Nosocomial infections are infections acquired by patients, visitors or staff in hospitals that produce clinical symptoms. With the development of hospital modernization and medical measures on invasive diagnostic and therapeutic means, hormones, chemical methods, radiation therapy and antibiotics are widely used, the incidence of nosocomial infections at home and abroad are significantly increased. The occurrence of nosocomial infections will not only add extra pain to patients, but also prolong the hospitalization time, increase the burden of medical care work, and often make the patients suffer from diseases that do not achieve the expected therapeutic effect, and even cause death. Therefore, the prevention of nosocomial infections is particularly important, the incidence of which has been listed as one of the indicators of China's hospital grading operation, for which our hospital to take the following measures to prevent: 1 to strengthen the hospital management
The characteristics of the hospital environment, a large number of bacteria and susceptible people coexist in the hospital place of the decision of the specificity of the hospital [1]. In order to reduce a variety of infections in the hospital, to take practical preventive measures.
1.1 Improve the reception and triage system According to the specific circumstances of the hospital to open different clinics, in order to prevent patients before diagnosis and general outpatient mixing and clinic caused by cross-infection.
1.2 Improve the management of disease According to the specific conditions of different departments to open isolation wards, critical wards, warm wards, etc., in order to meet the different types of patients admitted to reduce cross-infection.
1.3 Improve the regionalization management Strictly divide the management of contaminated area, semi-contaminated area and clean area, nursing staff should not only be strictly disciplined, but also control the patients and their families.
1.4 Strict implementation of bedside visitation system Control of visitors, reduce bedside companions, cut off the path of exogenous bacterial contamination, reduce the infection rate.
1.5 Proper handling of waste garbage Medical waste, household garbage, sharps are classified and properly handled, and collected and disposed of by specialized staff. 2 Strict implementation of disinfection
2.1 Strengthen the management of the air environment in the ward Air bacteria content is closely related to a variety of infections, nursing staff should be from a number of links to reduce the content of air microorganisms in high-risk areas. Regularly open the windows, ward wet cleaning, daily completion of bed linen replacement, centralized room checks after the use of 0.5% 84 disinfectant ultrasonic atomization for air disinfection. Protective isolation is implemented for high-risk key departments and high-risk groups, and strict visitation is carried out, and measures are taken to change clothes and wash hands when visitors enter the room, and to ventilate the room, disinfectant wipe, and spray disinfection after visitation. Once a month to do bacterial culture, such as failed, re-disinfection and then do the culture to ensure the cleanliness of the ward.
2.2 Strengthen the items disinfection sterilization treatment Sterilization laxity is the cause of hospital infections, there are many sterilization methods, but still think that high temperature, high pressure effect is better. Some studies have reported that contaminated oxygen humidification bottles, oxygen tubes, oxygen cannulae, ventilators, nebulizers, catheters, bedside cabinets, communal washing pools, etc. are important transmission factors causing cross-infection. Therefore, in addition to the disinfection of instruments and articles that must be disinfected, the disinfection of instruments and articles that are easy to ignore should be carefully disinfected.
2.3 Hand disinfection Nursing staff should wash their hands thoroughly before and after each nursing operation, because contaminated hands are the most important medium of hospital infection. Careful hand washing and hand disinfection is an effective measure for the two-way protection of patients and medical staff [2]. No rings or bracelets are allowed to be worn during working hours, and the aseptic operation system is strictly observed. Do one person, one needle, one tube, one pad, one towel and one belt, install sensor taps in the treatment room and equip hand dryers to avoid or reduce re-contamination, and conduct monthly sampling and monitoring of medical staff's hands to ensure that the number of fingers with bacteria is no more than 15cfu/cm2. 2.4 Terminal disinfection After the patients are discharged from the hospital and the death of the patient, the bed unit is strictly wiped and disinfected in order to achieve the purpose of thorough terminal disinfection. 3 Reduce invasive operations
Minimize various invasive operations, if the condition requires, must strictly implement aseptic technology, and effectively prevent the spread of pathogenic microorganisms. It has been reported that urinary tract intubation is an important cause of urinary tract infection [3]. In must catheterization, should choose small toxicity, low infection rate of silicone balloon catheter, strict aseptic operation, two times a day urethral disinfection, daily replacement of drainage bags, sterile urinary catheter weekly replacement, before and after the retention of urinary catheter and before and after the removal of the urinary catheter should be done before and after the patient urine bacterial culture, such as the occurrence of bacteriuria immediately stop catheterization, and the use of reasonable antibiotic treatment. 4 Reduce open treatment
Open operation is another cause of infection. Continuous bladder irrigation is unavoidable in urinary tract diseases. The use of 3 000 ml large bags of saline flushing, due to gravity does not need to drain the tube and connecting tube, changing the bag by the nurse to carry out the work, carefully check each bag of saline, to avoid turbidity and impurities of the liquid rushed into the bladder. Connected to 5000ml disposable drainage bag, commonly used closed, thick neck, not easy to block and can reduce the occurrence of nosocomial infections, properly fixed flushing fluid is not easy to reflux, more effective to avoid nosocomial infections. 5 Rational use of antibiotics
According to the results of the drug test to select effective antibiotics, careful use of broad-spectrum antibiotics, the implementation of the doctor's orders, nurses must grasp the rational use of common sense, according to the half-life of the drug to determine the time of administration, consciously according to the prescribed time of the drug, and actively observe the effect of treatment, and timely to the doctor to provide the basis for stopping and changing the drug to maximize the effectiveness of the use of antibiotics to reduce the emergence of drug-resistant strains of bacteria. At the same time, pay attention to the use of more than two antibiotics into, should not be placed in the same solution of static injection or drip, some antibiotics after matching, although the appearance of the drug solution is not obvious changes, but due to the interaction of the drug solution, there can be a change in the pharmacology or chemical structure, inactivity, loss of or reduction of antibacterial effect.
6 shorten the hospitalization time
Actively treat the primary disease, strengthen the supportive therapy, under the premise of improving the quality of medical care, shorten the hospitalization time. For some elderly patients with chronic diseases, after the stabilization of their chronic diseases, they should be discharged as soon as possible to continue treatment and regular outpatient follow-up.
In short, to do a good job of preventing hospital-acquired infections in the management of all health care workers is the key. As long as the above rules are strictly followed, nosocomial infections can be prevented and controlled, in addition, should be established, sound infection management organization. From the monitoring indicators in these years, it can be seen that the above preventive measures have greatly reduced the occurrence of hospital-acquired infections.