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Objective:To learn the application of nosocomial infection prevention and control measures as stipulated in COVID-19 emergency plans by medical institutions at all levels in the region, for the purpose of strengthening epidemic prevention and control.Methods:During March 12-13, 2020, customized questionnaires were used to learn from 186 hospitals and medical institutions regarding the basics of their nosocomial prevention management departments, emergency plan application and revisions made. Comparison of the ratios or constituent ratios were tested with χ2 test, while the continuous variables analysis between groups was verified with one-way ANOVA. Results:77.53% of the medical institutions had set up independent nosocomial infection management departments, and 87.30% of the institutions were qualified. 80% of the medical institutions had in place emergency plans for respiratory infectious diseases, but 98.05% of them had revised their plans during the pandemic, with an average of 10.85 newly added and revised provisions. Only 30.11% of emergency planed provide for clearly graded early warning.Conclusions:Efforts should be upgraded to develop an emergency prevention and control system for infection prevention and control in epidemics, and improve technical support for infection prevention and control in the system; to strengthen the clearly-graded early warning and graded responses in a scientific manner; and conduct regular drills, revise plan to ensure its applicability.
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Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.
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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 compare antioxidant activity of different extraction parts from flower buds of Buddlejae flos in vi-tro. METHODS:Ethanol crude extract (ET) was extracted from flower buds of B. flos with 60% ethanol and diffused by water;and petroleum ether,ethyl acetate and n-butanol were used to extract ET to obtain PE,EA,BU and water samples(SH). Using di-butyl hydroxy toluene(BHT)as positive control,the antioxidant capacity of PE,EA,BU and SH were investigated by using 1, 1-diphenyl-2-picrylhydrazyl(DPPH),2,2′-azino-bis(3-ethyl benzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radi-cal scavenging method and ironion reduction/oxidation resistance ability (FRAP) method. IC50 and antioxdant equivalent TEAC were calculated. RESULTS:Compared with other samples,ET and EA had stronger antioxidant activity,and IC50 of EA scaveng-ing DPPH and ABTS free radical were 13.75,9.78 μg/ml,and those of ET were 14.93,11.41 μg/ml;scavenging ability of EA to DPPH free radical was stronger than that of BHT(IC50 was 18.71 μg/ml). TEAC of EA,ET and BHT were 1 657.67,1 586.25 and 1 581.68μmol/g. CONCLUSIONS:The ethyl acetate extract from flower buds of B. flos has good antioxidant activity.
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Objective To summarize the effectiveness in monitoring activities for healthcare-associated infection (HAI)in China in the past 30 years,explore the changing trend in HAI monitoring,find a new model for the moni-toring of HAI in China.Methods A total of 194 comprehensive hospitals and military hospitals in 13 provinces (au-tonomous regions,municipalities)were selected,questionnaire survey was adopted to investigate the situation of HAI monitoring.Results Of 194 hospitals,184 (94.85%)had available data after being checked,incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively,difference was significant (P <0.01).Monitoring was divided into two stages,cumulative percentage of each monitoring activity before 2006 and during 2006-2016 were respectively as follows:environmental hygiene were 73.91% and 100.00%,disinfection ef-ficacy 69.57% and 97.28%,overall comprehensive monitoring 64.67% and 98.91%,surgical site infection(SSI) 13.04% and 94.57%,ICU HAI 4.89% and 87.50%,neonatal HAI 1.75% and 60.82%,multidrug-resistant or-ganisms(MDROs)5.43% and 95.65%,hand hygiene compliance 2.17% and 93.48%,antimicrobial agents 15.22% and 87.50%.The reporting rate of HAI outbreak in tertiary hospitals was higher than secondary hospitals (33.33% [n=37]vs 16.44%[n=12],P =0.01).Conclusion The monitoring of HAI in China starts late,but develops rapidly,defects still exist in HAI monitoring system,reporting rate of HAI cases is still high,reporting rate of HAI outbreak is low.
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Objective To understand the development situation of healthcare-associated infection (HAI)manage-ment departments in the rational antimicrobial application and management in hospitals in China.Methods A total of 166 hospitals from 12 provinces,municipalities,autonomous regions,and military hospitals were selected for survey,the participation of HAI management departments in the rational clinical antimicrobial application and man-agement in different years was compared.Results Of 166 hospitals,68(40.96%)in 2005,119(71.69%)in 2010, and 160(96.39%)in 2015 participated in the establishment of management organizations for rational antimicrobial application (χ2 =121.143,P <0.001).The percentage of HAI management departments participating in antimicro-bial management increased from 10.24%(n=17)in 2005 to 22.29%(n=37)in 2010,and 31.33%(n=52)in 2015 (χ2 =22.172,P < 0.001 ).The percentages of HAI management departments participating in formulating cata-logues for antimicrobial varieties and classification,stipulating permission for antimicrobial use,joining antimicrobi-al management teams,monitoring bacterial resistance,managing antimicrobial prophylaxis in clean incision,super-vising clinical antimicrobial use,conducting clinical consultation,and evaluating prescription were 10.87% -30.72% in 2005,25.90%-65.06% in 2010,and 36.14%-95.18% in 2015 (all P <0.01).Intensity of antimicro-bial use (defined daily dose/100 bed-days,DDD/ 100 bed-days)decreased from 69.16 in 2005 to 41.40 in 2015, antimicrobial usage rate decreased from 46.98% in 2005 to 36.90% in 2015,among patients receiving therapeutic antimicrobial use,specimens sending for pathogenic detection increased from 20.58% in 2005 to 49.39% in 2015. Conclusion Departments of HAI management in China play important role in management of rational antimicrobial application.
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Objective To understand the current situation of occupational exposure and protection among health care workers (HCWs ), and provide evidence for formulating preventive measures of occupational exposure. Methods From April 6,2016 to May 6,2016,questionnaire surveys were conducted in 158 different levels of hos-pitals in 13 provinces in China,occupational exposure,protection management,and monitoring of occupational expo-sure in the first year,2010,and 2015 was surveyed by cluster random sampling method.Results Occupational ex-posure in 81.65% (129/158)of hospitals was responsible by healthcare-associated infection management depart-ments;98.73%(156/158)of hospitals set up the relevant rules and regulations;77.22%(122/158)of hospitals had missing report of occupational exposure.A total of 11 116 times of occupational exposure occurred (1 542 cases in the first year,2 474 in 2010,and 7 100 in 2015).Of various types of occupational exposure,sharp injury accounted for 96.76%;among HCWs sustained occupational exposure,nursing staff accounted for 53.90%;the major de-partment that HCWs who sustained occupational exposure were general wards,operating rooms,and intensive care units;the main medical appliances related to occupational exposure were syringes,scalp needles,and surgical suture needles;high-risk behavior causing occupational exposure were intravenous injection,putting needles into the sharp con-tainers,and surgical suturing;among occupational exposure sources,HBV accounted for 58.69%.Conclusion HCWs in China face a high risk of occupational exposure,occurrence of occupational exposure should be reduced through gov-ernment legislation,application of safety appliances,standardizing behavior of HCWs,proper using of personal pro-tective equipment,strengthening education and training of HCWs,and establishing a sound occupational exposure report,evaluation and follow-up system.
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Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.
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Objective To understand the development of healthcare-associated infection(HAI)management organ-izations in China in the past 30 years.Methods Development of HAI management organizations in 12 provinces (municipalities,autonomous regions)in China was surveyed.Results A total of 166 hospitals were surveyed,96 (57.83%)were tertiary hospitals.Among 164 hospitals which had a history of development of HAI management department,46(28.05%)before 1995,63(38.14%)in 1995-2005,and 55(33.54%)in 2005-2015 set up HAI management departments.HAI management professionals per 1 000 beds in 165 hospitals decreased from 4.80 in 1995 to 4.09 in 2015,occupational categories in HAI management departments in 1995 -2015 were significantly different (χ2 =26.22,P <0.01).The constituent ratios of education background and profession of HAI manage-ment professionals in each province in 1995-2015 were significantly different(χ2 =242.91,47.10,respectively,all P <0.01).In 1995 and 2005,70.81%,53.30% of professionals were with college degree or below;in 2015,the percentage of professionals with bachelor’s degree,doctoral degree,and master’s degree were 53.79%,2.45%, and 22.86% respectively.Most professionals were nursing staff,but the percentage decreased from 58.38% in 1995 to 45.96% in 2015.Conclusion Although HAI management organizations have developed for 30 years and made some achievements,there still remain some problems,the proportion of professionals needs to be enhanced,and personnel structure should be optimized.
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Objective To describe the monitoring and control of pan-drug resistant Acinetobacter baumannii (XDRABA) colonization and infection in a medical intensive care unit (ICU),and to summarize the effective measures of surveillance of nosocomial infection and control.Methods Nonsurgical patients admitted to medical ICU of Peking University People's Hospital from September 2009 to April 2013 with length of ICU stay over 48 hours were surveyed.Number of cases of colonization and infection of XDRABA per month was recorded,and the clinical features of patients with XDRABA colonization and infection were observed.The control of XDRABA colonization and infection was divided into three stages:① Outbreak stage,from September 2009 to August 2010,the infection control measures included stringent hand hygiene and surface disinfection,use of disposable ventilator tubes and improvement in antibiotics use.② Environmental control stage,from September 2010 to April 2012,the infection control measures consisted of on-the-spot investigation,isolation of patients with XDRABA colonization and infection,tubes terminal environment disinfection.③ Microbial screening stage,from May 2012 to April 2013,throat,nose and axillary swabs were obtained when the patients admitted.Results From 2009 September to 2013 April there was a total of 193 patients colonized or infected with XDRABA,and 64 patients died (mortality rate was 33.2％),and 133 (68.9％) patients were on mechanical ventilation.Patients with XDRABA colonization and infection had severer illness [acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score 20.3 ±6.7],longer ICU stay [(34.6 ± 13.8) days].In outbreak stage,number of cases with XDRABA colonization and infection was 5-9 per month.In environmental control stage,case number of XDRABA colonization and infection was 3-6 per month.In microbial screening stage,case number of XDRABA colonization and infection,which were already present,was 2-4 per month,and they were mainly admitted from emergency department (59.5％).The number of cases of ICU acquired XDRABA colonization and infection decreased from 2-3 to 0-1 per month.Conclusion To control the colonization and infection of XDRABA,monitoring of microorganism,hand hygiene,isolation of patients with XDRABA colonization and infection,and stringent environment disinfection were very necessary.
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OBJECTIVE According to the characteristics of ophthalmic surgical instruments,to select the best sterilization method in order to guide clinic.METHODS The different methods of disinfection and sterilization,surgical volume and postoperative infection of ophthalmic surgical instruments from 2005 to 2007 were reiewed and compared the current pros and cons of various sterilization methods.RESULTS The use of low-temperature sterilizer before(2005) the number of surgical cases of 2275 cases,the infection rate was 0.04%;the use of low temperature plasma sterilizer after the(2006) the number of surgical cases of 2752 cases,the infection rate was 0;the use of low-temperature plasma and low-temperature steam formaldehyde sterilization sterilization(2007) Example surgery for 2830 cases,the infection rate was 0.035 percent;low-temperature sterilization of surgical instruments can ensure sterilization,but also enhance the volume of surgery.CONCLUSIONS Hydrogen peroxide plasma sterilization technology with the use of low-temperature range,fast,convenient and reliable features,more suitable for ophthalmic surgical instruments after the section of the sterilizer.
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OBJECTIVE To surveillance invasive fungal infection rate in SICU,in order to direct intervention to prevent invasive fungal infection.METHODS The samples collected from SICU patients in our hospital between Jan 2003-Nov 2008 were cultured.RESULTS According to the diagnosis standard of nosocomial infections,75 case of 3699 patients were isolated fungi.During 6-years invasive fungal infection rate is 2.027%,(1.05%-2.63%).Totally 86 fungi strains were isolated,the majority of them being Candida albicans,accounting for 46.51%;Candida glabrata 22.09%;Candida tropicalis 13.95%.CONCLUSIONS During 6-years,invasive fungal infection rate and incidence density do not increase.Candida are the major pathogens of fungal infections in SICU.
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OBJECTIVE To study on control measures of surgical site infection.METHODS By forward-looking survey methodology,surgical patients(including obstetrics) with surgical incision infection were investigated.RESULTS The highest infection rate(2.67%) were found in patients with surgical trauma to the largest,longest operation time,coronary artery bypass grafting.In 11 cases surgical site infections,only 1 case were given antibiotics before anesthesia,10 cases were administrated antibiotics post operation more than 4 days.The correct rate of preoperative and postoperative usage of antibiotics was only 9.09%.The size of surgical trauma,operative time,perioperative usage of antibiotics were related to the infection rate.CONCLUSIONS Target monitoing of the surgical site infection can decrease the infection rate.
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Objective To determine the effect of community family visit on patients with metabolic syndrome.Methods According to the diagnostic criteria set up by the Diabetes Society of the Chinese Medical Association 220 patients with metabolic syndrome were equally divided into two groups:family visit group and control group.The family visit group was followed up by full-time medical staff regularly,while not interfering with the control group.After one year before and after the intervention,the relevant indicators were compared between the two groups.Results The levels of SBP,DBP,TG,TC,LDL-ch,24-hour urine protein were lowered markedly by intervention (P＜0.05).HDL-ch increased compared to the previous (t= 7.921,P＜0.05),but body mass index were not significantly changed.Before and after the intervention the levels of SBP,DBP,TG were ideal This was followed by significant improvement of fasting plasma glucose (FPG),two hours after meal blood glucose (2 hPG),TC,HDL set standards,24-hour urine protein body mass index.Compared with the control group,the family visit group showed siguificant improvement of related indicators except body mass index and TC.Condusion Intervention by family visit is effective in improving the vales of metabolic syndrome.
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OBJECTIVE To investigate the management and sanitation status of the air circumstance in laminar flow operating rooms of grade two and above hospitals in Beijing.METHODS Air surveillance methods,cleaning methods of intakes,cleaning status of pipelines and frequency of renewing filter systems were investigated through interviewing charge nurse of 18 hospitals by questionnaires.RESULTS 50.0% of pipelines had never been cleaned,14.3% of intakes had never been cleaned.Air surveillance method of all hospitals was using sedimentation,with a low sensitivity.The monitoring systems were poor in 50.0% of hospitals.CONCLUSIONS Now there is only requirements of construction standard of clean surgery region,lacking routine regulations and technologies of contamination controlling standard,nor available dynamic contamination controlling system.Potential hazard exists in routine regulations of laminar flow operating room and it demands for making contamination controlling standard urgently in hospitals.
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OBJECTIVE According to the development of nosocomial infection management in China,we design a series of nosocomial infection surveillance and management system,in order to work effectively in real time to control nosocomial infection outbreak,standardly collecting and analyzing the surveillance data of the critical department/area and risk factors for nosocomial infection,so a scientific management for nosocomial infection can be realized.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 edition,the front application program used PowerBuilder7 programming.The application software where collected all data about nosocomial infection information was integrated into the each work station of the information system,in order to form nosocomial infection surveillance and management network related to any department of the hospital.RESULTS System could come down with the hospital infection case which every hospital department could find to check,put in order,report,count,analyze,have a look around,inquire about,feedback,form the monitoring chart with excellent pictures and texts,and make the better prognosis of the nosocomial infection outbreak.CONCLUSIONS Beijing nosocomial infection surveillance and management system is a medical quality control system of a hospital.This software could afford scientific and standard data for the health care institution and administration to realize the primary information of nosocomial infection and make decisions.
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OBJECTIVE To provide a practical action plan which can prevent and control the similar occurrence through studying the epidemiological characteristics of a norovirus-induced diarrhea outbreak in the wards of our hospital. METHODS To obtain the information about the epidemic situation of norovirus involving 15 patients in the two wards of our hospital, during the period from Nov 12 to 15, 2006. RESULTS It was a norovirus gastroenteritis outbreak in the 8 cases among 15 patients and there were other 7 sporadic cases. The consummate monitoring system on nosocomial infection could gain the information of disease, and be very helpful to control its transmission. Beijing Municipal Center for Quality Control and Improvement of the Management of Nosocomial Infection was known the information and shared it among different kinds of hospitals. Thus an unnecessary panic was avoided in Beijing at that time. CONCLUSIONS The social factor, senile situation and immunocompromise are the causes of this norovirus outbreak. The effective control measures and the information exchange in time could prevent the spread of infection. It is shown that the nosocomial infection monitoring network could catch the epidemic tendency of nosocomial infection sensitively, so to strengthen the monitoring network is the key.
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OBJECTIVE To investigate the hospitals containing above 500 sickbeds in the Beijing area,in order to find out the relationship between the environmental sanitation monitoring(including air,object surface,medical personnel hand,using desinfectant compound,and ultraviolet lamps) and the hospital infection control.METHODS Choosing hospitals with above 500 sickbeds in Beijing,through a written survey and questionnaire covering the actual environmental sanitation monitoring quantity,the positive rate and the situations of hospital infections outbreak in 2005,then calculate the statistical analysis.RESULTS After calculating the environmental sanitation monitoring cost for the hospitals with above 500 sickbeds,it could conclude the monitoring expense for 1000 sickbeds hospital per year for each bed was 192.10 RMB;the monitoring expense for 500 sickbeds hospital per year for each bed was 145.60 RMB.It could also conclude the positive rate of object surface and the hands of medical personnel was higher.CONCLUSIONS Through the analysis,each hospital carries out the monitor according to the requirement of the "Standards",the monitoring expense for hospitals with 1000 sickbeds is higher that of hospitals with 500 sickbeds.It is no correlation between the hospital monitoring positive rate and the hospital infection outbreak.The medical personnel′s knowledge of hospital infection control and hand hygiene training must be strengthened.
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OBJECTIVE To seek the effective dynamic air disinfector for hospitals,and investigate the effects of JBL nano-meter dynamic air disinfector.METHODS Choosing four different hospitals,using JBL nano-meter dynamic air disinfector device to collect,compare and analyze the data under a human being movement environment or a vacant environment on the basis of the air sampling method taken from Hospital Disinfection Technology Standard(in 2002 edition) issued by the Ministry of Health.RESULTS When all four hospitals using JBL nano-meter dynamic air disinfectors,the average air bacterium-killing rate in a human being movement environment reached 80.35%,which was obviously better than other similar devices.CONCLUSIONS JBL nano-meter dynamic air disinfector not only has very good function of removing the unusual odors,but has excellent active air disinfection effect.Meanwhile,the device can be installed conveniently.It is regarded as one of the best hospital air disinfection devices.
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OBJECTIVE To investigate the knowledge about hand hygiene among the outpatients and then take some valid methods to enhance their understanding about hand hygiene.METHODS By randomly asking patients from two departments in a level A of the tertiary hospital,one was a digestion and the other was a non-digestion department question designed by ourselves.The data were generally described by percentage and ?2 test with SPSS 6.0.RESULTS All the patients had not enough and correct hand hygiene knowledge from both two groups.The patients from digestion department paid more attention on their hand hygiene than from non-digestion one.The most patients from both two groups thought they needed to know more about hand hygiene and hospital should equipped with some fast hands cleaning instruments.CONCLUSIONS It is a very important duty for nurses to explain and publicize more about general hygiene and show patients how to clean their hands in order to decrease hospital infection.