医院感染基本概念

医院感染基本概念 一、有关基本概念 l、什么叫医院感染? 答:医院感染是指住院病人在医院内获得的感染～既包括在住院期间发生的感染～也包括在住院时获得出院后发生的感染,但不包括入院前已开始或入院时已处于潜伏期的感染。医院工作人员在医院内获得的感染也属医院感染。 2、医院感染按获得病原体的来源分哪几类? 答:医院感染按获得病原体的来源分两类:(1)外源性感染:外源性感染也称交叉感染～是指病人或工作人员在医院内通过日常诊疗活动、病人或病人间的接触或从污染的外环境中而接受的感染。(2)内源性感染:内源性感染也称自身感染～是指病人由于疾病导致机体抵抗力下降～在接受诊疗处理的过程中～体内正常菌群发生紊乱、激活机体潜在的病菌、患者体腔或体 表 关于同志近三年现实表现材料材料类招标技术评分表图表与交易pdf视力表打印pdf用图表说话 pdf 原来存在的常驻微生物发生移位等而引起的感染。 3、哪些情况属于医院感染? 答:(1)对于无明确潜伏期的感染～规定在入院48h后发生的感染为医院感染,有明确潜伏期者则以自入院时超过平均(或常见)潜伏期的感染。(2)本次感染直接与上次住院有关。(3)在原有感染基础上出现其他部位新的感染(脓毒血症迁徙灶除外)～或在原感染已知病原体基础上又分离出新的病原体(排除污染和原来的混合感染)的感染。(4)新生儿在分娩过程中和产后获得的感染。(5)经诊疗措施激活的潜在性感染～如疱疹病毒、结核杆菌等的感染。(6)医务人员在医院工作期间获得的感染。 4、哪些情况不属于医院感染?答:(1)皮肤粘膜开放性伤口只有细菌定植而无炎症表现。 (2)由于创伤或非生物性因子刺激而产生的炎症反应。(3)新生儿经胎盘获得(出生后48h 内发病)的感染～如单纯疱疹、弓形体病、水痘等。(4)患者原有的慢性感染在医院内急性发作。 5、某患者在住院第四天时出现了泌尿系统感染症状～该患者是否属于医院感染,为什么,答:属于医院感染。因为没有明确潜伏期的感染～在入院48小时后发生的感染均属于医院感染。 6、某患者因腿部皮肤感染久治不愈而入住某科～入院后行创面分泌 物培养为铜绿假单胞菌生长～经一周的治疗后再次做细菌培养又发现表皮葡萄菌生长～此次感染是否属于医院感染,为什么,答:该患者fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 属于医院感染。因为是在原感染已知病原体基础上又分离出新的病原体的感染。 7、新生儿在出生48小时内发现的弓形体病、单纯疱疹及水痘属于医院感染吗,答:不属于医院感染。因为该新生儿是在出生后48小时内即发病～是经胎盘获得的感染。 8、什么叫医院感染散发,答:医院感染散发是指医院感染在某医院或某地区住院病人中历年的一般发病率水平。 9、什么叫医院感染暴发,答:医院感染暴发是指在某医院、某科室的住院病人中～短时间内突然发生3例以上同种同源感染病例的现象。 10、什么叫医院感染流行,医院感染流行的三个环节是什么,答:医院感染流行是指某医院、某科室～医院感染病例发病率显著超过历年散发病例水平。感染的三个环节包括感染源、感染途径、易感者。 11、医院感染的特点是什么,答:医院感染具有以下三个特点:医院感染大多数由病人自身正常菌群引起,这些菌群往往是耐药性的菌群,可以发生流行。 12、什么叫二重感染? 答:二重感染是指正常菌群被抑制～条件致病菌或外来致病菌的大量繁殖而出现的新的感染。主要诱因是大量广谱抗生素的使用。 13、什么叫医院感染发病率,其意义是什么,答:医院感染发病率指在一定时间住院病人中新发医院感染病例的频率。它可以反映医院感染发生的强度～描述医院感染的分布情况～研究与危险因素的关系及病因或流行因素～评价预防措施或监控的效果。 14、什么叫医院感染例次发病率,答:医院感染例次发病率是指在一定时间内住院病人中发生医院感染例次的频率。 15、“三级甲等医院”的医院感染率及漏报率应控制在什么范围? 答:“三级甲等医院”的医院感染率及漏报率应?10,～漏报率?10,。 16、医院感染管理三级网络组织由哪几部分组成? 答:医院感染管理三级网络组织由医院感染管理委员会、医院感染管理科、医院感染管理监控小组三部分组成。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 17、哪些病人属于医院感染重点监测对象,答:,1,所患疾病严重影响或损伤机体免疫功能者。,2,接受各种免疫抑制疗法者。,3,长期使用抗生素者。,4,接受各种损伤及介人性检查、诊断、治疗者。,5,老年、婴幼儿及营养不良者。,6,住院时间长者。 二、 标准 excel标准偏差excel标准偏差函数exl标准差函数国标检验抽样标准表免费下载红头文件格式标准下载 预防与职业防护 1、什么叫标准预防,答:标准预防认定病人的血液、体液、分泌物、排泄物均具有传染性～必须进行隔离～不论其是否具有明显的血迹污染或是否接触非完整的皮肤 与粘膜～接触上述物质者～都必须采取防护措施。 2、标准预防的特点是什么,答:,1,既能防止血源性疾病的传播～也能防止非血源性疾病的传播。,2,强调双向防护～既要预防疾病从病人传至医务人员～又要防止疾病从医务人员传染给病人～因此～既能保护医务人员～又能保护病人。,3, 根据疾病的主要传播途径～ 采取相应的隔离措施～包括接触隔离、空气隔离和微粒隔离。 3、标准预防的具体措施包括哪些? 答:标准预防的措施包括:,1,洗手,,2,手套,,3,面罩,,4,隔离衣,,5,可重复使用的器械,,6,医院环境,,7,被服,,8,职务健康安全。隔离具体措施有:,接触血液、体液、分泌物、排泄物等物质以及被其污染的物品时应当戴手套～脱去手套后应立即洗手～必要时进行手消毒。,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。,医务人员的工作服、脸部及眼睛有可能被血液、体液、分泌物等物质喷溅到时～应当戴一次性外科口罩或者医用防护口罩、防护眼镜或者面罩,有可能发生血液、体液大面积飞溅或者有可能污染医务人员的身体时～还应当穿戴具有防渗透性能的隔离衣或者围裙。?医务人员在进行侵袭性诊疗、护理操作过程中～要保证充足的光线～并特别注意防止被针头、缝合针、刀片等锐器刺伤或者划伤。?使用后的锐器应当直接放人耐刺、防渗漏的利器盒～或者利用针对处理设备进行安全处臵。?禁止将使用后的一次性针头重新套上针头套。禁止用手直接接触使用后的针头、刀片等锐器。 4、医务人员个人分级防护有几级,各级适宜对象是哪些,答:一般分三级防护～一级防护针对发热门(急)诊医护人员,二级防护针对进fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 入隔离留观室和专门病区的工作人员,三级防护针对与病人密切接 触～病人实施特殊治疗的医护人员。 5、医护人员什么情况下须采取三级防护措施,答:医护人员在重大传染病发生时必须采取三级防护措施。 6、什么叫职业暴露,答:职业暴露是指医务人员从事诊疗、护理等工作过程中意外被各种感染性疾病病毒感染者或者病人的血液、体液(包括羊水、心包液、胸腔液、腹腔液、脑脊液、滑液、阴道分泌物等人体物质)污染了皮肤或者粘膜～或者被含有病毒的血液、体液污染了的针头及其他锐器刺破皮肤～有可能被感染的情况。 7、医务人员发生职业暴露后的紧急处理措施包括哪些,答:(1)医务人员发生职业暴露后如有伤口应立即用流动水清洗皮肤～用生理盐水冲洗黏膜～同时在伤口旁边轻轻挤压直至无血液流出～伤口冲净后应用75,酒精或0.5,碘伏进行消毒并包扎。,2,确定暴露源及暴露级别。,3,医务人员发生了职务暴露后应及时填写“医务人员职业暴露登记卡”报院感科～登记主要内容是:职业暴露发生时间、地点、暴露方式、暴露的具体部位及损伤程度及暴露源的基本情况。 三、手卫生 1、什么是手卫生,答:为医务人员洗手、卫生手消毒和外科手消毒的总称。 2、什么是洗手,答:医务人员用肥皂,皂液,和流动水洗手～去除手部皮肤污垢、碎悄和部分致病菌的过程。 3、什么是卫生手消毒,答: 医务人员用速干手消毒剂揉搓双手～以减少手部暂居菌的过程。 4、什么是外科手消毒,答:外科手术前医务人员用肥皂,皂液,和流动水洗手～再用手消毒剂清除或者杀灭手部暂居菌和减少常居菌的过程。使用的手消毒剂可具有持续抗菌活性。 5、什么是常居菌,答:能从大部分人体皮肤上分离出来的微生物～是皮肤上持久的回有的寄居菌～不易被机械的摩擦清除。如凝固酶阴性葡萄球菌、棒状杆菌类、丙酸菌属、不动杆菌属等。一般情况下不致病。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 6、什么是暂居菌,答:寄居在皮肤表层～常规洗手容易被清除的微生物。直接接触患者或被污染的物体表面时可获得～可随时通过手传播～与医院感染密切相关。 7、什么是手消毒剂, 答:用于手部皮肤消毒～以减少手部皮肤细菌的消毒剂～如乙醇、异丙醇、氯已定、碘伏等。 8、什么是速干手消毒剂,答:含有醇类和护肤成分的手消毒剂～包括水剂、凝胶和泡沫型。 9、手卫生设施包括哪些, 答:用于洗手与手消毒的设施～包括洗手池、水龙头、流动水、清洁剂、干手用品、手消毒剂等。 10、洗手与卫生手消毒应遵循原则是什么,,1,当手部有血液或其他体液等肉眼可见的污染时～应用肥皂,皂液, 和流动水洗手。,2, 手部没有肉眼可见污染时～宜使用速干手消毒剂消毒双手代替洗手。 11、洗手或使用速干手消毒剂指针有哪些,答:,1,直接接触每个患者前后～从同一患者身体的污染部位移动到清洁部位时。,2,接触患者黏膜、破损皮肤或伤口前后～接触患者的血液、体液、分泌物、排泄物、伤口敷料等之后。,3,穿脱隔离衣前后～摘手套后。,4,接触患者周围环境及物品后。,5,接触患者周围环境及物品后。,6,处理药物或配餐前。 12、医务人员在哪些情况下应先洗手～然后进行手卫生消毒,答:,1,接触患者的血液、体液和分泌物以及被传染性致病微生物污染的物 品后。,2,直接为传染病患者进行检查、治疗、护理或处理传染患者污物之后。 外科手消毒应遵循哪些原则,答:,1,先洗手～后消毒。,2,不同患者手术之间、手套破损或手被污染时～应重新进行外科手消毒。 13、“六步洗手法”具体步骤, ,1,在流动水下～使双手充分淋湿。,2,取适量肥皂,皂液,～均匀涂抹至整个手掌、手背、手指和指缝。,3,认真揉搓双手至少 15 秒钟～应注意清洗双手所有皮肤～包括指背、 指尖和指缝。,3,在流动水下彻底冲净双手～擦干～取适量护手液护肤。 具体揉搓步骤为: 第一步:掌手相对～手指并拢～相互揉搓。 第二部:手心相对～双手交叉指缝相互揉搓～交换进行。第三步:掌心相对～双手交叉指缝相互揉搓。第四步:弯曲手指使关fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 节在另一手掌心旋转揉搓～交换进行。第五步:右手握住左手大拇指旋转揉搓～交换进行。第六步:将五个手指尖并拢放在另一手掌心旋转揉搓～交换进行。 14、如何做好手卫生效果的监测,,1,采样时间在接触患者、进行诊疗活动前采样。,2,采样方法被检者五指并拢～用浸有含相应中和剂的无菌洗脱水液浸湿的棉拭子在双手指曲面从指跟到指端往返 2涂擦2次～一只手涂擦面积约 30cm～涂擦过程中同时转动棉拭子,将棉拭子接触操作者的部分剪去～投入10ml含相应中和剂的无菌洗脱液试管内～及时送检。,3,手消毒效果应达到如下相应要求:,cfu 2代表菌落数,卫生手清毒～监测的细菌菌落总数应?10cfu/? 外 2科手消毒～监测的细菌菌落总数应?5cfu/? 15、洗手前应进行哪些准备,答:,1,洗手前～先摘下首饰(戒指、手镯)和手表,,2,剪短指甲(不能配戴假指甲),,3,将袖子卷至肘部,,4,将手及手腕浸湿～保证手及手腕要低于肘部,保证水流向指尖～以免污染手臂,,,5,涂抹肥皂或洗手液并彻底揉搓,,6,按“六步洗手法”洗手,,7,如果手被严重污染～应重复以上操作1次。 四、消毒灭菌 1、什么叫清洁, 答:是指用物理方法清除物体表面的污垢、尘埃和有机物～其目的是减少微生物。 2、什么叫消毒, 答:消毒是指用物理或化学方法清除或杀灭芽胞以外的所有病原微生 物～使其达到无害化的处理。 3、什么叫灭菌,答:灭菌是指用物理或化学方法杀灭传播媒介上的一切微生物～包括致病微生物和非致病微生物～也包括细菌芽胞和真菌孢子。经灭菌处理的 物品称无菌物品。 4、什么叫消毒剂, 答:用于杀灭传播媒介上的微生物使其达到消毒或灭菌要求的制剂。 5、什么叫灭菌剂, 答:可杀灭一切微生物(包括细菌芽胞)使其达到灭菌要求的制剂。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 6、什么叫高效消毒剂,答:指可杀灭一切细菌繁殖体,包括分枝杆菌,、病毒、真菌及其孢子等～对细菌芽胞,致病性细菌芽胞,也有一定杀灭作用～达到高水平消毒要求的制剂。 7、什么叫中效消毒剂,答:指仅可杀灭细菌繁殖体、分枝杆菌、病毒、真菌等微生物～达到消毒要求的制剂。 8、什么叫低效消毒剂, 答:指仅可杀灭细菌繁殖体和亲脂病毒～达到消毒要求的制剂。 9、消毒、灭菌方法的选用应遵循什么基本原则,答:,1,根据污染微生物的种类和数量选择消毒方法和使用剂量,?对受到致病性芽胞菌、真菌孢子和抵抗力强、危险程度大的病毒污染的物品选用高效消毒法和灭菌法,?对受到致病性细菌、真菌、亲水病毒、螺旋体、支原体、衣原体污染的物体选用中效以上的消毒法,?对受到一般细菌和亲脂病毒污染的物品可选用中效或低效消毒法。污染特别严重时应加大消毒剂剂量和延长消毒时间。,2,根据消毒物品的性质选择消毒方法:?耐高温、耐湿物品和器材应首选压力蒸汽灭菌或干热灭菌, ?怕热、忌湿或贵重物品应选用环氧乙烷气体灭菌或等离子灭菌。 ,3,根据物品污染后的危害程度选择消毒灭菌方法。 10、影响消毒灭菌效果的主要因素有哪些,答:(1)处理剂量,强度、时间,,,2,微生物污染程度,,3,温度,,4,湿度,,5,酸碱度,,6,化学拮抗物质,,7,穿透条件,,8,表面张力。 l1、使用消毒药械时应注意什么,答:使用消毒药械时应掌握使用范围、方法、注事事项。 12、使用消毒药剂时应注意什么,答:使用消毒药剂时应掌握使用浓度、配制方法、更换时间、影响消毒灭菌效果的因素等。 13、消毒剂及消毒、灭菌物品合格的标准是什么,答:,1,使用中消毒剂细菌菌落总数应?100cfu,ml,无菌器械保存液必须无菌, ,2,灭菌后的物品、器械不得检出任何微生物,不得检出病原菌,3,接触粘膜的医疗用品细菌菌落总量?20cfu,g 或 100cm2,出致病微生物,,4,接触皮肤的医疗用品细菌菌落总数?200cfu,g 或 100cm2,不得检出致病微生物,,5,凡接触血液、粘液等分泌物的医疗用品消毒后不得检出HBSAg。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 14、使用中的消毒液、灭菌剂应怎样监测,答:消毒液及灭菌剂有化学监测及生物监测法～具体要求是:,1,化学监测:灭菌剂,无菌器械保存液,戊二醛每周至少监测一次,各类物品消毒液每天监测一次。,2,生物监测:灭菌剂,无菌器械保存液,每月监测一次,消毒液每 季度监测一次。 五、消毒药械及一次性使用医疗用品的管理 l、什么叫一次性使用卫生用品,答:使用一次后即丢弃的、与人体接触并为人体生理卫生或卫生保健目的而使用的各种日常用品。如薄膜或乳胶手套、餐巾、纸巾、口罩、妇女经期卫生用品、尿布等排泄物卫生用品、避孕工作等。 2、什么叫一次性使用医疗用品,答:使用一次后即丢弃的～深入人体组织或与皮肤粘膜表面接触～并为治疗或诊断目的而使用的各种用品～分灭菌与消毒的医疗用品。如一次性使用无菌注射器、输液,血,器、手术衣帽、口罩、手术巾和一次性口腔镜等。 3、医院采购一次性使用无菌医疗用品时必须审核哪些证件,答:医院采购一次性使用无菌医疗用品～必须从取得省级以上药品监督管理部门颁发的《医疗器械生产企业许可证》、《工业产品生产许可证》、 《医疗器械产品注册证》和卫生行政部门颁发卫生许可批件的生产企业或取得《医疗器械经营企业许可证》的经营企业购进合格产品,进口的一次性导管等无菌医疗用品应具有国务院药品监督管理部门颁发的《医疗器械产品注册证》。 6、一次性使用医疗卫生用品的“三证”具体指什么,答:生产厂家提供的医药部门和省级以上卫生行政部门颁发的产品“注册证”“企业生产许可证”～“卫生许可证”。 7、在使用一次性无菌医疗用品过程中若发生热原反应、感染或其它异常情况时应如何处理,答:在使用一次性无菌医疗用品过程中若发生热原反应、感染或其它异常情况时～必须及时留取样本送检～按规定详细记录～ 报告 软件系统测试报告下载sgs报告如何下载关于路面塌陷情况报告535n,sgs报告怎么下载竣工报告下载 医院感染管理科、药剂科和设备采购部门。 使用中的紫外线灯管辐照强度低于多少时应予以更换? 答:辐照强度低于70uw/cm2时应及时更换。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 8、用星光指示卡监测紫外线灯管辐照强度应多长时间进行一次, 答:用星光指示卡监测紫外线灯管辐照强度应每2个月进行一次。 医疗器械和用品根据污染的危害程度分为几类,答:医疗器械和用品根据污染的危害程度分为三类:高度危险性物品、中度危险性物品和低度危险性物品。 9、什么叫高度危险性物品,包括哪些物品,使用前消毒灭菌要求是什 么, 答:高度危险性物品即关键性物品～是指穿过皮肤或粘膜而进入无菌组织或器官内部的器材～或与破损组织、皮肤粘膜密切接触的器材和用品。主要包括各种外科器械、穿刺器械,注射器、穿刺针、针灸针等,、输血输液器具、无菌内镜,腹腔镜、关节镜、羊水镜和其他内镜及活检钳,、各种体内导管,心导管、静脉导管、各种造影导管、内脏引流管,、体内植人物 ,人工器官、植入药物等,、手术隔离衣帽、无菌巾单、外科手套等。高度危险性物品使用前必须进行灭菌处理。 10、什么叫中度危险性物品,包括哪些内容,使用前消毒灭菌要求是什么,答:中度危险性物品即半关键性物品～是指仅和皮肤粘膜相接触～而不进入无菌组织内的物品。主要包括普通内镜,胃镜、肠镜、气管镜、尿 道镜及其他接触体腔的内镜,、呼吸机、麻醉机管道、压舌板、口罩、口腔 诊具、体温计等。中度危险性物品必须进行严格消毒。 11、什么叫低度危险性物品,包括哪些内容,答:低度危险性物品即非关键性物品～是指虽有微生物污染～但一般情况下无害～只有当受到一定量致病菌污染时才造成危害的物品。主要包括诊疗设备、卧具、病房、家具、室内环境表面、听诊器、血压计、诊锤等。低度危险性物品以清洁为主。消毒时可根据情况使用含氯消毒剂。 12、可重复使用的医疗器械使用后应怎样处理,答:可重复使用的医疗器械使用后应按照去污染-酶洗-清洗-消毒-干燥-润滑-灭菌的程序进行处理。 五、医疗废物的管理 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the l、什么是医疗废物,答:医疗废物是指医疗卫生机构在医疗预防、保健以及其他相关活动中产生的具有直接或者间接感染性、毒性以及其他危害性的废物。 2、医疗废物分哪几类,答:医疗废物分为感染性废物、损伤性废物、病理性废物、药物性废物、化学性废物共五大类。 3、各类医疗废物包括哪些物品,答:,1,感染性废物:使用后棉球、棉签,废弃的医学标本,病原体培养基,使用后一次性输液器,手套及各种引流瓶,管,等。,2,损伤性废物:解剖刀、手术刀、载玻片、玻璃安瓿、缝合针等。,3,病理性废物:废弃的人体组织、器官,实验室动物的组织、尸体,病理腊块等。,4,化学性废物:医学影像室、实验室废弃的化学试剂,废弃的过氧 乙酸、戊二醛等各种化学消毒剂,废弃的汞血压计、汞温度计等。,5,药物性废物:废弃的一般性药品如抗生素、非处方类药品等,废 弃的致癌性药物、可疑致癌性药物,免疫抑制剂,废弃的疫苗、血液制品等。 3、损伤性废物、病理性废物也属于感染性废物吗,答:属于感染性废物。 4、使用后一次性医疗用品应如何处理, 答:,1,使用后的一次性医疗用品应及时毁型和消毒～专人回收进行无害化处理,使用后的输液器、注射器由卫生行政主管部门指定厂家回收。,2,传染病人使用后的一次性医疗用品或被血液严重污染的一次性输液器、注射器及其他物品必须焚烧。 5、医疗废物应怎样分类收集,答:,1,医疗废物应分类放臵在有专用标识的包装袋或容器中,,2,感染性医疗废物放臵在黄色的医疗垃圾袋收集,,3,放射性废物放臵在红色的医疗垃圾袋收集,,4,刀片、针头等锐器物应放入利器盒内收集,,5,传染病病人的生活垃圾及医疗废物均应用双层黄色医疗垃圾袋收集。 6、收集医疗废物时应注意什么,答:,1,根据医疗废物的类别～将其放入有医疗废物警示标识的包装 物或容器内,,2,盛装前应对包装物或容器进行检查～确保无破损、渗漏和其它缺陷,,3,放人包装物或容器内的感染性废物、病理性废物、损伤性废物不得取出,,4,病原体培养基、标本和菌种、毒种保存液等高危险废物应在产生地点fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 进行压力蒸汽灭菌或化学消毒处理～然后按感染性废物收集处理, ,5,隔离的传染病病人或者疑似传染病病人产生的医疗废物应当使用双层包装物～并及时密封,,6,各类医疗废物不能混合收集,批量的化学类废弃物应交专门机构处理,,7,盛装废物的容器、包装物的封口应紧实、严密、运送时防渗漏、遗散。 7、医疗废物暂时贮存点必须做到哪“五防”, 答:医疗废物暂时贮存点必须做到防鼠、防蚊蝇、防蟑螂、防渗漏、防盗。 8、什么是无害化处理, 答:指对生活、生产排放的污水、污物、垃圾及其他污染性物质进行 消毒处理～使病原菌失去活性～达到预防传染病传播的目的～即为无害化处理。 9、医疗卫生机构发生医疗废物流失、泄漏、扩散时应如何报告,答:应当在48小时内向所在地的县级人民政府卫生行政主管部门、环境保护行政主管部门报告～调查处理工作结束后～医疗卫生机构应当将处理结果向所在地的县级人民政府卫生行政主管部门、环境保护行政主管部门报告。 10、医疗卫生机构发生医疗废物流失、泄漏、扩散时应如何处理,答:应立即组织相关人员对污染现场进行封锁～做好防护～尽可能减少污染扩散～保护好周围人群。根据污染情况～采取有效安全的处理方法进行消毒～消毒工作应从污染较轻的区域向污染严重的区域进行彻底的清洁与消毒～并对清扫的工具进行消毒。同时配合有关部门的检查、监测、调查取证～不拒绝和阻碍～不提供虚假材料。 11、医疗卫生机构发生因医疗废物管理不当而导致1人以上死亡或3 人以上健康损害时～属于什么程度的事故,应如何报告,答:属于重大事故。应当在24小时内向所在地的县级人民政府卫生行政主管部门、环境保护行政主管部门报告～并根据《医疗废物管理条例》的规定～采取相应紧急处理措施。县级卫生行政主管部门接到报告后～应当在12小时内逐级向省级人民政府卫生行政主管部门报告。省级卫生行政主管部门接到报告后～应当在12小时内向卫生部报告。 12、《医疗废物管理条例》第四十三条规定～对医疗废物泄漏、扩散时～未采取紧急处理措施～造成传染病传播～对医疗卫生机构有哪些fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the 处罚措施,答:由原发证部门暂扣或者吊销医疗卫生机构执业许可证件,构成犯罪的～将依法追究刑事责任。 六、抗菌药物的管理 1、什么叫抗菌药物,答:抗菌药物是指能抑制或杀灭细菌～用于预防和治疗细菌性感染的药物。 2、什么叫抗生素,答:抗生素是微生物的代谢产物～分子量较低～低浓度时能抑制或杀灭其他病原微生物。 3、什么叫抗菌谱,答:抗菌谱是指抗菌药抑制或杀灭病原微生物的范围。 4、什么叫抗菌活性,答:是药物抑制或杀灭细菌的能力。 5、什么叫最低抑菌浓度(MIC),答:药物能够抑制培养基内细菌生长的最低浓度。仅能抑制细菌生长和繁殖～但不能将其杀灭的药物称为抑菌药。 6、什么叫最低杀菌浓度(MBC),答:药物能够杀灭培养基内细菌的最低浓度。不仅能抑制细菌生长～而且能将其杀灭的药物称为杀菌药。 7、什么叫获得耐药性,答:获得耐药性是细菌与抗菌药物多次接触后～细菌对药物的敏感性下降甚至消失。使用抗菌药是形成获得耐药性的重要原因之一。 8、什么叫微生态失调,答:正常的微生物群之间和正常微生物群与宿主之间的微生态平衡～在外环境影响下～由生理性组合转变为病理性组合的状态称为微生态失调。大量广谱抗生素的使用是造成人体内微生态失调的重要原因之一。 9、如何判断抗菌药物临床应用的正确性与合理性,答:(1)有无指征用抗菌药物,(2)选用的抗菌药物品种及给药 方案 气瓶 现场处置方案 .pdf气瓶 现场处置方案 .doc见习基地管理方案.doc关于群访事件的化解方案建筑工地扬尘治理专项方案下载 是否正确合理。 10、抗菌药物治疗性应用的基本原则是什么,答:,1,诊断为细菌感染者,包括由真菌、结核分枝杆菌、非结核分 枝杆菌、支原体、衣原体、螺旋体、立克次体及部分原虫所致的感染,,,2,尽早查明感染病原～根据病原种类及细菌药敏试验结果选用抗菌药物, ,3,按照药物的抗菌作用特点及其体内过程特点选择用药,,4,抗菌药物治疗方案应综合患者病情、病原菌种类及抗菌药物特点制定。 fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the ll、联合应用抗菌药物的指征是什么,答:,1,病原菌尚未查明的严重感染～包括免疫缺陷者的严重感染,,2,单一抗菌药物不能控制的需氧菌及厌氧菌混合感染～2种或2种以上病原菌感染,,3,单一抗菌药物不能有效控制的感染心内膜炎或败血症等重症感染,,4,需长程治疗～但病原菌易对某些抗菌药物产生耐药性的感染～如结核病、深部真菌病。 12、外科预防性应用抗菌药物的给药方法是什么? 答:,一,接受清洁手术者的给药方法:,1,在术前 0.5，2 小时给药～或麻醉开始时给药～使手术切口暴露时局部组织中已达到足以杀灭手术过程中入侵切口细菌的药物浓度,,2,手术时间>3h 或失血量>1500ml时～可术中追加一次,,3,抗菌药物的有效覆盖时间应包括整个手术过程中不超过24h～个别情况可延长至48h,,4,手术时间<2h 的清洁手术～术前用药一次即可。,二,接受清洁—污染手术者的给药方法:手术时预防用药时间为24h～必要时延长48h。 13、住院病人抗菌药物使用率应控制在什么范围,治疗用抗菌药物病 原学送检率应达到多少,答:住院病人抗菌药物使用率应<50,～治疗用抗菌药物病原学送检率应>50,。 14、住院病人使用或调整抗菌药物时病历记录有何要求,答:病程记录应 说明 关于失联党员情况说明岗位说明总经理岗位说明书会计岗位说明书行政主管岗位说明书 使用或调整抗生素的原因。 15、住院病人使用抗菌药物采集病原学样本的最佳时间是什么? 答:应在使用抗菌药物治疗开始前。 八、传染病管理,略, fertility better. Site preparation before planting, clearing rubble, if conditions for soil disinfection can be carried out. Thickness of planting soil: Arbor thickness not less than 90cm, shrubs not less than 60cm, to be not less than 20cm. Poor quality of the soil, should enlarge the hole (hole) specifications, and debris picked up by clearing encountered lime slag, against the growth substances such as stone, asphalt, you should pit (hole) diameter increased 1 to twice times, harmful substances removal clean and put on suitable planting soil. F, green natural trees found in the planting hole dug seriously affect the operation of the underground obstacle, get in touch with designers, the appropriate changes. ?, seedling quality of trees dug a well ... C, trees have been delivered to the site in a given place, to turn the roots covered with straw to prevent water loss. ? trees planted seedlings before planting quality requirements: should be checked according to the design drawings and seedling varieties, specifications and plant location. Principles of plant "outside the high to low, the first after the first" grown order "big tree---small tree---shrub-plants" before the tree into planting holes, you should check the planting hole size and depth, while root system requirements are not met, trimming plants dibble. A, seedling rate should be commensurate with the speed of planted seedlings, planted along, kind of finish, minimizing root exposure. On planting trench, remaining seedling exposed roots should be kept buried with soil. B, depending on the specific seedlings, good seedlings and planting depth should be identified, roots with soil plug solid rear mud balls can be under the