2021年醫(yī)院感染基礎(chǔ)知識word版

1、醫(yī)務(wù)人員標(biāo)準預(yù)防與職業(yè)暴露醫(yī)院感染的相關(guān)知識一、標(biāo)準預(yù)防在2世紀9年代中期，美國疾病控制中心提出了“標(biāo)準預(yù)防”目的在于盡最大可能來降低醫(yī)務(wù)人員與病人之間，病人與病人之間微生物傳播的危險性，起到了雙向防護的作用標(biāo)準預(yù)防應(yīng)用于所有病人的診療活動，不論病人的診斷是什么，處理污染的醫(yī)療器械標(biāo)準預(yù)防的主要措施1、手衛(wèi)生2、使用個人防護用品（手套，口罩，防護鞋），避免接觸病人的體液和非完整的皮膚3、呼吸道衛(wèi)生和咳嗽禮節(jié)4、預(yù)防銳器傷5、正確處理醫(yī)療廢物6、清潔消毒環(huán)境和呼吸道設(shè)備who關(guān)于手衛(wèi)生的六個指征包括接觸病人前后摘除手套后進行侵入性操作前接觸病人體液，排泄物，粘膜，破損的皮膚或者傷口敷料后從病人臟

2、的身體部位到干凈的身體部位直接接觸接近病人的無生物物體（包括醫(yī)療器械）后戴手套的優(yōu)點減少病原體遷移到手上或從手上遷移出來的最好方法如果規(guī)范性戴手套及更換，成本效果好手套的類型，用途和材料比較多樣降低病原體雙向傳播的危險明顯減少被針頭刺破皮膚的幾率，保護不受血液性傳染病的感染佩戴口罩的注意事項佩戴口罩前后都必須清潔雙手要讓口罩緊貼面部口罩有顏色的一面向外系緊固定口罩的繩子，或把口罩的橡筋繞在耳朵上，使口罩緊貼面部針刺安全與防護法案強調(diào)在醫(yī)療場所使用安全醫(yī)療設(shè)備以降低醫(yī)務(wù)工作者出現(xiàn)銳器傷和血液接觸的國家級法規(guī)醫(yī)院應(yīng)選用安全器械以防止或減少醫(yī)務(wù)人員發(fā)生銳器傷害讓第一線的醫(yī)務(wù)人員參與安全器具的評價和應(yīng)

3、用情況醫(yī)院堅持記錄銳器傷發(fā)生情況，記錄引起傷害的設(shè)備類型以及對每一起事件的情況進行解釋。上海市調(diào)查情況69所醫(yī)院醫(yī)務(wù)人員48351名，69所醫(yī)院合計醫(yī)務(wù)人員6151名，調(diào)查率高達76%。2243名人員發(fā)生銳器傷，合計383次，人均每月發(fā)生銳器傷.6次（每百床年114例，遠高于美國的27年3例）上報率僅為6%銳器傷管理的國內(nèi)現(xiàn)狀發(fā)生率高，危害大不安全的銳器使用量大銳器盒使用不規(guī)范標(biāo)準預(yù)防制度不完善，落實不到位缺乏職業(yè)暴露上報制度醫(yī)務(wù)人員宣傳教育不夠暴露后的處理制度缺失政府及醫(yī)院無保障制度空氣消毒1自然通風(fēng)是最簡便，經(jīng)濟，有效的保持室內(nèi)空氣新鮮，減少細菌濃度的方法2在出現(xiàn)呼吸道傳染病人后，較合理的

4、方法應(yīng)物體表面消毒和空氣消毒同時進行，可選用過氧乙酸或過氧化氫等消毒劑進行熏蒸3人在時的空氣消毒方法，可選用循環(huán)風(fēng)消毒機或靜電等空氣消毒器進行連續(xù)動態(tài)消毒處理紫外線消毒1適用于無人狀態(tài)下室內(nèi)空氣的消毒2沒有持續(xù)作用3需要一定的時間及強度二、職業(yè)暴露預(yù)防去除傷害，減少不必要的注射使用無針系統(tǒng)或安全器具防止重復(fù)蓋帽，正確使用銳器收集盒個人防護設(shè)備，口罩，手套等職業(yè)暴露處理原則及時處理原則及時報告原則保密原則知情同意原則職業(yè)暴露后的處理步驟1、在傷口旁輕輕擠壓，盡可能擠出損傷的血液再用肥皂液和大量流動水沖洗污染的傷口，沖洗后用75%酒精，.5%碘伏消毒傷口2、皮膚和粘膜污染時，立即用肥皂液和流動水清

5、洗污染的皮膚3、賤入口腔，眼睛等部位，用清水，自來水或生理鹽水反復(fù)沖洗粘膜處理步驟2及時報告主管部門，填寫針刺傷報告表下一步工作消除危害，盡量避免使用銳器大力推廣安全器具加強醫(yī)務(wù)人員職業(yè)暴露檢測加強醫(yī)務(wù)人員宣教規(guī)范使用合格的銳器盒規(guī)范醫(yī)務(wù)人員銳器操作，禁止回套針帽規(guī)范使用個人防護用品規(guī)范職業(yè)暴露后的追蹤和處置加強高危醫(yī)務(wù)人員的疫苗接種三、醫(yī)院感染的定義指住院病人在醫(yī)院內(nèi)獲得的感染，包括在住院期間發(fā)生的感染和在醫(yī)院內(nèi)獲得出院后發(fā)生的感染，但不包括入院前已開始或者入院時已處于潛伏期的感染。醫(yī)院感染微生物的來源在水中或潮濕的地方，偶爾出現(xiàn)在無菌物品或消毒劑中（假單胞菌屬，不動桿菌屬，分枝桿菌屬）物品

6、如被服，護理過程中使用的器械和物品在食物中*細小的塵埃和咳嗽或說話產(chǎn)生的飛沫醫(yī)院感染的主要危險因素1、侵入性操作2、使用未經(jīng)完全滅菌的各種醫(yī)療器械3、環(huán)境污染（醫(yī)療用具，空氣，醫(yī)務(wù)人員手等）4、輸入已被污染的藥品，血液，血制品等5、醫(yī)務(wù)人員的職業(yè)暴露等等 牢記院感“一二三四五六”1、1雙手（重視手衛(wèi)生）2、2天院感就是入院48小時后發(fā)生的院內(nèi)感染3、3例短時間內(nèi)發(fā)生3例同種同源的感染為醫(yī)院感染暴發(fā)4、4種常見的耐藥菌 耐甲氧西林金黃色葡萄球菌，耐萬古霉素腸球菌，多重耐藥的鮑曼不動桿菌，泛耐藥銅綠假單胞菌。5、5類小心使用5類抗菌藥（頭孢，加酶抑制劑，碳青霉烯，糖肽，喹諾桐類6、6步洗手法結(jié)束語

7、 醫(yī)院感染防控像一道防線，保護患者的安危，保護醫(yī)院的正常運行，保護醫(yī)療行業(yè)的聲譽。醫(yī)院感染控制工作有自身的特殊性，實際上是防范于未來，重視醫(yī)院感染控制任重道遠，預(yù)防為主，杜絕感染，醫(yī)院方可取得經(jīng)濟效益，社會效益雙豐收。and work. many classes established the duty monitor system, let every students have class member services and for the class the opportunity to work, this is not a fixed position of the monito

8、r system of rotation, which not only can let the monitor on duty in a day's work for class service work, also can let students know more of the solution in the class, every student can learn. and the class cadre conference held regularly. pay attention to class and major incidents in the recent

9、, concerned about the class need to help students and make the class committee work plan and the new division.a good class of .each class in the formulation of the goal, the class of the convention at the same time, pay more attention to the class a good class construction work class. the class cons

10、truction is the pillar industry of class education work, to perform the correct public opinion guide guide, schools, teachers' education intent can be more smoothly issued, strict execution. discipline, clean environment, learning atmosphere, most students with emotional attachment and collecti

11、ve identity, and consciously safeguard the collective honor and so on. we must first establish a collective concept, the formation of we are the best, and i win glory for the class collective concept, then do the selection of class cadres appointment work. finally, we must adhere to the positive gui

12、dance, set up the correct example in the class.5 class warm atmosphere to create a warm atmosphereregularly engage in various small activities in the class, such as class members birthday, so these usually small activities can become the lubrication class work, the formation of heavy important part

13、of team cohesion.b, material carrier1, classroom environmentone of the material carrier class culture in the classroom environment, custody arrangement and class a variety of hardware facilities and perfect, the following is the class certificate, notice.concise typethe classroom inside decoration s

14、mall, quiet harmony learning environment. the usual props: students of their own creation painting and excellent articles and class certificates, inform the knowledge.warm typein the classroom can make the class more decorative ornaments, a warm warm feeling of home. every member of all will partici

15、pate in the layout and landscaping of the process to use props: collective action. photos, photos of various kinds of students, small decorations, potted plants and so on.festival typea simple method and warm, usually a simple layout of the classroom clean, but in every festival or major activities

16、will be arranged and re decoration cloth on the classroom. the usual props: jie qingqing theme decorations, blackboard, ribbon, christmas tree, window and so on.2, class slogan, logo, class, class songeach class for their struggle direction and goal force and put forward the corresponding slogan, em

17、blem, subject to production class and class song creation is one students of various class loading to highlight the personality mode.3, class login the class log records every class of what happened, the true sense of the expression of feelings and thoughts, the exchange of thoughts and feelings. th

18、e class log has authenticity, communication flow and rich and colorful, so this to create a healthy, positive class culture and public opinion atmosphere is very important.4, class team, class small band and so on.the students practice according to their own strengths, not only in class, to show a v

19、ariety of school activities in the skill, but also enhanced the mutual affection and friendship, but also cultivate interest interest and ability, and excellent to enrich students' campus life, this is the students' independent development, very good way to self management.5, class teachin

20、gthe formation of teachers, students, teachers in teacher-student interaction scenarios. understanding the teacher teaching or spare time, and teachers can become friends. when students listen carefully, assiduously, extracurricular foreign teachers and students as a friends sincere exchange flow. w

21、hether it is learning, work is life, have the interaction between teachers and students, enhance the students, friendship, understanding and cooperation.6, class the enthusiasm of the class web fully class students, their photos, photo, articles, etc. according to the information of interest, hobbie

22、s, aesthetic beauty and other factors constitute the class of out with style, encourage each class in the school web game, in the game communicate with each other by the exchange of learning, to explore for expertise in web design students, and excellent web links to the school home, showing the flo

23、w characteristics and style of each class, for all to enjoy.7, publicity column, black blackboard newspapereach class in the classroom layout, beautification process will be in the publicity column, some innovation and breakthrough in the process of the blackboard. some classes will be used in the s

24、ocial practice, military training, basketball, sports in the photos posted on the bulletin board or blackboard, some students will learn calligraphy class the works, for exchange and appreciation to the students in the publicity column and blackboard. in addition, the class blackboard design also cr

25、eate new styles. there are some things some classes, the class in recent writing on the blackboard, there will be some class class slogan, the objectives of painting in the struggle on the blackboard.c, specific activity1 regular class activitiesmany classes will often organize class class in the ho

26、liday party, to be in nervous at ordinary times more than learning can easily more, better communication and communication between each other, in order to increase the understanding and feelings, enhance the class cohesion setting.2 class volunteersmany organizations volunteer to class activities, e

27、very holiday, the class of alternate students will go to some communities, the elderly, some school or kindergarten, primary school to carry out volunteer service. or to help the community, street cleaning cleaning, filing, board newspaper publicity and other things. some of the class is arrange the

28、 students to go to kindergarten or small school compulsory counselling, usually with classes, extracurricular knowledge to help more students in lower grades have difficulties or learning difficulties of the students, and the students actively participate in the city, district, the volunteer activit

29、ies organized by our school.3 loving actionpart of the class and the poor old man, or that some poor students in poor areas became trapped on the poor peers, as well as students are free on the streets to raise money or sponsored charity in the campus and other activities to help the people who need

30、 help.4 warm classevery holiday or with the classmate's birthday, the class held a simple ceremony to celebrate the birthday of the students, give blessing and birthday gifts, not only enhance the students understanding between the solution and feelings, is a good method of class cohesion cohes

31、ion and class culture.5 autonomous learningsome classes than pay more attention to the common progress of students academic performance in the class, to help each other in school or holiday period, autonomous learning. take one to one structure for learning methods, to achieve common progress with t

32、he purpose and effect. and the establishment of students' autonomous learning class adviser asked group, a real school self learning and learning mode.6 art activitiesclass art, sports and other activities are also very rich and colorful, the students will arrange spare time to rehearse chorus,

33、 recitation, aerobics, gymnastics, the activities in the school to get good grades but also to show their talents and efforts, such as the positive class team in the basketball game. not only can eliminate the fatigue and tension of learning, can enhance students, between teachers and students toget

34、her.the 7 main theme class meetingeach class regularly held open meaningful theme class meeting, through the distinctive theme, rich and colorful activities, the interaction between teachers and students in the ideological education to students ideological purpose, and the theme class meeting of wri

35、tten materials, pictures, data file.8 group activitiesregularly organize students to watch the same movie, visit the museum and so on, so that the students in the rich extracurricular life, an increase of knowledge. there are often organized class activities, including condolences to solitary elderl

36、y, participate in various activities such as neighborhood living, have played a very good self education effect.parent committee1, organizationthe parent committee is composed of representatives from each class of students' parents, and is the supreme authority of the council. it is set up by t

37、he standing committee and the grade group.the standing committee shall be elected by the members of the parent committee of the year grades, and the director shall be elected one, 22 deputy directors and 1 members.parent committee liaison office: xx city no. 1 middle school moral education office, t

38、el: 369266872, ,the members of the parents committee have the right to participate in the activities of the school's parent committee.the members of the committee of the parents have their views and suggestions on the work of the school, and the right to supervise and improve.under the arrangem

39、ent of the senate, the members of the parents committee have the right to observe the school education and to carry out the work of teaching and learning.a member of the standing committee members attended the meeting at the parents long school staff congress right3,the members of the board of paren

40、ts have the obligation to cooperate with the school to carry out education and teaching activities.the members of the board of parents have the obligation to help other parents raise their children's level of education.the parents' committee members have the obligation to collect other par

41、ents' opinions and suggestions, and to feed back to the school.the members of the committee of the parents have the responsibility to coordinate the relationship between parents and school.arrangement of major activities in schools1, make the activity with specific programs. implement the activ

42、ity of specific content, time, responsible person, clear all the offices of the division of labor, make the responsibilities clear, play their respective roles.2, do the activities of the mobilization work. for the school teachers and students of the week monday activities of the speech under the fl

43、ag, and a specific solution to each class under various activities, to attract attention to teachers and students, encourage students to actively participate in excitation. at the same time held a class meeting, specifically to do requirements and arrangements for the class activities. use classes w

44、ill be described for the students, and in the moving process, to guide the students.3, arrange the details of the activities of the activities of the day. the day of the event such as the rules say leadership class admission order, class teacher evaluation, administrative leadership column in attend

45、ance, specific activities and activities in a project person in charge of the arrangements.4, with the school general office to do logistics service work, and to defend, the communist youth league committee for safety management.5, do a good job in the activities of the propaganda work. organization

46、 campus reporter, youth volunteers, such as the use of campus radio, publicity, publicity banners, campus network, to conduct a comprehensive campaign to create a good atmosphere.6, do a good summary of the activities report. all teachers and students to complete a summary of this event by monday un

47、der the flag of the speech, pointed out the advantages and disadvantages, in order to show the model. and at the same time for school leadership award, let the students experience to show the pride and joy of success. a happy ending.campus cultural construction1, keep the school clean and beautiful

48、appearance of the whole campus environment, beautiful landscaping, greening, cleaning, to form a thick green atmosphere for education;2, starting from the establishment of the motto, the actual school school school school spirit, teaching style, study style, making its flag, emblem, flag and class ;

49、3, the establishment of a fixed position of education, such as the school honor room, the team activities, the office of mental health counseling room;4, the establishment of a fixed position, such as the national flag under the flag speech, publicity column, the radio room, by the special managemen

50、t, planning to use these fixed positions to carry out the development of educational activities;5, according to the school education arrangements, combined events, major festivals, anniversaries, combined with the routine education of students, to determine the main content of the theme class meetin

51、g;6, the positive pole of xx local culture and school liuliushiduo years of school history, finishing, mining, the formation of the school in the history of rescue in the spirit of culture;7, in a series of compilation , established the alumni association, editor xx reported. safety education a, stu

52、dent's birthday is often safe1, out of the school gate to consciously get off, to enter the school gate to the required parking.2, out of the classroom, not urgent, not crowded.no, teach in laboratory teaching, chasing and running off the corridor, to avoid slipping and falling., it is forbidde

53、n to climb the walls of any one of the schools, doors and windows, fences, trees, and the ball.are not allowed to carry flammable, explosive, toxic substances and flammable, weapon into school.if the electric fan, lighting and electrical failure, shall not exclude private private hands, teachers sho

54、uld report or the general office, the electrical troubleshooting by the school, do not open the distribution box, touch switch. fire fighting equipment without permission, not free to move., pay attention to the safety of cleaning, the glass window on the high, do not scrape wipe., are not allowed t

55、o go out for a swim., students are not allowed to be outside the public places for entertainment, sports and any form of fun activities. any private party, you must obtain the consent of the parents.1, doing a civilized student, do not have any intention to harm others, steal the behavior of other p

56、eople's property, not allowed to participate in any place in the fight.11, to detect any unsafe factors and should always report for teachers. in order to ensure the preservation of their calm, safe, not quite reckless impulse.12, on the experimental class to strictly comply with the safety req

57、uirements of the laboratory to complete the experiment.113, extracurricular activities and physical exercise, according to the relevant safety rules.14, in the school on the way back home, we should pay attention to traffic safety, road to strictly abide by the traffic rules.15, participate in the s

58、chool organization's outdoor collective activities, activities must strictly abide by the discipline, are not allowed to leave the individual actions.16, the accommodation must be strictly abide by the rules and regulations of the safety management of accommodation.17, give full play to the stu

59、dent's self management ability, students are responsible for the preservation of students' characters, should be careful to do a good job security.b, classroom safety1, the doors and windows of the classroom must be kept in good condition all the year round, no one can not be deliberately damaged.2 doors and windows, the window was found damaged, the teacher has the responsibility to take measures to prevent and repair timely, and its prevention measures.key to the door of the classroom, the key class should appoint a special person to keep the door