医疗废物管理培训内容

医疗废物管理培训内容 《医疗废物管理条例》已于,,,？年,月,日公布施行。 一、《医疗废物管理条例》制定的目的: 1.为了加强医疗废物的 安全管理 企业安全管理考核细则加油站安全管理机构环境和安全管理程序安全管理考核细则外来器械及植入物管理 ～防止疾病传播～保护环境～保障人体健康～根据《中华人民共和国传染病防治法》和《中华人民共和国固体废物污染环境防治法》～制定本条例。 2.条例适用范围:各种医疗卫生机构～关于医疗废物的收集、运送、贮存、处臵以及监督管理等活动的规范化管理。 二、医疗废物分类目录 ,一,根据《医疗废物分类目录》～将医疗废物分为:?、感染性废物～?、病理性废物～?、损伤性废物～?、药物性废物～?、化学性废物。 医院收治的传染病病人或者疑似传染病病人产生的生活垃圾～按照医疗废物进行管理和处臵。医疗废物禁止与生活垃圾混放。不能出售:最好是焚烧或掩埋。 A、感染性废物:携带病原微生物具有引发感染性疾病、传播危险的医疗废物包括:?、被病人血液、体液、排泄物污染的物品,?、医疗机构收治的隔离传染病病人或者疑似specification erection and scaffolding inspection score requirements for acceptance in the JGJ59-99. (3) workers built a shelf arrangement through the training. (4) set up warning flags of the erection, dismantling, special care. (5) checks on a regular basis. 2, control point: (1) the material must comply with the specified requirements. (2) when used according to the provisions of the load required to use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well within the scaffolding must be protection in place, no foot shaft with two-layer within a quarantine or every 10m the provision of a safety net. (4) facilities available to coordinate and transfer procedures, demolition of a large scaffolding with programme, and approved before implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the construction work is an important part of safety. 1, the implementation of points: (1) led group under the leadership of the fire, found according to key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the project to establish volunteer fire brigade, normal activities. (3) the construction site must be equipped with adequate fire-fighting equipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, control point: (1) 传染病病人产生的生活垃圾,?、病原体的培养基、标本和菌种、毒种保存液。?、各种废弃的医学标本。?、废弃的血液、血清。?、使用后的一次性使用医疗用品及一次性医疗器械视为感染性废物。 B、病理性废物:诊疗过程中产生的人体废弃物和医学实验动物尸体等。?、手术及其他诊疗过程中产生的废弃人体组织、器官等?、医学实验动物的组织、尸体。?、病理切片后废弃的人体组织、病理腊块等。 C、损伤性废物:能够刺伤或者割伤人体的废弃的医用锐器。?医用针头、缝合针。?各类医用锐器包括:解剖刀.手术刀.备皮刀.手术锯等。?、载玻片、玻璃试管、玻璃安瓿等。 D、药物性废物:过期、淘汰、变质或者被污染的废弃的药品。?废弃的一般性药品～如:抗生素、非处方类药品等。 ?、废弃的细胞毒性药物和遗传毒性药物～包括:致癌性药物～可疑致癌性药物～免疫抑制剂。?、废弃的疫苗、血液制品等。 E、化学性废物:具有毒性、腐蚀性、易燃易爆性的废弃的化学物品。 ?医学影像室、实验室废弃的化学试剂。?废弃的过氧乙酸、戊二醛等化学消毒剂。?废弃的汞血压计、汞温度计。 ?生活垃圾:包括病人吃的剩余饭菜、果皮、果核、罐 an important part of safety. 1, the implementation of points: (1) led group under the leadership of the fire, found according ork isfore implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the construction wfacilities available to coordinate and transfer procedures, demolition of a large scaffolding with programme, and approved belayer within a quarantine or every 10m the provision of a safety net. (4) -ding must be protection in place, no foot shaft with twoo use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well within the scaffolired tint: (1) the material must comply with the specified requirements. (2) when used according to the provisions of the load reque training. (4) set up warning flags of the erection, dismantling, special care. (5) checks on a regular basis. 2, control po99. (3) workers built a shelf arrangement through th-specification erection and scaffolding inspection score requirements for acceptance in the JGJ592l point: (1)fighting equipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, contro-nteer fire brigade, normal activities. (3) the construction site must be equipped with adequate firevoluto key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the project to establish 头盒、饮料瓶、手纸、各种包装纸、粪、尿等排泄物。 ,二,医疗废物专用包装物、容器要求: ?“感染性废物”、“病理性废物”用黄色防渗漏、可封闭的塑料袋或容器装～并注明。 ? 损伤性废物注明“损伤性废物”～用黄色不易刺破～防渗漏、可封闭的容器,锐器盒, ? 药物性废物注明“药物性废物”～褐色塑料袋或容器 ? 化学性废物注明“化学性废物”～用黄色容器 ,三,清洁工、护工人员的自身防护措施和损伤后处理方法。 职业暴露的定义:职业暴露:是指由于职业关系而暴露在危险因素中～从而有可能损害健康或危及生命的一种情况。 医务人员职业暴露:是指医务人员在从事诊疗、护理活动过程中接触有毒、有害物质～或传染病病原体～从而损害健康或危及生命的一类职业暴露。 途经一:皮肤黏膜暴露 由于在工作中要面对各种不同的患者～医务人员接触各种病原体的概率远比普通人群高。医务人员的皮肤黏膜暴露于患者的血液或体液中～精液、阴道分秘物、滑液、脑脊液、胸膜液、心包液、腹膜液、羊水、处理牙齿过程中的唾液等均存在着医务人员被感染的危险。 struction work is an important part of safety. 1, the implementation of points: (1) led group under the leadership of the firapproved before implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the con cedures, demolition of a large scaffolding with programme, andlayer within a quarantine or every 10m the provision of a safety net. (4) facilities available to coordinate and transfer pro-the scaffolding must be protection in place, no foot shaft with two withinhe load required to use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well , control point: (1) the material must comply with the specified requirements. (2) when used according to the provisions of tl care. (5) checks on a regular basis. 299. (3) workers built a shelf arrangement through the training. (4) set up warning flags of the erection, dismantling, specia-ication erection and scaffolding inspection score requirements for acceptance in the JGJ59specif3ipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, control point: (1)fighting equ-to establish volunteer fire brigade, normal activities. (3) the construction site must be equipped with adequate fire und according to key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the projecte, fo 高危感染性体液:血液 ～精液 ～胸水～腹水～脑脊液 ～羊水～组织～阴道分泌物～脓液。 低危感染性体液:唾液、痰液、泪液、汗液、尿、粪便 途经二:锐器伤 文献报道～因职业感染途径中针刺损伤占80%～现已证实～有20种病原体可经针刺伤传播～其中一旦经针刺伤即可发生感染的有艾滋病病毒、乙型肝炎病毒。在美国～大约有440万名医务人员～其每年平均发生针刺和其他锐利器械损伤事件约80万人次～其中约1(6万人次感染艾滋病病毒、乙型肝炎病毒及丙型肝炎病毒。 途经三:手 北京某大医院的感染控制专业人员～按医疗护理操作规程计算过～作治疗的护士一天应洗15至20次手。管床的医生一天应洗10至15次手。医生、护士和其它医务人员做一个简单的操作都可能增加手上的细菌100-1000个～如:把病人从床上扶起来～测量血压或脉搏～接触病人的手～给病人翻身～接触病人的衣服或床单～接触床头柜、床垫、输液。 途径四:空气传播 国内外调查表明～空气是病原体传播的重要途径之一～尤其是在医院～空气中的病原体来源于患者呼吸道分泌物、伤口脓液、排泄物、皮肤屑等～干燥后形成菌尘～通过 fighting equipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, contro-nteer fire brigade, normal activities. (3) the construction site must be equipped with adequate firevoluto key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the project to establish an important part of safety. 1, the implementation of points: (1) led group under the leadership of the fire, found according ork isfore implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the construction wfacilities available to coordinate and transfer procedures, demolition of a large scaffolding with programme, and approved belayer within a quarantine or every 10m the provision of a safety net. (4) -ding must be protection in place, no foot shaft with twoo use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well within the scaffolired tint: (1) the material must comply with the specified requirements. (2) when used according to the provisions of the load reque training. (4) set up warning flags of the erection, dismantling, special care. (5) checks on a regular basis. 2, control po99. (3) workers built a shelf arrangement through th-specification erection and scaffolding inspection score requirements for acceptance in the JGJ594l point: (1) 讲话、咳嗽、喷嚏、清扫整理病房、人员走动、物品传递、空气流动等扬起而污染空气。一些医疗器械如呼吸机、雾化器、吸引器等在操作过程中也会把病原体播散到空气中。 感染性职业暴露后的处理 发生感染性职业暴露～主要指锐器伤、皮肤粘膜暴露后～处理程序包括: 职业暴露现场处理流程图 1(职业暴露部位----皮肤刺伤----健侧手立即从近心端向远心端挤压受 伤部位～使部分血液排出--- 75%酒精、0.5%碘伏或0.2-0.5%过氧乙 酸涂抹消毒。 2(职业暴露部位----粘膜损伤----先用肥皂再用生理盐水或清水冲洗-- 0.5%碘伏冲洗或涂抹消毒。 3(职业暴露部位---溅入口腔眼睛----用清水、生理盐水长时间彻底冲洗 职业暴露部位---完整皮肤污染----肥皂和生理盐水冲洗----一般性消毒 医务人员在下列情况下需要洗手 处理污染物品后,穿脱隔离衣前后～摘手套后,接触病人的血液、体液、分泌物、排泄物、黏膜、破损皮肤或伤口敷料后,接触伤口前后, -to establish volunteer fire brigade, normal activities. (3) the construction site must be equipped with adequate fire und according to key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the projecte, fostruction work is an important part of safety. 1, the implementation of points: (1) led group under the leadership of the firapproved before implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the con cedures, demolition of a large scaffolding with programme, andlayer within a quarantine or every 10m the provision of a safety net. (4) facilities available to coordinate and transfer pro-the scaffolding must be protection in place, no foot shaft with two withinhe load required to use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well , control point: (1) the material must comply with the specified requirements. (2) when used according to the provisions of tl care. (5) checks on a regular basis. 299. (3) workers built a shelf arrangement through the training. (4) set up warning flags of the erection, dismantling, specia-ication erection and scaffolding inspection score requirements for acceptance in the JGJ59specif5ipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, control point: (1)fighting equ 医务护人员在下列情况下应进行手的消毒: 进行无菌操作之前,诊查、护理、治疗免疫功能低下的病人之前～进入隔离病房、重症监护病房、烧伤病房、新生儿重症病房、进入传染病房等重点感染科室之前及离开这些病房脱隔离衣后,接触未经消毒的仪器和设备之后,理特殊易感病人前后。双手直接为传染病人检查、治疗、护理或处理传染病人污物后,接触具有传染性、血液、体液和分泌物之后,接触被传染性致病微生物污染的物品后,需双手保持较长时间抗菌活性～如需戴无菌手套时。 戴手套 医务人员接触病人的的血液、体液、分泌物、排泄物及其污染物品时～接触病人粘膜和非完整皮肤前均应戴手套,对同一病人既接触清洁部位～又接触污染部位时应更换手套。医务人员手部皮肤发生破损～在进行有可能接触病人血液、体液的诊疗和护理操作时必须戴双层手套。有研究表明:如果一个被血液污染的钢针刺破一层乳胶手套或聚乙烯手套～医务人员接触的血量比未戴手套可能接触到的血量少50%以上。国内还有研究者对供应室回收人员的手上细菌进行了检测。其结果为:戴手套操作后～不脱手套细菌检测率达100,～表明手套上微生物存留严重,脱手套后未洗手者～手细菌检测不合格率为26(7,,脱手套后用机械清洁法洗手后～手细菌检测菌数则明显减少～全部合格。 6l point: (1)fighting equipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, contro-nteer fire brigade, normal activities. (3) the construction site must be equipped with adequate firevoluto key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the project to establish an important part of safety. 1, the implementation of points: (1) led group under the leadership of the fire, found according ork isfore implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the construction wfacilities available to coordinate and transfer procedures, demolition of a large scaffolding with programme, and approved belayer within a quarantine or every 10m the provision of a safety net. (4) -ding must be protection in place, no foot shaft with twoo use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well within the scaffolired tint: (1) the material must comply with the specified requirements. (2) when used according to the provisions of the load reque training. (4) set up warning flags of the erection, dismantling, special care. (5) checks on a regular basis. 2, control po99. (3) workers built a shelf arrangement through th-specification erection and scaffolding inspection score requirements for acceptance in the JGJ59 个人防护 与普遍预防相同～在病人的血液、体液、分泌物、排泄物等有可能发生喷溅时应戴眼罩、口罩～并穿防护衣～以防止医务人员皮肤、粘膜和衣服的污染,牙医工作时会产生大量的气雾～例如水枪、手机冷却系统和超声洁牙机会使空气中漂浮的细菌数增加30倍～这种气雾是具有高度感染性的,相对于常人～医生的感染风险是双倍的～而对于口腔医生～感染的危险增大到3倍,据国外数据～一般人群乙肝病毒携带者为2-5%～普通口腔医生为16%～口外医生为24%～我国口腔科医生50,为乙肝表面抗原阳性 正确处理锐器 1(禁止将使用后的一次性针头重新套上针头套。 2(禁止用手直接接触使用后的针头、刀片等锐器。 3. 禁止用手分离使用过的针头和针筒。 4(禁止直接传递锐器物。 5(禁止手持锐器物指向他人。锐器收集到3/4满即停止使用～以减少刺伤的机会 e, fostruction work is an important part of safety. 1, the implementation of points: (1) led group under the leadership of the firapproved before implementation. Fire safety fire safety at construction site and to facilitate the smooth progress of the con cedures, demolition of a large scaffolding with programme, andlayer within a quarantine or every 10m the provision of a safety net. (4) facilities available to coordinate and transfer pro-the scaffolding must be protection in place, no foot shaft with two withinhe load required to use, it is forbidden to place all kinds of construction materials, and avoid overloading. (3) tube, well , control point: (1) the material must comply with the specified requirements. (2) when used according to the provisions of tl care. (5) checks on a regular basis. 299. (3) workers built a shelf arrangement through the training. (4) set up warning flags of the erection, dismantling, specia-ication erection and scaffolding inspection score requirements for acceptance in the JGJ59specif7ipment, is maintained by the project safety, management, regular updates, guaranteed in good condition. 2, control point: (1)fighting equ-to establish volunteer fire brigade, normal activities. (3) the construction site must be equipped with adequate fire und according to key parts of the fire protection system against fire hazards must be immediately eliminated. (2) the project