open wounds only bacterial colonization without inflammation;

② due to trauma or non-biological factors that stimulate the performance of inflammation;

③ neonatal placental acquired (within 48 hours after onset) of infections, such as herpes simplex, toxoplasmosis, chicken pox and so on;

④ patients with the original chronic infection in the hospital an acute attack.

30. Outbreaks of nosocomial infections refer to the phenomenon of more than 3 cases of homologous infections in a short period of time among patients in medical institutions or their departments.

31. Report of hospital infection requirements

(1) report a nosocomial infection within 24 hours after the diagnosis of a hospital-acquired nosocomial infection and report an outbreak trend immediately.

(2) Confirmed the following conditions should be reported to the hospital immediately sensory, Narcotics Division immediately report to the hospital department, the hospital must report to the Health Bureau and the CDC within 12 hours: ① more than 5 cases of outbreaks of hospital infection; ② as a direct result of nosocomial outbreaks Patients died; ③ as a result of nosocomial infections led to more than 3 people damage the consequences.

(3) In the following cases, the hospital should be immediately informed of the sensory medicine, the total duty, the hospital in accordance with the "national public health emergencies related information reporting management practices (for Trial Implementation)" requirements: ① more than 10 cases of hospital outbreaks; Nosocomial infection of a particular pathogen or a new pathogen; nIncidence of a nosocomial infection that may have significant public or serious consequences.

(4) If a hospital infection in a medical institution is a notifiable infectious disease, it shall be reported and dealt with in accordance with the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases and the Emergency Plan of the State's Public Health Emergencies.

32. Infection by pathogen can be divided into two categories: endogenous and exogenous.

33. Pathogen characteristics of nosocomial infections

(1) mostly opportunistic pathogens, mainly gram-negative bacilli;

(2) Due to the selective effect of antibacterial drugs, the pathogens are often resistant to many antibacterial drugs;

(3) a pathogen can cause multiple parts of the infection, a site can also be caused by a variety of pathogens.

34. Common bacteria that cause nosocomial infections

① G-bacteria in Escherichia coli, Pseudomonas aeruginosa, Klebsiella and cloacae-based.

② G + cocci Staphylococcus aureus, Staphylococcus epidermidis, enterococci based.

35. The basic principles of submission of microbiological specimens

① infection or suspected infection should be timely collection of microbial specimens for etiological examination, the pathogen delivery rate should not be less than 80%.

② in the acute phase of infection, the use of antimicrobial agents or wounds before the local treatment of samples collected.

③ collection of the true infection of the lesion at the sample, and sufficient. Strict implementation of collection of specimens aseptic operation, to avoid contamination of the habitants in the vicinity of the habitat to minimize the pollution.

④ collection of specimens immediately after submission, the best within 2h. If they can not be submitted in time, the specimens should be placed in the appropriate storage environment to be sent, but the storage can not be more than 24h.

⑤ mixed with normal flora specimens, can not be placed broth training.

⑥ specimen containers to be sterilized to prevent leakage, but may not use disinfectants. Preservatives can not be added to the specimen.

⑦ inspection specimens should indicate the source and test purposes, so that the laboratory can correctly select the appropriate culture medium and suitable culture environment.

36. Blood culture specimens collection and delivery requirements

Patients suspected of bacteremia, blood culture should be taken immediately prior to the use of antimicrobial drugs. If you can chills, fever within 1 hour before and after collecting the best. Recommended peripheral venous blood collection, do not advocate the use of arterial blood, venous catheter or indwelling port blood samples were cultured.

Blood inoculation blood culture flask must be immediately sent to the microbiology laboratory. Blood culture bottles that have not been submitted in time should be stored at room temperature.

37. Indwelling catheters urine specimens taken

Available iodine disinfection of the urethra at the ureter wall, with a sterile syringe diagonally through the wall to suck the urine; or pull the drainage bag closed drainage set, to discard the urine before the catheter, leaving non-polluting Urine bladder a few milliliters of submission. Do not take samples from the lower end of the urine collection bag.

38. Surgical site infection (SSI) refers to the incision, surgical deep organs or lacunar infections

39. There are three main sources of infection of surgical infections

① staff (surgery staff hand, hair, upper respiratory tract)

② patients (the four normal bacterial flora of patients)

③ environment (including the operating room environment, equipment, disinfectants, dressings, etc.)

40. Preoperative skin preparation surgery the correct time, place, way should be

On the day of surgery, the operating room, scissors or hair removal agent.

41. Surgery in patients with hypothermia hazards: patients can reduce oxygen intake, leading to: ① damage neutrophil bactericidal ability

② reduce collagen deposition, delayed wound healing.

42. Intraoperative insulation measures are: ① the use of insulation pads or blankets ② minimize exposure to parts ③ using hot lavage solution

43. A method of preventing ventilator associated pneumonia (VAP)

① bed elevation 30 degrees

(2) once daily sedatives and evaluation of whether weaning

③ disable stress ulcer prevention drug as soon as possible

④ oral care

⑤ intubation bag above the secretion of airbags attract

44. Prevention of surgical site infection (SSI) method

① preoperative 0.5 ~ 1h antibiotics, 24h disabled

② avoid unnecessary skin preparation, the day of surgery skin preparation

③ during the operation to patients warm

④ perioperative glycemic control normal level

⑤ shorten the preoperative hospital stay

⑥ mandatory reporting rate of infection to the public

45. A method of preventing a catheter-related bloodstream infection (CR-BSI)

① indwelling catheter surgery using large drapes

② skin disinfection

③ try to use the subclavian vein puncture site

④ strict implementation of hand hygiene rules

⑤ daily assessment of the need to continue catheterization

46. The Ministry of Health calls for the strengthening of drug-resistant bacteria for surveillance and control

Methicillin-resistant Staphylococcus aureus (MRSA)

Vancomycin-resistant Enterococcus (VRE)

Produce extended-spectrum β-lactamase (ESBLs) bacteria

Pan-resistant Acinetobacter baumannii (PDRAB)

47. The reason for the increase of resistant bacteria

① increase in drug-resistant bacteria (antibiotic selective pressure): due to doctors too much use of antibiotics, resulting in gene mutations and resistance gene transfer of resistant bacteria were screened

② increased transmission of drug-resistant bacteria: the medical staff, especially by hand exposure, cross-parasitic bacteria in patients caused by the transmission of resistant strains in the hospital, and subsequent transfer of host patients, resistant bacteria in the hospital and even community transmission

48. The main measures for the effective prevention and control of the spread of multi-drug resistant bacteria

① strengthen medical hand hygiene

② strict implementation of isolation measures

③ comply with aseptic techniques and practices

④ strengthen hospital environmental health management

51. Flora are divided into three categories

Eccentric disorders, metastasis, endogenous infections.

52. The Ministry of Health Office issued "on the further strengthening of the clinical application of antibacterial drugs," the clinical application of antimicrobial agents early warning mechanisms are:

① antibacterial drug resistance rate of more than 30% of the anti-bacterial drugs should be early warning information promptly notify the medical institutions and medical personnel;

② bacterial resistance rate of more than 40% of antimicrobial drugs should be careful experience medication;

③ antibacterial drug resistance rate of more than 50% of antimicrobial drugs should refer to drug susceptibility test results;

④ antibiotic resistance rate of more than 75% of antibiotics should be suspended clinical application of such antimicrobial drugs, bacterial resistance based on monitoring results, and then decide whether to resume clinical application.

53. Neonatal patients with the basic principles of antimicrobial application

① should avoid the application of toxic antibacterial drugs, including mainly by the renal excretion of aminoglycosides, vancomycin, vancomycin and so on, and mainly by the hepatic metabolism of chloramphenicol

② avoid or disable the possibility of serious adverse reactions of antimicrobial drugs.

③ avoid the application can affect the growth and development of newborn tetracyclines, quinolones.

④ avoid the application can lead to cerebral kernicterus and hemolytic anemia sulfa drugs and furans drugs.

⑤ mainly by renal excretion of penicillins, cephalosporins and other β-lactam drugs need to be reduced.

54. Antibacterials are divided into non-restricted use, restricted use and special use of the three categories of grading management.

55. The principle of antimicrobial drug delivery method is: can not oral intramuscular injection, intravenous injection can be intramuscularly.

56. The basic principles of antimicrobial prophylaxis for surgery: Depending on whether the surgical field is contaminated or contaminated, decide whether to prevent medication. Class Ⅰ incision surgery generally do not prevent the use of antibacterial drugs

 

 

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