In order to maintain the occupational safety of medical staff and related personnel in other departments, effectively prevent the occupational exposure infection of blood-borne diseases such as syphilis, hepatitis B, hepatitis C and hepatitis D, especially AIDS, and avoid or reduce the viral infection of blood-borne diseases to the maximum extent in case of occupational exposure, this prevention and control plan is formulated.
1. Occupational exposure refers to medical personnel and related staff engaged in medical prevention and related work.
In the process of doing it, the skin or mucous membrane is inadvertently contaminated by blood and body fluids of patients with blood-borne diseases, or the skin is punctured by sharp instruments such as needles contaminated with blood and body fluids containing blood-borne diseases, which may infect hepatitis B virus and AIDS virus.
2. Data analysis shows that strict safety operation and protective measures, medical and inspection personnel's responsibilities are
Industry exposure events can be avoided.
Second, the preventive measures of occupational exposure
1. The medical staff made a survey of all patients' blood and body fluids (including amniotic fluid, pericardial fluid, pleural fluid, peritoneal fluid,
Cerebrospinal fluid, synovial fluid, vaginal discharge and other human substances are regarded as infectious pathogenic substances, and preventive measures must be taken when contacting these substances. 2. Medical personnel must wear gloves when conducting diagnosis, treatment and nursing operations that may come into contact with blood and body fluids.
Wash your hands immediately after taking off your gloves and disinfect your hands if necessary.
3. In the process of diagnosis, treatment and nursing operation, the patient's blood and body fluids may splash on the medical staff.
On the face, medical personnel should wear gloves, masks with anti-permeability performance and protective glasses; When blood and body fluids may splash in a large area or pollute the health of medical staff, isolation gown or apron with anti-leakage performance should also be worn (such as surgery, oral treatment, digestive tract endoscopy, urinary system endoscopy and other special examinations and treatments).
4. The skin of medical staff's hands is damaged, which may come into contact with the patient's blood and body fluids.
Double gloves must be worn during nursing operation.
5. The medical staff in the process of invasive diagnosis and treatment, nursing operation, to ensure adequate light, especially
Pay attention to avoid being stabbed or scratched by sharp tools such as needles, sewing needles and blades.
6. After use, sharps should be directly put into the stab-proof and leak-proof sharps box, or treated with needles.
Prepare for safe disposal, or use safe medical sharp instruments such as syringes and infusion sets to prevent stab wounds.
7. After use, it is forbidden to put the disposable needle back on the needle cover. It is forbidden to touch the used needle directly with your hands.
Needles, blades, etc.
Third, prevention and treatment after occupational exposure.
(1) Emergency local treatment:
First of all, local first aid treatment should be carried out immediately, including light blood extrusion, cleaning and local disinfection.
1. Wash the contaminated skin with hand sanitizer and running water, and wash the mucosa with normal saline.
2. If there is a wound, gently squeeze it on one side of the wound to squeeze out the blood from the injured part as much as possible, and then rinse it with hand sanitizer and running water; It is forbidden to locally compress the wound.
3. After the wound of the injured part is washed, it should be disinfected with disinfectant, such as 75% ethanol or 0.5% iodophor, and the wound should be bandaged; Exposed mucosa should be washed repeatedly with normal saline. 4. Passive immunization should be carried out as soon as possible for mucous membranes or wounds exposed by hepatitis B virus. (2) Registration, immunization, reporting and follow-up system.
1. After occupational exposure, it shall be reported to the hospital infection management department, and the hospital shall organize relevant experts to assess the risk degree of exposure, report to the prevention department, and conduct relevant serological examination, follow-up and monitoring on the exposed persons and patients.
2. According to the type and viral load of the exposed virus, the preventive medication scheme is implemented for the exposed personnel. (3) Disposal of different pathogens after exposure
Treatment 1 exposure to HIV (blood-borne diseases). There are the following three points (1): prevention should be carried out within 4 hours at the latest, and antiretroviral drugs are recommended.
(2) Take blood samples for HIV test as soon as possible after exposure, regularly check the seroconversion, and report to the relevant departments of the hospital in time, including other diseases. (3)
The hospital should immediately carry out serological examination on patients with infectious sources.
2 exposure to HBV (blood-borne diseases) has the following three points.
(1) antibody HBs antibody >: at 10mlU/ml, no further treatment is needed.
(2) For people without immunity, preventive intramuscular injection of hepatitis B immunoglobulin should be used as soon as possible (preferably within 48 hours, at the latest
(3) The treatment of exposure to hepatitis C virus (blood-borne disease) is the same as that of hepatitis B. Although there is no post-exposure treatment for hepatitis C at present, seroconversion must be checked. For patients with hepatitis B virus infection, HCV infection must also be checked. Exposed personnel should be tracked and monitored regularly. Follow-up for 6-9 months.
Hospital infection management section
June 20 1 1