The analysis of the reasons for disinfection and isolation quality control and the corrective measures are written as follows:
1. The environmental layout is unreasonable.
The laboratory environment is dirty and messy; the division of clean areas, contaminated areas, and semi-contaminated areas is unclear, which may lead to cross-infection among laboratory personnel, hospital medical staff, and patients.
Rectification measures: Design the layout according to the laboratory biosafety level and equip it with experimental instruments. The laboratory workplace should be divided into clean areas, contaminated areas, and semi-contaminated areas as needed. The clean area includes offices, conference rooms, and lounges; the semi-contaminated area refers to sanitary passages, locker rooms, and buffer rooms; and the contaminated area includes specimen collection, storage, and testing. The work flow should be designed reasonably to avoid repeated cross-flow of people, logistics, and specimen flows.
2. Weak awareness of occupational protection.
Laboratory department staff have been in contact with patient specimens for a long time, diluting their awareness of infection risks, resulting in poor awareness of self-protection: for example, they do not wear work caps and masks when working, do not wear gloves when touching specimens, and use contaminated hands Frequent contact with work surfaces and objects, or eating and drinking in the laboratory.
Corrective measures: Strengthen the training of hospital infection prevention and control knowledge for laboratory personnel, strengthen their awareness of self-protection, and require them to wear appropriate protective equipment when working; gloves must be worn when touching specimens; it is strictly prohibited to wear gloves in contact with daily life Supplies and office instruments and equipment. If occupational exposure occurs, the exposed area should be disposed of promptly and reported to the infection control office.
3. Poor hand hygiene compliance.
Blood drawing staff in the laboratory department, including outpatient and bedside blood collection staff, generally have poor hand hygiene awareness and low hand hygiene compliance. They do not follow the WHO "Hand Hygiene Timings" to perform hand hygiene before and after contact with patients. It is easy to become the spreader of pathogenic bacteria, especially multi-drug-resistant bacteria, from one patient to another patient, from one ward to another, leading to the spread and prevalence of drug-resistant bacteria among all employees.
Corrective measures: Strengthen hand hygiene knowledge training, strengthen hand hygiene awareness, provide convenient and convenient hand hygiene facilities, and provide hand hygiene products within reach in the work area of ??blood collectors, including clinical blood collectors for blood collection. The box is equipped with quick-drying hand sanitizer for their convenience. Hospital infection management personnel should be responsible for training, education and supervision of implementation.
4. Disinfection and isolation measures are not implemented in place.
The leaders of the laboratory department do not pay enough attention to hospital infection prevention and control, and the staff do not have a thorough understanding of hospital infection control, which brings great hidden dangers to hospital infection control. For example, laboratory instruments and environmental disinfection measures are not implemented in place, and the disinfection treatment of the environment and items is not strict. Such as the pollution problem on the inspection report.
Rectification measures: Strictly implement disinfection measures. The work surface should be wiped with 500mg/l chlorine-containing disinfectant; the air should be disinfected with window ventilation, ultraviolet light, and dynamic air disinfection machines according to specific conditions; the inspection report should be disinfected. Inspection report forms should be effectively disinfected before issuance.
5. Medical waste and inspection waste are not handled according to specifications.
Medical waste is not classified and processed. Infectious waste is mixed with damaging waste and chemical waste, and is not clearly classified and treated equally with domestic waste. Staff are extremely vulnerable to needle stick injuries; discarded The pathogen culture medium, bacterial strains, and virus strain preservation solutions were not disinfected and sterilized on-site, directly polluting the environment and causing infections among different groups of people.
Rectification measures: discarded pathogen culture media and bacterial strains must be disinfected and sterilized on site; liquid waste must be strictly disinfected before being discharged; medical waste is collected in categories, and damaging waste is put into sharps boxes and infectious waste. The waste is put into medical waste collection yellow bags. When the waste reaches 3/4 of the package, the entrance is closed, unified recycling, and centralized processing.