Summary of the first half of the hospital sensory management work
Time is passing, never stop, a period of time has come to an end, looking back on the past this period of time, the work, the harvest is quite fruitful, I think we need to write a good summary of the work. I think many people are in how to write a good summary of the work and trouble, the following is my first half of the hospital management work summary, I hope to help you.
Summary of the first half of the management of hospital inpatient work1
In the first half of the hospital hospital inpatient work under the leadership and guidance of the President and the President in charge, according to this year's hospital inpatient work objectives and plans to carry out the following work:
First, to strengthen the reporting of hospital infections
Seriously carry out the State Ministry of Health Nosocomial infection control standards and related regulations, the establishment of a sound nosocomial infection cases of discovery, registration, reporting, analysis and feedback, the discovery of nosocomial infection cases, immediately reported in accordance with the prescribed procedures, timely isolation and treatment, and take appropriate precautions, the discharge of cases, the Hospital Infection Branch from time to time to spot checks, the first half of the hospital infection cases 13 cases.
Second, strengthen the management of medical equipment disinfection
Strictly in accordance with the "Hospital Disinfection Technical Specification", the hospital hospital sentinel monthly sampling of sterilized items to do bacterial culture, so that the sterilized rate of sterile items up to 100%.
Three, strengthen the rational application of antibiotics
In accordance with the spirit of the notice of the Ministry of Health of the special rectification of antimicrobial drugs, the Department of Hospital Sentinel monthly hospital inpatient and hospital discharged patients with the use of antimicrobial drugs for tracking, investigating, and timely summarization, reporting, feedback, for the rational use of antimicrobial drugs to provide an important basis for the rational use of antimicrobial drugs.
Four, strengthen the ward disinfection isolation work
The ward air, object surfaces, disinfectant, medical staff hand regular monitoring and spot checks, on the oxygen device, nebulizer inhaler and so on as far as possible to take the use of disposable, to do one person, one with a disinfection.
V. Strengthening hand hygiene
The Hospital Infectious Disease Department carries out monthly spot checks on the implementation of hand hygiene in each department and assesses the hand hygiene of medical staff, and the head nurse of each department is responsible for checking and guiding to really cut off the path of spreading diseases through the hands of medical staff.
Six, strengthen the key departments standardized management
standardize the layout of the departments, clean area, contaminated area, aseptic area, clear signs, clear demarcation, the key departments of disinfection and isolation from time to time to supervise the work of strengthening the concept of asepsis awareness, improve the aseptic operation technology, to ensure the smooth progress of the work of the hospital will eliminate the hidden danger of infection in the bud. The company's main goal is to provide the best possible service to its customers.
Seven, carry out targeted monitoring
From January in the Department of Surgery to carry out the targeted monitoring of class I incision (thyroid, hernia), the monthly summary analysis, there is no case of class I incision infection. Eight, strengthen the management of medical waste in the classification of garbage, collection, delivery of various links, in strict accordance with the medical waste management system for inspection and supervision, the implementation of strict handover, each bad section of the registration, handover, signature is clear, each section has a spring weighing, weighing, registration of each section of the handover, the last statistics of the medical waste specialists, the various links of the person responsible for the emergence of the problem, to track down the responsibility of the Hospital Sensory Department from time to time on the garbage storage site The company's website has been updated with the latest information about the company's products and services, and the company's website has been updated with the latest information about its products.
eight, strengthen the hospital's sterilizing agent and disinfectant monitoring
Hospital Sentinel monthly sampling of sterilizing agent, quarterly sampling of disinfectant, the pass rate at 100% ten, the first half of the hospital hospital-wide hospital sentinel knowledge training, hospital sentinel quality analysis meeting, the more successful completion of the first half of the hospital sentinel task.
Summary of the first half of the hospital infection management work 2I section in the hospital leadership and infection management committee under the leadership of the hospital, according to the "Hospital Infection Management Code", "Disinfection Technology Code" and "Infectious Diseases Prevention and Control Act" and other relevant documents and regulations, the development of the corresponding hospital infection control plan, and organize the implementation of timely monitoring of the effect of the timely revision of the measures, so that the incidence of nosocomial infections in our hospitals in the control of a better range, no outbreak of nosocomial infections. The incidence of nosocomial infection in our hospital is controlled within a better range, and there is no outbreak of nosocomial infection. Now the main work of this year is summarized as follows:
First, improve the management system, play the role of the system
1, in order to further strengthen the management of hospital infections, clear responsibilities, the implementation of the task in August this year, re-adjusted to enrich the Department of Hospital Infection Management Team, improve the three-tier network management system. In the work, encountered the need for multi-disciplinary coordination and cooperation, timely report to the competent leadership to solve the problem.
2, November in the infection management committee under the initiative and hospital leadership support, hospital infection management part of the hospital to join the quality of medical care inspectors, the development of severe rewards and punishments.
Second, the hospital infection monitoring
I am responsible for the monitoring of the incidence of infection in the Department of Radiology, regular monitoring of the environmental hygiene of the Department of Radiology, disinfection, sterilization effect of supervision, monitoring, timely summary, analysis of the monitoring results, to find the existence of risk factors of hospital infections, and to look for effective prevention and control methods. Through monitoring-control-monitoring, ultimately reduce and control the occurrence of hospital infections and improve the quality of medical care.
1, medical records monitoring
Retrospective survey mode of hospital infection cases (in the case room to check the discharge medical records one by one, to prevent underreporting), a true understanding of the hospital infection rate of our hospital baseline. And at the same time used the form of prospective investigation, down the ward on the key patients throughout the treatment process of follow-up, close observation of the occurrence of hospital-acquired infections, not only to do the process of patient management, but also to the bedside doctor's continuous training, this work has received the expected results, can be timely detection of hospital-acquired infections, to prevent outbreaks of hospital-acquired infections epidemic.
① Infection rate monitoring:
② Monitoring of underreporting rate: the rate of reporting of infectious diseases. Meet the requirements of the Ministry of Health.
2, environmental monitoring
Regular sampling of the environment of the Radiology Department, the pass rate of 98.6%. For those who do not pass, find out the reasons and re-sample in time.
3, disinfection and sterilization monitoring
Monthly pre-vacuum autoclave disinfection room to monitor the effect of the national disinfection norms require that every day to do the B-D test, and monthly to do the biological monitoring, to ensure that the quality of autoclave disinfection and sterilization. The rapid pressure steam sterilizer in the operating room is monitored for sterilization quality as required by the National Sterilization Code.
Monthly monitoring of disinfectants in use in the Radiology Department: *** monitoring 246 copies, qualified 246 copies, a pass rate of 100%. And gradually cancel the surgical ward 'glutaraldehyde immersion disinfection, the use of pressure steam sterilization.
In June of the use of ultraviolet lamp monitoring, the first half of the **** monitoring 79, qualified 75, pass rate of 94.9%.
4, the hospital used disinfectants and disposable medical devices and items for the record.
Third, the key parts of the hospital infection management
Quarterly sampling of key DSA infection management, found that the problem, and take the initiative to communicate with the director of each department or head nurse and supervise the improvement.
Four, multi-channel training to improve medical staff awareness of hospital infection.
1, new employee training for three new employees on the introduction of hospital infection, medical waste management knowledge training and assessment, the assessment pass rate of 100%; on the new hospital interns, nurses, hospital infection knowledge training, so that they have a preliminary understanding of the hospital infection profile;
2, to take a variety of forms of knowledge of infection Training will be centralized training and morning meeting departmental training organic combination, increased clinical medical staff of hospital infection knowledge, improve hospital infection awareness.
V. Problems
1, the clinical infection management team did not give full play to its role.
2, some doctors do not pay enough attention to hospital-acquired infections, the patient's diagnosis of hospital-acquired infections as well as the lack of analysis of the condition of the hospital infection registry can not be reported in a timely manner.
Summary of the first half of the management of hospital-acquired infections 3The first half of the hospital-acquired infections mainly around the city quality control center supervision and inspection problems, and gradually improve the work. The specific situation is as follows:
First, monitoring work:
January-June hospital infection cases occurred 13 cases, the incidence rate of 0.62%, the aetiology of the rate of 84.6%; in the monitoring of urinary catheter-related urinary tract infections indwelling urinary catheter 53 cases, urinary catheter utilization rate of 3.27%, the occurrence of urinary tract infections in one case, its catheter The rate of catheter-associated urinary tract infection was 1.49%; one case of type II surgical incision infection occurred in the department of Surgery II, and the rate of surgical incision infection was 0.85%. *** Detection of multi-drug resistant bacteria patients 2 times, in accordance with the requirements of the isolation clinic. In accordance with the plan to carry out a cross-sectional survey of hospital infections, the data will be uploaded to the National Sensory Control Base.
Second, hand hygiene:
The first half of the sampling hand hygiene timing 558 times, the actual implementation of 464 times, hand hygiene compliance 83.15%, timing is mainly contact with the patient or clean / aseptic operation before compliance is poor; correct rate of 77.59%, there is a main hand wash hand execution time less than 15 seconds, individual six-step wash The correct rate was 77.59%.
Third, training:
1, the hospital: the new recruits to carry out pre-service training in hospital infection knowledge 14 times, and qualified; for the work of the 20xx occupational exposure of the problems that exist in the work of hiring experts to our hospital lectures to enhance the level of health care personnel prevention and control; according to the needs of the clinical departments in-depth department targeted training 4 times (content influenza), the hospital has been the first time in the past year, the hospital has been the only hospital in the world that the hospital has been the only hospital in the world. Training 4 times (content influenza prevention and control, hand hygiene, medical waste, safe injection, diagnosis of infection cases, cross-sectional survey).
2, outside the hospital: 11 people to participate in the training sessions organized by the city; to participate in the training courses organized by the Municipal Quality Control Center personnel passed the examination in May.
Fourth, the key aspects of management:
1, the operating room: January on the operating room air evolution facilities for maintenance, after the clean test and air culture results qualified to re-open the operation; for the quality control center experts put forward by the operating room there are problems such as instrument cleaning and other issues one by one to rectify.
2, gastroscopy room: according to the Tianjin endoscopy quality control requirements of our hospital's sterilization records to standardize.
3, stomatology: selected and dispatched three times respectively to participate in the training organized by the Medical University Hospital, to enhance the awareness of infection prevention and control in the stomatology department.
4, hospital infection outbreak disposal drill: April carried out a drill to strengthen the medical staff of hospital infection outbreak related knowledge, to further clarify the functions of each department, improve the mechanism to improve the clinical department's ability to identify, rapid response and disposal capacity, minimize the harm, to protect the safety of medical care.
V. Revision of the relevant systems:
Based on the hospital infection-related norms and clinical care management quality standards implementation manual and the existing system of our hospital processes to compare and contrast, and constantly improve our relevant systems. (Intestinal clinic, stomatology hospital infection management system, contaminated goods recovery operation regulations, reuse of equipment processing procedures, etc.)
Summary of the first half of the hospital infection management work4In the first half of this year, in the hospital leadership and the hospital infection management committee's correct leadership and strong support, my department in strict accordance with the "Hospital Infection Management", "Disinfection Technical Specification," "Regulations on the Management of Medical Waste" and other laws and regulations and the newly promulgated by the Ministry of Health. In strict accordance with the "Measures for the Management of Hospital Infections", "Technical Standards for Disinfection", "Regulations on the Management of Medical Wastes" and other laws and regulations and the new industry standards issued by the Ministry of Health, with the goal of standardized and process-oriented management, we have continuously standardized and improved our hospital's hospital-acquired infections rules and regulations and responsibilities, strengthened the training of hospital-acquired infections for all hospital healthcare personnel, improved the hospital-acquired infections awareness of all hospital healthcare personnel, and kept hospital-acquired infections at a relatively low level, thus ensuring the safety of medical treatment. In order to further improve the management of hospital-acquired infections in the future, the hospital infection control work in the first half of the year is summarized as follows:
First, standardize and improve the hospital-acquired infections of the regulations and duties
In order to hospital-acquired infections of the work can be standardized, systematized, scientifically, in the first half of this year, hospital-acquired infections of the hospital infection according to the "Hospital Infection Management Measures," the relevant national laws and regulations, as well as the hospital to develop The first half of this year, the hospital in accordance with the "hospital infection management approach" and other relevant state laws and regulations, as well as the hospital developed a series of hospital infection rules and regulations and responsibilities, standardized, standardized, procedural considerations of the hospital medical staff, so that they are engaged in their respective health care activities will have to follow the rules, the establishment of the department of hospital infection quality control team, but also clear all levels of various types of personnel in the management of hospital infections in the corresponding duties.
The strict implementation of a variety of basic methods of prevention and control of hospital infections and operating procedures
In order to prevent and control hospital infections, in order to make our hospital in the future hospital infection rate control at the lowest level, I in the first half of this year in accordance with the relevant national laws and regulations, combined with the actual situation of the hospital, to develop a series of prevention and control of hospital infections and the basic methods of control of hospital infections. The control of hospital-acquired infections in a variety of basic methods and operating procedures, in order to standardize our hospital medical staff in the future medical activities in the prevention and control of hospital-acquired infections, laid a good foundation.
Three, to strengthen the whole medical staff hospital infection knowledge training, improve the whole medical staff hospital infection awareness
Through the holding of the whole medical staff hospital infection knowledge training, with the usual self-study self-checking, departmental organization of the study, so that the whole medical staff to make clear that their respective responsibilities in the work of the hospital infection, and to improve the whole medical staff hospital infection awareness. In the first half of all clinical medical staff to carry out a hospital infection knowledge test, achieved an overall good results.
Fourth, strengthen the disinfection and sterilization management, effective control of hospital infections
adhere to the weekly departmental inspection and guidance in disinfection, isolation work, hand hygiene, aseptic operation, environmental hygiene and cleaning and sanitation quality of work, in accordance with the annual work plan, to complete the monitoring of key departments: monthly environmental hygiene, environmental hygiene, sterilization effect monitoring of the seven departments. hygiene, disinfection and sterilization effect monitoring, sampling 198 copies, the pass rate are 100%. Ultraviolet lamp monitoring are also qualified.
Fifth, standardize the management of medical waste
According to the Ministry of Health, "Regulations on the Management of Medical Waste", "Classification Catalog of Medical Waste" and other laws and regulations related to medical waste, combined with the actuality of the hospital, the development of the medical waste, including how to collect, classify, incinerate registered and medical waste proliferation, loss of the emergency response plan and other related measures, thus regulating the hospital's medical waste. Measures have been taken to standardize the management of medical waste in our hospital. In particular, we have focused on strengthening the requirements for the treatment of medical waste in the laboratory and the recovery and treatment of medical waste in the medical office of the Bureau. Deficiencies and the second half of the work focus:
1, continue to increase the hospital infection monitoring efforts, strict requirements, supervise the clinical departments to carry out the use of antimicrobial drugs patient bacterial culture work to standardize the use of antimicrobial drugs to provide a scientific basis. Implement the Ministry of Health "hospital infection monitoring norms", monthly statistics, analysis, feedback infection case monitoring.
2, standardize the laboratory biological specimens disinfection and sterilization work; increase the standardization of disinfection supply room management to do sterilization monitoring formalization, regularization. Monthly operating room, maternity ward, intensive care unit, abortion room, disinfection supply room, and other key departments and general departments of the treatment room, dressing room for air, object surfaces, health care workers hand environmental hygiene monitoring and related guidance, failed departments, departments to find the reasons for the election to re-examine the relevant monitoring.
3, continue to pay close attention to the implementation and management of the hand hygiene system for health care workers, strengthen the awareness of hand hygiene of medical staff, improve hand hygiene compliance.
4, strengthen the management of medical waste, strict implementation of the "Medical Waste Management Regulations".
5, continue to carry out hospital personnel hospital awareness training to improve hospital personnel hospital awareness, medical waste classification, management of guidance and supervision. The new medical staff to carry out pre-service training and examination of hospital infection knowledge.
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