课件：医院感染暴发流行调查与控制.ppt

The risk of having an abscess increased with the number of intramuscular injections that contained normal saline. One nurse was responsible for managing the intramuscular injections. She used a 100ml bottle of normal saline to dilute the drug. She used one syringe (A) and needle to plug the hole in the rubber septum of the bottle between preparing injections. To prepare an injection she would detach syringe A from the needle and lay syringe A on the table. Next she would invert the bottle and let saline drip through the open needle. After that, she would attach another syringe (B) to the needle and withdraw saline to mix with the drug. Then, she would reattach the needle from syringe B and use it to add saline to the drug and then to give the injection. Finally, she would discard syringe B and reattach syringe A to the needle that had remained through the septum of the saline bottle. One opened bottle used for 3-7days. According to the nurse , she always used a new syringe and needle for each new bottle of saline. Bob’s notr – it could help to use arrows as an animation showing the path of each syrtinge. You have an arrow showing syringe B going back to the table. Shouldn’t it go into the syringe disposal (trash)? BoB’s Note Use arrows to show how the syringe goes from one picture to the next. We found no cases from the other 3 similar village clinics. Two of them use the same batch 100ml NS from the same manufacturer ,but used a new bottle every day and discarded the used bottle. We knew that Mycobacterium abscess was an environmental mycobacterium and sampled multiple sites. Considering this organism is often found in water we paid special attention to the sink, the soap container, and the cleaning cloth that was used to wipe the treatment table. And since the organism favors water, we suspected that the well supplying tap water to the treatment room could be the source. So we also sampled water from the well. Results of these environmental c