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Ventilator related events is a new concept proposed by the America Center for Disease Control and Prevention of the United States. Compared with ventilator-associated pneumonia, ventilator related events has objectivity in diagnosis. In 2013, the National Health Safety Network replaced ventilator-associated pneumonia monitoring in adult inpatients with ventilator-associated event monitoring. This review mainly introduces the concept of ventilator-related events, the evaluation of the relationship between ventilator-related events and respiratory pneumonia, the monitoring situation at home and abroad, and the related factors of ventilator-related events, so as to lay a foundation for the further study in the future.
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OBJECTIVE：To pro vide reference for exposure protection countermeasures for Novel coronavirus （SARS-CoV-2） infection in hospital pharmaceutical staff. METHODS ：According to the recommendations of related medical staff protection guideline，combined with the characteristics and prevention and control requirements of novel coronavirus pneumonia （COVID- 19），based on the basic principle of exposure protection ，actual exposure risk of infections for hospital pharmaceutical staff were evaluated，and the countermeasures for exposure protection were constructed under the epidemic condition of COVID- 19. RESULTS：According to the standard prevention principle and the risk evaluation of infection exposure ，most of the pharmaceutical posts in the hospital belonged to low-risk exposure posts ，and only a few posts belonged to medium-and high-risk exposure posts. Personal protective equipment should be provided according to the exposure risk level of different pharmaceutical posts and work demand. At the same time ，infection protection training should be strengthened ；environment and facilities in pharmacy should be cleaned and disinfected. CONCLUSIONS ：Standard prevention principle should be followed by hospital pharmaceutical staff during epidemic period. Based on the characteristics and exposure risks of pharmacy posts ，and according to the regulations of the hospital，personal protection for hospital pharmaceutical staff should be conducted according to the exposure risk level determined by the pharmaceutical department and relevant management regulations to avoid over-protection or inadequate protection ，so as to ensure the smooth and safe development of pharmaceutical care.
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Elderly patients with COVID-19 are at high risk of nosocomial infection due to the factors such as advanced age, frequent invasive operations, extensive use of antimicrobial agents, and lower compliance of medical staff to implement hospital infection control measures during epidemic prevention and control. During the COVID-19 epidemic, on the basis of actively treating patients, we should pay attention to the prevention and control of nosocomial infection in elderly patients, and strictly prevent and control the aggregation and outbreak of nosocomial infection.
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Objective To understand the cleanliness of hands and uniforms of health care workers(HCWs)while they were working in a hospital.Methods Specimens of hands and uniforms of HCWs while they were working were collected and detected.Results A total of 342 specimens were collected, 173 were specimens from hands and 169 were from uniforms, the total qualified rate was 78.65%,qualified rates of hands and uniforms were 76.30% and 81.07% respectively.Qualified rates of hands and uniforms of different HCWs were compared respectively, differences were both statistically significant (both P<0.05);qualified rates of hands and uniforms of nurses were both highest (87.93% and 92.86% respectively), followed by doctors (75.86% and 87.72% respectively), while medical auxiliary persons were the lowest(64.91% and 62.50% respectively).Correlation analysis between qualified rates of hands and uniforms of HCWs in general wards showed that the correlation coefficient was 0.930 (P<0.01).Conclusion Cleanliness of hands and uniforms of HCWs needs to be further improved, especially medical auxiliary persons;cleaning frequency and cleanliness standard of HCWs' uniforms needed to be studied further.
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Objective To investigate the current status of preoperative skin preparation in abdominal surgery in China,and put forward suggestions for improvement.Methods From April to May,2016,187 secondary and above hospitals in China were selected,questionnaires were used to investigate the methods for hair removal,skin disinfection on operative field,and application of surgical adhesive drape in abdominal surgery.Results A total of 187 hospitals in 14 provinces were investigated,of which 108 and 79 were tertiary and secondary hospitals respec-tively.87.70% of hospitals performed conventional preoperative hair removal in abdominal surgery,the percentage of conventional depilation in secondary hospitals was higher than tertiary hospitals(93.67% vs 83.33%,χ2 =4.520,P =0.033).85.98% of hospitals selected blade-shaving,7.93% and 23.78% applied chemical depilation and electric depilation respectively.Most hospitals (98.17%)performed skin preparation in the wards,mainly by ward nurses (98.17%),and conducted on the day of surgery (56.10%).86.63%,29.95%,and 3.74% of hospi-tals used iodophor,iodine plus alcohol,and chlorhexidine respectively for disinfecting skin on operative field. 92.51% of hospitals used skin incision/surgical adhesive drape (74.57% used selectively).Conclusion Most hos-pitals in China conventionally perform preoperative hair removal in abdominal surgery,and the primary method for depilation is blade-shaving,nearly half of the hospitals performed depilation on the day of surgery.Iodophor is the major skin antiseptic,surgical adhesive drape is widely used,but it is utilized in limited types of surgery.
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Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.
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Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.
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OBJECTIVE To investigate a case of nosocomial infection incident in a hospital,analyze the reasons and put forward preventive measures.METHODS Investigation was carried out on the related people and environment in the department where the incident occurred.Analysis was made on the reasons and processing.RESULTS The nosocomial infection incident was caused by Norovirus;fecal-oral transmission and contact transmission were 2 main pathways of Norovirus.There were 7 persons who had been contaminated by Norovirus,included 5 old inpatients,1 doctor and 1 nurse.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,hospital works etc.Hand-washing and disinfection isolation should be enhanced among the hospital staffs in the normal works.
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Objective To explore a management strategy for disinfection supply in hospital. Methods A PDCA (plan, do, check, and action) model was applied to establish a manngement strategy for the disinfection supply, strengthen the education among all staff, promote the competence level of disin-fection supply center, organize joint inspection group for regular union supervision, give feedback promptly and implement strictly. Results By applying the PDCA model, the staff in the disinfection supply center strengthened the consciousness in standard cleanness, disinfection and sterilization, the number of pack-ages prepared by clinic room was reduced, and the supply of sterilized materials were more centralized. Conclusion The management strategy based on PDCA model of disinfection supply in hospital is effec-tive.
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Objective This study compared the cleaning effect of gastroscope by different cleaning mehtods and discuss practical and reliable evaluation method for the cleaning degree of gastroscope.Methods Three cleaning methods were selected and used in the cleaning of gastroscope.The Endocheck lumen was used to examine the cleaning degree of gastroscope and the effects of different methods were compared. Results The qualification rate by using ordinary cleaning method was 50.0%and it reached 60.0%and 73.3%by elevation of polyenzyme concentration and adding bedside pre-washing.which Was statistically different from that by using ordinary cleaning method(P＜0.05).Conclusions Bedside pre-washing could increase the cleaning degree of gastroscope;Endocheck lumen could be regarded as an evaluation method for the cleaning degree of gastroscope.
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OBJECTIVE To understand the situation of the nosocomial infection among the hospital inpatients in a grade-A hospital in Beijing.METHODS Surveillance on nosocomial infection was performed among the hospital inpatients from Jan 2005 to Dec 2007.RESULTS From Sept 2006 to Aug 2007,803 cases were infected,the incidence was 1.99%.The lower respiratory tract ranked the first place(38.97%)and the highest infected rate was in ICU(16.16%).The species were predominated by Gram-negatives.The main pathogenic microorganisms were Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii,Klebsiella pneumoniae and Candida albicans,etc.From 2005 to 2007,the infections caused by P.aeruginosa increased gradually,and the infections caused by C.albicans reduced gradually.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,management workers,etc.