First, the concept of disinfection and isolation
1. Hospital disinfection: the process of killing or removing pathogenic microorganisms contaminated in hospital environment and media.
2. Medium: refers to the solid, gas and liquid substances that pollute pathogenic microorganisms in people's living and working environment, including the polluted human body surface and superficial body cavity.
3. Terminal disinfection: complete disinfection after the source of infection leaves the epidemic spot. For example, patients with infectious diseases in hospitals should be disinfected after discharge, transfer or death.
4. Preventive disinfection: disinfect articles and places that may be contaminated by pathogenic microorganisms.
5, cleaning: use detergent to wash away all the dirt on the items.
6. Disinfection: kill or eliminate pathogenic microorganisms and propagules by physical or chemical methods.
7. Sterilization: completely kill all pathogenic and non-pathogenic microorganisms, propagules and spores on articles by physical or chemical methods.
8. General pollution: articles contaminated by general patients after contact.
9. Special pollution: articles contaminated after contact with special patients such as hepatitis, tuberculosis and AIDS. Articles that come into contact with blood and body fluids of patients.
Second, the preparation of disinfectant
Chlorine-containing preparation:
(1) Add 1000 ml of water and 2 pieces of trichloro disinfection tablets to make a disinfectant containing available chlorine1000 mg/L.
(2) Add 1000 ml of water and 4 tablets of trichloro disinfectant to make a disinfectant containing 2000mg/L of available chlorine.
Three, all kinds of items commonly used disinfection and sterilization methods
1. Floor and wall:
(1) When there is no obvious pollution, wet cleaning shall be adopted, and it shall be mopped with water twice a day.
(2) general pollution, the application of effective chlorine 1000mg/L disinfectant scrub. ..
(3) Under special pollution, scrub with disinfectant containing 2000mg/L available chlorine.
④ Disinfect with disinfectant containing available chlorine 1000mg/L once a week.
2. Indoor articles (tables, chairs, bedsteads, etc.). ):
(1) When there is no obvious pollution, it is usually cleaned by wet method twice a day.
(2) general pollution, the application of effective chlorine 1000mg/L disinfectant scrub. ..
(3) Under special pollution, scrub with disinfectant containing 2000mg/L available chlorine.
④ Disinfect with disinfectant containing available chlorine 1000mg/L once a week.
3. Various means of transportation (flat car, wheelchair, etc.). ):
① Clean it once a day.
(2) For general pollution, scrub with disinfectant containing available chlorine1000 mg/L. ..
(3) Under special pollution, scrub with disinfectant containing 2000mg/L available chlorine.
④ Disinfect with disinfectant containing available chlorine 1000mg/L once a week.
4. Wipe the surfaces of various articles in the treatment room, injection room, dressing room and laboratory with disinfectant containing 1000mg/L of available chlorine every day. Dirt pipes should be cleaned once a day.
5. The bedside table should be a table and a towel. The disinfection method of tablecloth is the same as that of bed towel. Soak in disinfectant containing available chlorine 1000mg/L for 30min, and in case of special pollution, soak in disinfectant containing available chlorine 2000mg/L1h.
6. Cleaning tools (mops, rags, etc. ):
(1) Clean utensils dragged with clean water shall be soaked in disinfectant containing available chlorine 1000mg/L for 30 minutes every day.
(2) The cleaning appliances wiped with disinfectant shall be disinfected once a week and soaked in disinfectant containing available chlorine 1000mg/L for 30 minutes.
(3) When mopping general pollutants, immediately soak them in disinfectant containing available chlorine 1000mg/L for 30 minutes.
(4) After mopping the floor, especially polluted articles shall be immediately soaked in disinfectant containing 2000mg/L available chlorine 1 hour.
7. Toilet disinfection?
(1) The concentration of disinfectant is 2000mg/L, which contains available chlorine? Replace it every Monday and Thursday.
② Collective disinfection every Thursday? Every time it is used, it is not disinfected.
8 sewage (vomit and diarrhea, secretions, body fluids, etc.). ):
(1) Units with sewage treatment tanks are directly discharged.
(2) Units without sewage treatment tanks should be disinfected before being discharged.
③ 2000mg/L of specially infected body fluid? Soak for 2 hours.
9. Final disinfection method: one dismantling, two wiping, three exposure and four spreading.
Dismantle: Dismantle the bed unit? Clean up the patient's used items.
Second wiping: ordinary patients should wipe with disinfectant containing available chlorine 1000mg/L? Special patients were wiped with disinfectant containing 2000mg/L available chlorine.
Three exposures: irradiate the bed unit with ultraviolet rays for 40 minutes? Effective distance of one meter? Pay attention to protection.
Berth 4: Make a spare bed to prepare for new patients.
Fourth, self-protection in disinfection operation.
1, to prevent the damage caused by disinfectant.
2. Prevent pathogens from harming themselves.
General rules for hospital disinfection and isolation management
I. Principle of aseptic technology Principle of aseptic technology
1, the aseptic operation environment should be clean and wide. Stop sweeping the floor and changing sheets half an hour before the operation to reduce walking and prevent dust from flying.
2, before aseptic operation, the staff should wear clean, hats must cover the whole hair, masks must cover the nose and mouth. It is best to use a disposable mask. Under normal circumstances, change the mask every 4-8 hours. Once wet microorganisms are easy to penetrate, they should be replaced in time.
3, sterile items must be placed separately from non-sterile items, and clearly marked. Sterile articles should not be exposed to air and should be stored in sterile bags or containers. Sterile packaging should be marked with the name of the article, sterilization date and expiration date, and placed in the order of expiration date. The validity period of aseptic packaging is usually 7 days, and 5 days in May. If it expires or is contaminated by moisture, it must be sterilized again.
4, aseptic operation, should first clear sterile area and non sterile area. Any sterilized and uncontaminated area is called sterile area, such as the inner surface of laid sterile tray, sterilized operating area and puncture site.
5. During aseptic operation, the operator's body should keep a certain distance from the aseptic area. When taking and placing sterile articles, they should face the sterile area. Sterile holding forceps should be used when taking sterile materials. Keep your arms at the waist or on the treatment table, do not cross the sterile area, and do not touch sterile materials with your hands. Avoid laughing, coughing and sneezing in sterile areas. If it is suspected that the substance is contaminated or contaminated by water, it should be replaced and sterilized again.
6, a set of sterile items is only for one patient to use, to prevent cross infection.
Two. general rules
1, strictly implement the principle of aseptic technology.
2, medical personnel should dress neatly, don't wear rings, bracelets, earrings, no long nails, no nail polish.
3, wash your hands before and after contact with patients, soap should be stopped, towels should be replaced daily or disposable paper towels, contact with patients with special infections or infectious diseases should be soaked and disinfected.
4. One person, one needle, one pad and one hand wipe during injection.
5. All articles used by infected patients must be disinfected twice, that is, disinfection-cleaning-sterilization or disinfection.
6. All articles that can withstand pressure steam sterilization shall be sterilized by pressure steam, and vaseline, oil and powder shall be sterilized by dry heat.
7. Thorough cleaning (decontamination) is the key to ensure the success of disinfection or sterilization.
8, cotton packaging materials should be washed before use to pulp, packaging materials and containers used repeatedly, should be cleaned before use.
Third, air, surface and ground disinfection
1. air disinfection: methods: ultraviolet lamp, fumigation, air disinfection machine and laminar ventilation. Time: the treatment room and dressing room in the ward are twice a day, once a week in the ward, once a night after each operation in the operating room, and once a day in the clinic for more than 30 minutes.
2. Object surface: including tables, chairs, stools, bedside tables, medical records clips, door handles, faucets, doors and windows, wash basins, urinals, bathrooms and other objects. Methods: Wipe the surface of various articles twice a day with a clean wet rag. When the surface is contaminated by pathogenic bacteria, wipe it with disinfectant containing 500mg/L available chlorine or irradiate it with ultraviolet rays at a distance of 1m for 30 minutes.
3. Floor: Wet cleaning is adopted, and clean water or detergent is used to mop the floor 1-2 times a day. When the floor is polluted by pathogenic bacteria, mop the floor with available chlorine 1000mg/L disinfectant. Treatment room, dressing room, injection room and laboratory should be mopped with 500mg/L chlorine-containing disinfectant every day.
Fourth, disinfection of common medical supplies
1. On the basis of cleaning, soak the thermometer in 75% alcohol for 30 minutes, then rinse it with water, dry it, clean it and dry it for later use.
2, humidification bottle, spiral tube, atomization tank, drainage bottle, oxygen mask on the basis of cleaning with 500mg/L chlorine disinfectant soak for 30min, rinse with water, drain, wash and dry, sealed for later use, one person a day for disinfection.
3. Syringes, infusion sets, gloves, nasal catheters, stomach tubes, tracheal intubation, drainage tubes, sputum suction tubes, etc. It should be used once and replaced once.
4. Keep the cuff of sphygmomanometer clean. In case of pollution, soak it in 500mg/L chlorine-containing disinfectant for 30 minutes, then clean it and dry it for later use. The sphygmomanometer housing and stethoscope can be wiped and disinfected with ethanol on the basis of cleaning.
5, tongue depressor, mouth opener, tongue pliers, voyeur after cleaning decontamination, dry, sterilized with pressure steam, clean and dry for later use.
6. Vein tying: wash and dry after use, soak in 500mg/L chlorine-containing preparation for 30min or put in an ethylene oxide sterilization box, wash and dry for later use.
7. Processing plates, centrifuges and micropumps should be cleaned daily, wiped with 500mg/L chlorine-containing preparation in case of pollution, and disinfected once a week.
8, bubble tweezers barrel, iodine, alcohol bottle change twice a week, after cleaning and drying, autoclaving, bubble tweezers barrel dry storage for 4 hours.
Five, tableware, sanitary ware disinfection
1. Tableware, washbasin and toilet are disposable. * * * Use the toilet every day to wipe the seat plate and cover plate with 500mg/L effective chlorine disinfectant, and then rinse it with clear water. 2, dishcloth mop used separately, shall not be mixed, mop logo is clear, partition use, soak in 500mg/L chlorine disinfectant for 30min after use, and then wash with water, dry for later use.
Six, commonly used items disinfection principle
1, sterile articles must be packed in double layers and cleaned one by one.
2. Sterile bags should be put into special cabinets. Disposable sterile articles must be placed in clean containers, placed at fixed points, placed and used in chronological order to avoid backlog and failure.
3, dressing, cotton storage tank disinfection once a day.
4, wound dressing change sterile wound first, then change the contaminated wound, and finally change the infected wound. 5. The humidifying bottle shall be replaced and disinfected daily, and the humidifying liquid shall be replaced with sterile distilled water daily.
6. After the negative pressure aspirator stops using, the drainage bottle, drainage tube and bottle cap should be soaked and disinfected with 500mg/L chlorine-containing preparation for 30 minutes, and then washed and dried for later use. The drainage nozzle should be inserted into the disinfection bottle.
7, deep venipuncture or phlebotomy, tracheotomy, disinfection dressing once a day.
8, intravenous infusion catheter must be replaced every 24 hours.
9. Wipe the skin at the puncture site twice with compound iodine, and then inject it after it is half dry.