流感暴发期小儿输液室空气质量监测及其控制措施的研究

发布时间：2018-05-10 08:33

本文选题：流感暴发期 + 小儿输液室　；参考：《青岛大学》2012年硕士论文

【摘要】：背景流感暴发期门诊小儿输液室患儿数量骤增,病人及家属等众多的人员流动带动气流,加速空气中病原微生物的播散,对病人和医护人员呼吸道感染形成威胁。因此,测定小儿输液室空气中的细菌含量并采取有效的预防控制措施对改善医院环境控制医院获得性呼吸系统感染有重要意义。目的本研究通过采集动态环境下小儿输液室空气和护士手部样品,培养后计数细菌菌落,并从增加动态环境下空气消毒的时间和强化护士手卫生两方面干预,使流感暴发期小儿输液室环境监测符合《医院消毒卫生标准》的要求。方法1.在流感暴发期,监测动、静态环境下小儿输液室空气质量,并增加动态环境下的空气消毒,即除常规夜间消毒2小时外(静态环境下消毒),另增加上午持续消毒4小时、下午持续消毒4小时(动态环境下消毒)。然后在每种环境下分别采样、送检。2.随机监测护士手卫生情况,强制护士按WHO规定的5个重要的手卫生时刻：即在接触患者前、进行清洁(无菌)操作前、接触患者后、接触患者体液后、接触患者周围环境后都要按照六步洗手法的步骤洗手或使用速干手消毒剂行卫生手消毒。分别观察两种情况下护士手卫生的依从性、正确率和手部细菌情况。结果1.常规消毒后动态环境下小儿输液室的细菌含量明显高于静态环境下,持续消毒后空气中动态环境下细菌含量明显减少,甚至达到消毒后静态环境下的效果,符合《医院消毒卫生标准》的要求。随机所测140株细菌中,革兰氏阴性菌占71.8%,革兰氏阳性菌15.4%,真菌9.8%。其中葡萄球菌和埃希杆菌属是主要菌群,占空气中细菌数的68.82%-78.57%；革兰氏阴性杆菌中大肠杆菌的含量明显高于其它阴性杆菌含量。2.强制情况下护士手卫生依从性、正确率和随机情况下相比明显提高,手部菌落数降低未检测出致病菌。结论 1.静态环境下的空气监测,不能反映工作状态下的空气质量；增加动态环境下的持续空气消毒,能有效的提高空气洁净度。 2.加强对医务人员的督导培训,做好手卫生和卫生手的消毒是防止院内感染的重要措施之一
[Abstract]:Background during the influenza outbreak, the number of children in the infantile transfusion room of the outpatient clinic has increased sharply, and many people, such as the patients and their families, are moving through the airflow, which accelerates the spread of pathogenic microorganisms in the air and threatens the respiratory tract infection of the patients and medical staff. Therefore, it is important to measure the bacterial content in the air of infantile transfusion room and take effective prevention and control measures to improve the hospital environment and control nosocomial respiratory system infection. Objective to collect air samples from infantile infusion room and hand samples of nurses in dynamic environment, count bacterial colonies after culture, and intervene in two aspects: increasing the time of air disinfection in dynamic environment and strengthening the hand hygiene of nurses. The environmental monitoring of infantile infusion room during influenza outbreak is in accordance with the requirements of hospital disinfection and hygiene standard. Method 1. During influenza outbreak, air quality of infantile infusion room was monitored in dynamic and static environment, and air disinfection in dynamic environment was increased, that is, in addition to routine nocturnal disinfection for 2 hours (disinfection in static environment, and continuous disinfection for 4 hours in morning), Disinfection lasted 4 hours in the afternoon. Then in each kind of environment, sample separately, submit to check. 2. According to the five important hand hygiene times stipulated by the WHO, the nurses were randomly monitored for hand hygiene: before contact with the patient, before cleaning (sterile) operation, after contact with the patient, and after contact with the patient's body fluid. After contact with the patient's surroundings, wash hands with the six-step hand-washing method or use a quick-drying hand disinfectant for hand sanitization. The compliance, accuracy and bacteria of hand hygiene of nurses were observed. Result 1. The bacterial content in the infantile infusion room after routine disinfection was significantly higher than that in the static environment, and the bacterial content in the air under the dynamic environment after continuous disinfection was significantly reduced, and even reached the effect under the static environment after disinfection. Meet the requirements of Hospital Disinfection and Sanitation Standard. Gram-negative bacteria accounted for 71.8, Gram-positive bacteria 15.4and fungi 9.8. Among them, Staphylococcus and Escherichia coli are the main flora, accounting for 68.82-78.57 in the number of bacteria in air, and the content of Escherichia coli in Gram-negative bacilli is obviously higher than that of other negative bacilli. The nurses' hand hygiene compliance and accuracy were significantly higher than those under random conditions, and no pathogenic bacteria were detected in the decrease of hand colony number. Conclusion 1. Air monitoring under the static environment can not reflect the air quality in the working state, and increasing the continuous air disinfection in the dynamic environment can effectively improve the air cleanliness. 2. One of the important measures to prevent nosocomial infection is to strengthen the supervision and training of medical personnel and to do hand hygiene and hand disinfection well.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R183

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