RESUMO
Objective To determine the current disinfection quality and understand existing problems in clinical institutions in Yangpu District， and provide scientific evidence for improving hospital infection control. Methods From 2018 to 2020， the specimens were collected from medical instruments， disinfectant in use， dialysis water in hemodialysis rooms， air， surface of objects， sterilization equipment， hands of medical staff， dental therapy water and sewage in clinical institutions in Yangpu District， and then examined for disinfection quality. Results A total of 1 420 samples were collected consecutively in 3 years， in which the total qualified rate was determined to be 88.52%. The qualified rates in secondary and tertiary hospitals， primary health centers， and private clinics were 94.86%， 90.22% and 75.74%， respectively， with a significant difference （χ2=95.01， P<0.01）. The qualified rates in sterilization equipment， air， and dialysis water were all 100.00%； in contrast， the rates in medical instruments， surface of objects， hands of medical staff， disinfectants in use， dental therapy water， and sewage were 98.28%， 97.63%， 95.05%， 93.39%， 54.71% and 50.00%， respectively. Conclusion Overall disinfection quality remains good in clinical institutions in Yangpu District of Shanghai， whereas the quality in private clinics is low. In addition， dental therapy water and hospital sewage might be susceptible to contamination， which warrants further improvement in the disinfection and monitoring.
RESUMO
A partir de dificuldades concernentes ao tempo clínico observadas nos ambulatórios de instituições de ensino voltados para o atendimento de população de baixa renda, este texto tenta problematizar o que poderia vir a ser uma apreensão contemporânea da noção de tempo. De uma concepção historicizante, eminentemente simbólica e baseada na sucessão, exploram-se aqui outras possibilidades, baseadas agora na conexão e na associação, nas quais uma abordagem topológica do tempo mostrar-se-ia mais adequada.
Considering the difficulties regarding clinical time observed in emergency/waiting rooms in educational institutions dealing with the treatment of the lower-income population, this article aims to lay out the problems that may develop into a contemporary apprehension of the notion of time. Looking from an historical approach that is both eminently symbolic and based on succession, we explore some other possibilities based on connection and association, where a topological approach regarding time may be more adequate.