I. Basic Environment
1. Reasonable layout and flow, clean and contaminated areas are clearly divided into zones, and clean, semi-contaminated and contaminated areas are clearly marked
2. All kinds of medicinal fluids, solvents, and disinfectants are used in the stipulated period of time
3. The opened date and time of the pumping of medicinal fluids shall be indicated, and the period of time for leaving them after opening them shall not exceed 2 hours
4. The date and time of opening of various solvents shall be indicated, and the solvents shall not be used after the date of opening
2. Specification of post-disinfection treatment of reused medical supplies
1. Tourniquets shall be sterilized by one person for one use
2. The items on the treatment trolley and medication exchange trolley shall be arranged in an orderly manner, with the upper level as the clean area and the lower level as the contaminated area; the sharps box shall be placed on the side of the trolley; the treatment trolley entering the patient room shall be placed on the side of the trolley. The side of the car; into the sickroom treatment car, dressing car should be equipped with quick-drying hand disinfectant
3. Equipped with quick-drying hand disinfectant, marked with the activation time, used within the validity period
4. Layout process should follow the principle of separation of cleanliness and pollution, the diagnostic and treatment area, the sewage treatment area, the living area and other areas of the relative independence of the layout is reasonable, well-marked, well ventilated
5. The clinic room is neat, fresh air or regularly ventilated, well ventilated
5. The air is fresh or regularly ventilated, disinfected, and documented
6. Cleaning utensils are partitioned for use, clearly labeled, and positioned
7. Sterile goods, clean goods, and contaminated goods should be placed in separate areas. Sterile items stored in a special cabinet, clean environment, no expiration date. When there is no special cabinet, the upper layer of sterile goods, the lower layer of clean goods. Sterile articles are opened with the date and time of opening and used within the expiration date. Sterilized items (cotton balls, gauze, etc.) once opened, the use of time shall not exceed 24 hours.
8 disposable sterile items must keep the packaging intact, imported products have Chinese marking single-use medical supplies shall not be reused, used within the validity period. Disposable items without a special cabinet should be layered with non-disposable items, positioning placed, clearly marked.
9. Immersion disinfection or sterilization should be immersed in the date, time, signature, immersion with disinfectant should be concentration monitoring, there are records
Acupuncture needles to do "one person, one needle, one use, one sterilization," fire cans to do "one person, one use, one disinfection".
Into the patient's body cavity of all diagnostic and therapeutic equipment, must be a person with a disinfection or sterilization
★ "Hospital Infection Management" is the Ministry of Health issued Decree No. 48, September 1, 2006 implementation.
★ Hospital-acquired infections - refers to infections acquired by hospitalized patients in hospitals, including infections that occur during hospitalization and infections that occur after discharge from hospitals, but does not include infections that have begun prior to hospitalization or have been in the incubation period at the time of hospitalization. Infections acquired by hospital staff within the hospital are also hospital-acquired infections.
★ The epidemiologic aspects of hospital infections - susceptible populations, sources of infection, and routes of transmission.
★ Hospital infection outbreak - refers to the phenomenon of more than three cases of the same kind of homologous infections occurring in a short period of time in a health care institution or other department of patients.
★ Disinfection - refers to the use of chemical, physical, biological methods to kill or eliminate pathogenic microorganisms in the environment.
★ Sterilization - refers to the killing or elimination of all microorganisms in the transmission medium, including pathogenic and non-pathogenic microorganisms, but also including bacterial spores and fungal spores.
★ Standard prophylaxis - is recognized that the patient's blood, body fluids, secretions, excretions are infectious and need to be isolated, regardless of whether they have obvious blood contamination or contact with non-intact skin and mucous touch, must be taken to protect measures.
★ Standard precautions
(1) Wash your hands
(2) Wear gloves, hats, masks, eye or face protection, and protective clothing.
(3) Clean contaminated medical devices and equipment in a timely manner.
(4) Prevent sharps injury.
★ Medical personnel need to wash the finger signs
(1) before and after direct contact with the patient.
(2) After visible contamination of the medical staff's hands or contamination by the patient's blood or body fluids.
(3) Between contacts with different patients or when moving from a contaminated part of the patient's body to a clean part.
(4) Before and after aseptic operation.
(5) Before handling clean or sterile items.
(6) After handling contaminated items.
(7) Before and after putting on and taking off isolation gowns and after removing gloves.
(8) After contact with the patient's blood, body fluids, secretions, excretions, mucous membranes, broken skin, or wound dressings.
(9) Before and after contact with wounds.
(10) Before and after caring for a special susceptible person.
★ Needle-stick wound treatment process: squeezing blood - rinsing - disinfection, stabbed by sharp instruments contaminated with blood and body fluids of HBV-positive patients should be injected with hepatitis B immune high-value globulin within 24 hours, and at the same time, the blood hepatitis B markers should be examined, and the negative patients should be injected subcutaneously with hepatitis B immune high-value globulin. Those who are negative should be injected subcutaneously with hepatitis B vaccine 10ug, 5ug, 5ug (according to 0, 1 month, 6 month intervals).
★ In accordance with the "Disinfection Management Measures", medical institutions must strictly implement the technical specifications for the disinfection of medical devices and instruments:
(1) Medical devices, instruments and articles that enter human tissues and sterile organs must reach the level of sterilization.
(2) contact with the skin, mucous membranes of medical devices, instruments and articles must reach the level of sterilization.
(3) a variety of medical instruments for injection, puncture, blood collection and other invasive operations must be sterilized once used.
(4) medical institutions to use the disinfection of medicines, disposable medical devices and appliances should be in line with the relevant provisions of the state.
(5) disposable medical devices and instruments shall not be reused.
★ Medical waste - refers to the medical and health institutions in the medical treatment, prevention, health care and other related activities generated by the direct or indirect infectious, toxic and other hazardous waste. Medical and health institutions to treat patients with infectious diseases or suspected infectious diseases patients generated by the domestic waste, in accordance with the management and disposal of medical waste.
★ Medical waste classification: infectious waste, pathological waste, injurious waste, pharmaceutical waste, chemical waste.
★ Classification of medical waste collection requirements:
★ ★ (1) black bags for domestic waste, yellow bags for medical waste.
★ ★ (2) Injurious waste is collected separately from other wastes, using injurious waste boxes (sharps boxes).
★ ★ (3) Require trash bags to be tough and durable and not leak.
★ ★ (4) All waste should be discarded or put into polluted bags (buckets) marked with the appropriate color, and a person is responsible for sealing and transporting the bags when they are 3/4 full.
★ Some suggestions and requirements for surgical dressing change:
1) Wash your hands before and after operation, and wear a mask and cap during operation.
(2) According to the size of the wound to take gauze and other items, a sterile items used only for a patient,
(3) uncovered wound dressings are not placed on the ground.
(4) Dispose of medical waste yourself after dressing change, do not order family members or caregivers to dispose of it.
(5) Change sterile wounds first, then infected wounds.