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8、消毒隔离工作制度

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8、消毒隔离工作制度8、消毒隔离工作制度 消毒隔离工作制度 一、隔离的一般要求 隔离是采用各种非方法、技术,防止病原体从患者及携带者传播给他人的措施。隔离技术是针对疾病的传播的环节而制定的,造成疾病的传播需要“三个环节”,即感染源、感染途径和易感宿主。隔离即是针对这“三个环节”。 1)在新建、改建与扩建时,建筑布局应符合医院卫生学要求,并应具备隔离预防的功能,区域划分应明确、标识清楚。 2)应根据国家的有关法规,结合本医院的实际情况,制定隔离预防制度并实施。 3)隔离的实施应遵循“标准预防”和“基于疾病传播途径的预防”原则...

8、消毒隔离工作制度
8、消毒隔离工作制度 消毒隔离工作制度 一、隔离的一般要求 隔离是采用各种非 方法 快递客服问题件处理详细方法山木方法pdf计算方法pdf华与华方法下载八字理论方法下载 、技术,防止病原体从患者及携带者传播给他人的措施。隔离技术是针对疾病的传播的环节而制定的,造成疾病的传播需要“三个环节”,即感染源、感染途径和易感宿主。隔离即是针对这“三个环节”。 1)在新建、改建与扩建时,建筑布局应符合医院卫生学要求,并应具备隔离预防的功能,区域划分应明确、标识清楚。 2)应根据国家的有关法规,结合本医院的实际情况,制定隔离预防制度并实施。 3)隔离的实施应遵循“标准预防”和“基于疾病传播途径的预防”原则。 4)应加强传染病患者的管理,包括隔离患者,严格执行探视制度。 5)应采取有效措施,管理感染源、切断传播途径和保护易感人群。 6)应加强医务人员“隔离与防护”知识的培训,为其提供合适、必要的防护用品,使其正确掌握常见传染病的传播途径、隔离方式的防护技术等知识,熟练掌握操作规程。 7)医务人员的手卫生应符合WS/T313。 8)隔离区域的消毒应符合国家的有关规定。 may be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, properly handle the relationship between life, teaching research and teaching. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. often reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are taught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflection and cured by means of words your thoughts down and 二、手卫生管理 1.提供手卫生设施 保持手卫生,进行手部清洗与消毒离不开手卫生设施。手卫生设施包括一般手卫生设施和外科手消毒设施。一般手卫生设施包括洗手用流动水,清洗剂,水龙头,手消毒剂,干手设施(纸巾、干手机、毛巾等);外科手消毒设施包括洗手池‘非手触式水龙头、洗手液及刷手工具、消毒液及其分配器、无菌巾、钟表等。 1)病房及各诊疗科室应设有流动水洗手设施,开关采用脚踏式、肘式或感应式。 2)使用洗手液。 3)可选用纸巾、风干机、擦手毛巾等擦干双手。 4)擦手毛巾一人一巾一用,用后消毒。 5)不便于洗手时,应配备快速手消毒剂。 2.制定相应的 管理制度 档案管理制度下载食品安全管理制度下载三类维修管理制度下载财务管理制度免费下载安全设施管理制度下载 手卫生是控制医院感染的重要措施,因此医院应制定相应的手卫生制度,并严格执行。 医院应建设或改善手卫生设施,选择有效又无刺激的手清洁剂和手消毒剂,为医务人员提供良好、便捷的洗手设备与设施,提高全体医务人员洗手的自觉性。 3..开展培训 手卫生涉及面广,需要广大医务人员和各个层面如医院管理层的配合,因此需要开展广泛的培训。培训的形式和内容应根据培训对象 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p102 的不同而进行调整,使他们掌握必要的手卫生知识与方法,提高医务人员的无菌观念和自我保护意识,正确掌握洗手操作规程,保证洗手效果。 4. 财力与物力的支持 医院应在财力与物力上,给予手卫生工作大力支持,包括提供合适的手卫生设施和手卫生产品如速干手消毒剂,为医务人员执行手卫生措施提供必要的条件。 5.监督与指导 医院的感染管理部门,应加强对全院临床、医技及有关部门手卫生的监督,包括多手卫生设施的管理;加强对医务人员的指导,提高手卫生的依从性,使广大的医务人员将手卫生变成自觉行动。 三、标准预防 1.概念 标准预防(standard precaution)是针对医院所有患者和医务人员采取的一组预防感染措施。包括手卫生,根据预期可能暴露选用手套、隔离衣、口罩、护目镜或防护面罩,以及安全注射;也包括穿戴合适的防护用品处理患者环境中污染的物品与医疗器械。 标准预防基于“患者的血液、体液、分泌物(不包括汗液)、非完整皮肤和薄膜均可能含有感染性因子”的原则。 该方法认定患者的血液、体液及分泌物均具有传染性,不论是否有明显的患者血液与体液的污染;采取双向防护,即既预防患者发生 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p103 医院感染,同时也预防医务人员发生医院感染;采取的隔离措施有3种,即空气隔离、飞沫隔离与接触隔离。 标准预防适用于所有患者的诊断、治疗、护理等操作的全过程,当医务人员每一次进行可能导致污染的接触时,必须戴手套。衣服或面部可能受到污染时应穿隔离衣、戴口罩和眼罩。 各科配备必要的隔离防护用品,如:一次性手套、护目镜、隔离衣、标准利器收集盒等。物品放置做到定位、定数、定时检查。 2.标准预防的措施 以下标准预防的措施适应于对所有患者的预防。 1)接触感染物品应立即洗手。 2)尽可能应用不接触技术。 3)接触血液、体液、分泌物、排泄物、黏膜和污染物品时戴手套。 4)脱手套后立即洗手。 5)处理所有尖锐物品时应特别小心,防锐器伤。 6)立即清洁溅出的感染污物。 7)保证对受到感染性物质污染后的器械、用品、被服作出适当处理: a.可复用的医疗用品和医疗设备,根据需要进行消毒或灭菌处理。 b.需重复使用的利器,应放在防刺的容器内,以便运输、处理和防止刺伤。 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p104 c.一次性使用的利器,如针头等放置在防刺、防渗漏的容器内进行无害化处理。 d.如果清洗被感染性物质污染的被服、衣物时没有洗衣机,则应对被服等进行煮沸处理。 8)急救场所可能出现需要复苏时,用简易呼吸囊(复苏袋)或其他通气装置以代替口对口人工呼吸方法。 9)操作时或操作后,尽快将使用过的医疗废物直接丢弃在分类收集箱中。按照国家颁布的《医疗废物管理条例》及其相关法律法规对医疗废物分类收集。 10)物体表面、环境、衣物与餐饮具的消毒: a.对医院普通病房的环境、物体表面包括床栏、床边、床头桌、椅、门把手等经常接触的物体表面定期清洁,遇污染时随时消毒。 b.在处理和运输被 、体液、分泌物、排泄物污染的被服、衣物时,要防止医务人员皮肤暴露、污染工作服和环境。 c.可重复使用的餐饮具应清洗、消毒后再使用,对隔离患者尽可能使用一次性餐饮具。 d.复用的衣物置于专用袋中,运输至指定地点进行清洗、消毒,并防止运输过程中的污染。 11)禁止在可能存在血液暴露的工作场所进食。不得将食物及饮料放置在有感染性材料的冰箱内。 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p105 四、预防人与人之间的传播 医院感染或医源性感染可以通过空气、飞沫、接触等多种途径传播。 1.手卫生 手卫生方法见《医务人员手卫生规程》。 2.个人卫生 所有的工作人员必须保持良好的个人卫生。指甲要清洁并剪短,不戴假指甲。头发剪短或束起来。 3.着装 1)工作服:工作服必须是由容易清洗和去污的材料制成的。如有可能每天应穿清洁的工作服。工作服在暴露于血液后或其他的体液浸湿后应立即更换。 2)鞋:在层流病房或手术室里,工作人员必须穿特制的、容易清洁的鞋子。 3)帽:在层流病房、手术室或执行进入体腔的侵入性操作时,工作人员必须戴帽并将头发全部遮住。 4.口罩 面口罩、纱布口罩和一般的纸口罩不能完全阻止微生物,由具有过滤作用的合成材料制成的纸口罩才是防止微生物的有效屏障。进行不同的操作,要求使用不同的口罩。 1)保护患者:手术室、护理免疫能力低下的患者,做支气管镜或类似检查时,工作人员必须戴口罩,外科口罩就可以满足需要。呼 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p106 吸道传染患者出隔离室时,必须戴外科口罩。 2)保护工作人员:护理呼吸道传染患者,做支气管镜或类似检查时,工作人员必须戴口罩。推荐戴高效口罩。 5.手套 1)保护患者:医务人员进行手术操作、护理免疫力低下患者、进入体腔的侵入性操作时,应戴无菌手套。 2)保护工作人员:护理接触而引起传染的患者时,做支气管镜或类似检查时,应戴清洁手套。接触患者手可能被污染时或接触黏膜时,也应戴清洁手套。 6.安全注射 取消不必要的注射;使用无菌针头和注射器;使用一次性针头和注射器;预防因治疗药物造成的污染遵循锐器使用管路办法。 参照《临床护理技术 规范 编程规范下载gsp规范下载钢格栅规范下载警徽规范下载建设厅规范下载 》关于各类注射法的要求。 五、预防环境传播 为减少来自器械和环境的微生物传播,必须正确运用清洁、消毒、灭菌的方法。护理部感控小组要制定预防医院内器械和环境传播感染的制度和操作程序,并监督执行。 1.医院环境的清洁 1)常规清洁或保洁。至少从视觉上看是清洁没有灰尘的。常规清洁的目的是清除灰尘,因为90%的微生物存在于肉眼可见的灰尘中。肥皂和清洁剂都没有抗微生物的活力,清洁过程主要依靠机械作用。 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p107 2)护理部感控小组要会同医院后勤部门建立保洁制度。对墙壁、地面、窗、床、帘子、屏幕、安装用具、家具、浴室、卫生间等的清洁作出规定,包括清洁频率、清洁剂使用、工作标准等。 3)根据医院区域划分及可能污染的程度,采取合适的清洁方法: A区:不接触患者的区域。正常的家具清洁。 B区:非感染患者,非高度易感患者的护理区域。清洁时不能扬起灰尘。不推荐干式打扫或吸尘器清洁。使用清洁液可以提高清洁质量。对于任何肉眼可见的被血液、体液污染的区域,在清洁前要先消毒。 C区:感染患者的区域(隔离病房)。使用清洁剂或消毒剂进行清洁,,每个房间有单独的清洁用具。 D区:高度易感患者的区域或科室。使用清洁剂或消毒剂和独立的清洁用品进行消毒。 B区、C区、D区的所有水平面和所有的卫生间都应每天清洁。 4)不需要对环境进行细菌学监测,除非是因为:?经流行病学调查,怀疑病原体来自环境。?按标准要求,对透析水监测细菌计数。?改变清洁措施时,需要进行质量控制。 5)普通临床科室的环境、物体表面如无肉眼可见污物时,可采用清水湿式擦拭或拖地,保持表面清洁。 6)被患者血液、呕吐物、排泄物或病原微生物污染时,应根据实际情况,采用中水平以上消毒方法擦拭、涂抹、喷洒、浸泡等。 7)明确为MRSA等耐药菌株患者污染的环境、物体表面应进行终 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p108 末消毒。 2.热水消毒 对卫浴设备、便器等卫生设施可以选择80?热水消毒,持续45-60s。对烹饪用具、食具可以选择80?热水消毒,持续1min。对被服等可以选择90?热水消毒,持续10min。 3.患者器械的消毒 1)消毒不能完全灭菌,但能去除致病微生物,从而能预防微生物在患者间的传播。 2)选择医院内使用的消毒剂时,应考虑具备以下特点,使用方便,不易挥发,对器械、工作人员和患者无害,无异味,在较短的时间内能发挥作用。 3)为确保消毒剂的效果,消毒程序必须符合杀灭微生物的标准(按照规定的浓度、接触时间、温度和pH值等;具有清洁作用;能独立发挥作用、不受细菌数量、水的硬度和蛋白质的影响。 4)不同的消毒剂及或使用的程序,达到的消毒水平不同。 a.高水平消毒:能杀灭所有微生物,包括芽孢,除非受到细菌芽孢的严重污染。能满足高水平消毒的消毒剂有过氧乙酸、戊二醛、稳定型过氧化氢、次氯酸钠、二氧化氯等。 湿化瓶、吸引瓶、婴儿暖箱水瓶等应采用高水平消毒并每天更换。 b.中等水平消毒:能杀灭结核分枝杆菌、细菌繁殖体、大多数病毒和真菌,但不能杀灭细菌芽孢。消毒剂有乙醇和酚类衍生物等。 c.低水平消毒:能杀灭大多数细菌、部分病毒和真菌,但不能杀 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p109 灭结核分枝杆菌或细菌芽孢。消毒剂有季胺类。 5)根据患者获得感染的危险性和器械操作类型(接触患者身体部位的不同)可以选择不同水平的消毒。 a.获得感染危险程度高的患者,手术或高危侵入性操作(如中央静脉导管、气管插管),器械可能进入血管系统、无菌体腔或组织时,应选择灭菌或高水平消毒。 b.接触黏膜、体液或破损皮肤,或侵入性非手术操作,如胃镜、导尿管插入时,应选择高水平消毒。 c.接触患者完整皮肤或不接触患者时,可以选择低水平消毒。 6)灭菌剂、皮肤黏膜消毒剂应使用纯水或无菌水配制,其他消毒剂的配制用水应符合《生活饮用水卫生标准》。 7)消毒剂浓度应符合要求,连续使用消毒液应定期进行有效浓度测定。 8)灭菌用消毒液的菌落总数应为0cfu/mL,皮肤黏膜消毒液的菌落总数应不大于10cfu/mL,其他消毒液的细菌菌落总数不应大于100cfu/mL,不得检出致病性微生物。 9)不得使用过期的消毒剂。 4.灭菌 1)灭菌能杀灭所有的微生物。 2)灭菌可以通过物理和化学方法实现。灭菌首选高压蒸汽灭菌方法。 3)因为安全或具有温室效应的气体释放问 快递公司问题件快递公司问题件货款处理关于圆的周长面积重点题型关于解方程组的题及答案关于南海问题 ,很多国家已经淘 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p110 汰或不推荐环氧乙烷和甲醛溶液灭菌的方法。过氧乙酸自动操作系统可以用于化学灭菌的选择。 4)对于穿透身体进入无菌体腔、组织和血管的器械,以及所有胃肠外液体、药物都要灭菌。 5)无菌物品的包装材料要符合要求。 a.纸:如果没有破损,可以预防感染,较长时间保持无菌,能作为无菌区,还能在操作后用于包裹脏的器械。 b.塑料:只有聚乙烯和一次性无纺布适用于环氧乙烷灭菌。 c.容器:所装物品只能用于单个患者的单个操作。容器必须配有过滤和瓣膜装置,并定时监测。 6)操作前,使用者必须检查无菌物品的包装是否完全,处于密闭状态,是否在有效期内。 7)灭菌程序的质量控制指标必须记载灭菌过程周期信息,包括:装载数量、装载内容;温度和暴露时间记录表;定时(至少每天进行)物理或化学监测;定期(至少每周)进行生物学监测。蒸汽灭菌操作过程用嗜热脂肪杆菌芽孢进行生物监测;环氧乙烷灭菌过程用枯草黑色变种杆菌芽孢进行生物监测。 8)所有灭菌过程必须保留以下记录:灭菌日期,型号和序列号,地点,更换零件的记录,生物学检测记录,B-D试验记录,操作者姓名和签名。 9)科室设专人或固定班次进行无菌物品的常态管理(每天固定一个班次进行质量、数量的检查,其余班次交接数量即可)。 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p111 10)无菌物品的检查设专用登记本,登记内容包括:检查时间,无菌物品名称,数量,质量(有无过期、潮湿、霉变、破损、穿孔等),检查后签名确认。 11)布包的灭菌物品,有效期为7天,每天清点;纸塑包装高压、环氧乙烷、低温等离子灭菌物品,有效期一般为半年至5年(以物品外包装注明的失效期为准),每月清点一次。 12)无菌物品开启后要写开启时间,已开启物品要先用。 六、特殊部门的隔离预防 (一)感染性疾病病房的隔离预防 1.建筑布局 感染性疾病病房应设在医院相对独立的区域,远离儿科病房、ICU和生活区,中小型医院可在建筑物的一端开辟感染性疾病临床科室,设单独出入口和出入院处理室,并设工作人员通道和患者通道。病房布局见第一节区域隔离。 2.隔离要求 1)严格“三区两通道”,界线清楚,有明显标识。 2)医务人员进入三区,严格区域流程。 3)不同种类的感染患者分开安置,每间病室不超过4人,床间距不少于1.1米。 4)病房通风设施良好,以自然通风为主,温度适宜时可长期开窗,通风不良时可安装排风扇,以保证病房内空气新鲜。禁止使用中 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p112 央空调。 5)配备适量非手触式开关的洗手设施。 6)严格按照国家《医疗废物管理条例》及其相关法律法规进行医疗废物的处置。 7)严格探视制度。 (二)普通病房的隔离预防 1.建筑布局 1)普通病房一般设若干病室、办公室、男女更衣值班室、治疗室、处置室、换药室、储物间、配餐室、盥洗室、卫生间以及污物间等。 2)病室内床间距不少于0.8m,单排不超过3床,特殊情况不超过4床,双排不超过6床,特殊情况不超过8床。 3)配备适量非手触式开关的流动水洗手设施,以方便医务人员和患者洗手。 4)不要在病房走廊抖动污物或暂存污物,认真执行国家《医疗废物管理条例》及其相关法律法规进行医疗废物的处置。 5)严格探视制度。 (三)门诊的隔离预防 1.建筑布局 1)一般门诊的布局应从便利患者诊治出发,单设出入口,交通便捷,减少患者往返,挂号、候诊、诊断、检查、治疗、交费、取药等流程清楚顺畅,减少或避免交叉感染的发生。在门诊出入口或大厅 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p113 设置挂号、问询、预检分诊、交费、取药等窗口(或柜台)。 2)门诊量大的科室最好安排在楼的低层或出入口附近,各科配备适量诊室,并有指定的隔离诊室。 3)儿科门诊应自成一区,设在首层出入方便处,并设单独出入口,有预检处、挂号、取药处,另设单间隔离诊查室,隔离诊查室有对外出口。 4)妇产科应自成一区,设单独出入口。 5)感染疾病门诊应自成一区,设单独出入口,或在门诊区以外的地方单独建立,按区域隔离布局,设专用挂号、收费、取药窗口、诊室、隔离诊室、观察室、治疗室、化验室等,严格区域管理。 2.隔离要求 1)为了避免不同科室患者相互穿行和干扰,应分科挂号、分科候诊。门诊量小的医院可合科挂号、合科候诊。 2)诊室采光好,采取自然通风,无窗户的诊室应安装通风设施,保证诊室内空气新鲜。 3)诊室内应有非手触式开关的流动水洗手设施,或备有速干手消毒设施。 4)外科处置室应分为无菌切口处置室和感染切口处置室。若在同一室内进行,应先进行无菌切口的处置,再进行污染切口的处置。 5)建立预检分诊制度,发现传染患者或疑似传染患者,应到指定隔离诊室诊治,并及时消毒。 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p114 (四)急诊科的隔离预防 1.建筑布局 急诊科与门诊部毗邻,设单独宽敞出入口,有与医院其他科室或部门的通道,各主要通道应考虑推车(床)的便利,交通应便捷,方便患者就诊,急救大厅应宽敞,急诊科(室)应设预检分诊、诊查室、隔离诊查室、抢救室、治疗室、观察室、值班更衣室等,有条件的医院还应设挂号、收费、取药、化验、X线检查、手术室等,也可利用门诊和医技科室的设施。 急诊观察室床间距不应小于1.2m。 2.隔离要求 1)严格预检分诊制度,及时发现传染患者,及时采取隔离措施。 2)各诊室内应配备非手触式开关的流动水洗手设施,或备有速干手消毒设施。 3)急诊观察室按病房进行管理。 急诊抢救器械一用一消毒或灭菌。 (五)产科的隔离防护 1.建筑布局 1)产房周围环境必须清洁、无污染源,应与母婴室和新生儿室相邻近,相对独立。 2)布局合理,严格划分无菌区、清洁区、污染区,区域之间标志明确,无菌区内设置正常分娩室、隔离分娩室、无菌物品存放间;清洁区内设置刷手间、待产间、隔离待产间、器械室、办公室;污染 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p115 区内设置更衣室、产妇接收区、污物间、卫生间、车辆转换处。 3)墙壁、天花板、地面无裂痕,表面光滑,有良好的排水系统,便于清洗和消毒。 2.隔离要求 在病房医院感染管理基础上达到以下要求: (1)人员管理 1)严格出入人员的管理,最大限度地减少人员流动。 2)进入产房工作人员应先洗手、更衣、戴帽子和口罩、换产房专用鞋。 3)离开产房时,应换外出衣和鞋。 4)接生时应严格遵守无菌操作规程。 5)陪产人员必须穿隔离衣、戴口罩和帽子等。 (2)环境的消毒 1)空气的消毒:每日空气消毒1—2次。有条件可采用空气动态消毒器。无人的情况下可采用化学消毒剂密闭喷雾消毒。 2)地面和物品表面的消毒:湿式清扫或擦拭,每日常规进行,以清洁为主;若被污染应及时用消毒剂拖地(擦拭)。 3)待产床、产床、平车每次使用后必须更换一切用品,并用含氯消毒剂擦拭床单位。其他物品应定期清洁消毒。产妇出产房后应终末消毒。 (3)环境卫生学监测 1)产房为重点易感区域,应每月进行环境卫生学监测,监测项 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p116 目包括:空气培养、物体表面及医护人员手培养。 2)标准为空气培养菌落不大于200cfu/m?;物体表面培养菌落不大于5cfu/m?;医护人员手培养菌落不大于5cfu/m?,且不得检出致病微生物。 (4)接生中的预防措施 1)应根据标准预防的原则实施消毒隔离。 2)有刷手禁忌者严禁上台。 3)保持无菌单布及手术衣干燥,潮湿视为污染应更换。 4)无菌包在使用前,必须检查核对包装原样、有效期和灭菌指示带。 5)灭菌后的物品必须在有效期内使用,产包打开超过4h视为污染。 6)助产用的器械视为相对污染,必须与脐带处理器械分开使用,严禁用侧切剪刀断脐。 7)重复使用的无菌布单,一经打开,无论是否使用,均必须重新灭菌;一次性物品,一旦开启,若未用完,也视为已污染。 8)持物钳灭菌后干燥保存,每次接生使用一套。 a.及时清理新生儿口腔和上呼吸道内吸入物,以防止吸入性肺炎。 b.新生儿娩出后,应尽快与母亲皮肤接触获得正常菌群。 (5)隔离孕产妇的医院感染管理 1)凡患有传染性疾病的产妇均应收入隔离待产室待产、隔离分 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p117 娩室分娩,按隔离技术规程护理和助产。 2)需手术者,手术 通知 关于发布提成方案的通知关于xx通知关于成立公司筹建组的通知关于红头文件的使用公开通知关于计发全勤奖的通知 单上应注明隔离类别和感染疾病的诊断。 3)隔离产房的一切器械、物品应单独固定使用,所有物品严格按照消毒灭菌要求单独处理。 4)用后的一次性用品及胎盘必须放入黄色塑料袋内,密闭运送,无害化处理。 5)分娩及出院后应严格对隔离待产室、隔离分娩室及床单位进行终末处理。 (六)手术室(部)隔离预防 1.建筑布局 1)手术室分无菌区、清洁区、污染区,区域间标志明确。手术室布局合理,符合功能流程和洁污分开的要求。办公室、敷料室、洗涤室、器械室、高压蒸汽无菌室、麻醉室、复苏室等应设在清洁区;手术间、洗手间、无菌储藏室设在无菌区,两者应有门相隔。 2)手术室内应设无菌手术间、一般手术间、隔离手术间;隔离手术间应靠近手术室入口处。 2.隔离要求 1)进入手术室必须更换鞋衣裤、帽,手术室的鞋、外出鞋应分区存放。 2)天花板、墙壁、地面无裂痕,表面光滑,有良好的排水系统,便于清洗和消毒。 3)经血传播疾病病原学诊断阳性者,应在手术通知单注明;特 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p118 殊感染患者手术通知单上应注明感染情况,严格隔离管理。术后应进行严密消毒处理。手术器械及物品双消毒后再处理;病理标本应按隔离要求处理。手术间严格终末消毒。 4)医务人员必须严格遵守消毒灭菌制度和无菌技术操作规程。有上呼吸道感染、手部外伤、皮肤病的医护人员不宜参加手术。 5)环境清洁。每天第一台手术前,湿擦去除所有平面上的灰尘。手术过程中,清除溢出物,收好感染的废物;手术后,现场清洗仪器、器具和墙壁,清洗物桶、手术台,只在需要的时候用清洁拖把清洁手术台周围;一天手术结束后,清洗所有器具、光源和照明设备,清洗所有地板,清洁物桶;现场清洗托盘架、把手、刷手水槽、过道、通风面板和天花板上的仪器。定期清洁高压灭菌器、休息室、存储区、冰箱、暖箱、墙壁和天花板。 6)换气。手术室每小时换气20次,保持20%新鲜空气,双过滤系统,正压。空气传播和飞沫感染地保持负压。保持门窗关闭。温度20-23?,湿度30%-60%。 a.凡进入人体组织的各种手术器械、导管、内置器械等必须一用一灭菌,注明灭菌有效期,过期重新处理。能压力蒸汽灭菌的应避免使用化学灭菌剂浸泡灭菌。 b.麻醉用器具应定期清洁、消毒,接触患者的用品应一用一消毒;严格遵守一次性医疗用品的管理规定。 c.洗手刷应一用一灭菌。 d.手术室内设消毒供应间的管理见《消毒供应室消毒隔离管理制 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p119 度》。 e.开手术包前后均要检查化学指示胶带和压力蒸汽灭菌指示卡。如高压灭菌的手术包潮湿不得使用,应重新包装、消毒。 f.严格限制手术室内人员数量,严格控制参观人数,参观者不可任意进入其他手术间或无菌储藏间。 g.凡手术中切除的坏死组织、污染物、体液等医疗废物须置黄色并有明显标识的塑料袋内,封闭运送,立即从污物通道送出手术间。 h.接送患者的平车定期消毒;车轮应每次清洁,车上物品保持清洁。接送隔离患者的平车应专车专用,用后严格消毒。手术室的车床与病房的不能混用,车床最好设有交界处。 (七)消毒供应(中心)室隔离预防 1.建筑布局 1)严格执行《广东省医疗卫生机构消毒供应(中心)室审核验收标准》。 2)消毒供应(中心)室的设计符合国家和省的消毒隔离法规和标准,建筑面积与医院规模相适应,床位与建筑面积之比达到1:(0.7-0.9),100张床位以下医院最小建筑面积为70m?。 3)建筑位置合理,周围环境无污染源。供应室应接近住院部、门诊部和手术室之间,避开垃圾处理站、食堂、洗衣房、交通要道等处,形成相对独立的区域。 4)内部布局合理,分办公、污染、清洁、无菌区域,四区严格划分清楚,区域间应有实际屏障;人流、空气流由洁到污,物流由污 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p120 到洁,单向流程设置,强行通过,不得交叉和逆行。污染区和无菌区工作人员出入口设置缓冲间(区),缓冲区面积不少于3m?,有洗手更衣设备。 2.隔离要求 1)室内通风采光良好。各区域的空气洁净度应符合标准:无菌物品存放区按?类标准,细菌菌落不大于200cfu/m?;清洁区按?类标准,细菌菌落不大于500 cfu/m?;污染区按?类标准。 2)若设置空气净化系统,无菌区净化空气压力10-15Pa;清洁区净化空气压力5-10Pa;污染区净化空气压力-5-0Pa。没有条件设置空气净化系统的,必须有空调换风与空气消毒的设施,通风量8倍/(m??h)。低温室必须建立独立的排风系统。 3)具备使用后器械回收、清洗、消毒、包装、灭菌、存储、发送全过程所需要的设备和条件,并建立相应的规章制度和工作流程。 4)四区内设备及物品各自分开管理,污染物品、清洁物品和无菌物品严格划分,在相应的区域内使用固定设施和设备进行处理。 5)各临床、医技科室使用后污染的可重复使用的医疗用品和器械集中装入密闭容器,送供应室集中清洁、包装,以尽量减少污染物品和器械对环境和工作人员的伤害。 (八)内镜诊疗中心隔离防护 1.建筑布局 内容参考第二节 2.隔离要求 内镜及附件清洗、消毒或灭菌应遵循原则。 ion and cured by means of words your thoughts down andeflectmethods. Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching raught as normal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, are t s on itself to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachersoften reflection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teacher0% d. s] option small meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 ng. 5. teachers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topicroperly handle the relationship between life, teaching research and teachimay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p121 1)凡进入人体无菌组织、器官或者经外科切口进入无菌腔室的内镜及附件,如腹腔镜、关节镜、脑室镜、膀胱镜、宫腔镜等,必须灭菌。 2)凡穿破黏膜的内镜附件,如活检钳、高频电刀等,必须无菌。 3)凡进入人体消化道、呼吸道等于黏膜接触的内镜及其附件,如喉镜、气管镜、支气管镜、胃镜、肠镜、乙状结肠镜、直肠镜等,应当达到《消毒技术规范》要求的高水平消毒。 4)内镜及附件使用后应当立即清洗、消毒或者灭菌。 5)禁止使用非流动水对软式内镜进行清洗。 隔离技术的有关名词术语: (1)隔离预防技术(Skills of isolation and prevention):为达到隔离预防的目的而实行的一系列措施和操作统称为隔离预防技术。 (2)隔离(Iolation):采用各种方法、技术,防止感染因子从患者及携带者传播给他人的一种措施。 (3)清洁区(Clean area):不易受到患者血液、体液和病原微生物等物质污染及感染患者不得进入的区域。 (4)半污染区(Semi-clean area):介于清洁区与污染区之间,有可能被患者血液、体液和病原微生物污染的区域。 (5)污染去(Pollution area):感染患者和疑似患者接受诊疗的区域,包括被其血液、体液、分泌物、排泄物污染的衣物、用具等暂存和处理场所。 ured by means of words your thoughts down andand c Therefore attaches great importance to teaching in the mind at the same time, must pay attention to write teaching reflectionnormal to reflect. But we believe that reflection is the best means to promote teachers ' professional development, methods. ht as lf to daily teaching work whether for reflection. Judging from the statistics, and our spirits, most of the teachers are tauglection 30 62.5% beside the effective fill in passengers 48 design beside the of purpose heavy in test young teachers on itsen refsmall meter proportion a,. occasionally reflection 3 6.25% b. sometimes reflection 15 31.25% c. never reflection 0 0% d. ofte achers of teaching reflection behavior data analysis 41st problem you on you of daily teaching work () [single topics] optionroperly handle the relationship between life, teaching research and teaching. 5. temay be less serious about our teacher vacancies, and hope that our young teachers dauntless spirit, overcome the difficult, p122
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