课件：手卫生与职业安全.ppt

* * * * * * * * * Barrier equipment includes gloves, sterile and nonsterile, disposable gowns, masks, and protective eyewear. To make the workplace safer, barriers should be available in all patient care areas. Gloves, disposable gowns and surgical masks are single use items. Single use means that they are not to be re-used and they should be discarded after use. Remember to always wash hands after removal of barrier equipment. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * After Semmelweis insisted that students and physicians clean their hands with a chlorine solution between each patient, the maternal mortality rate in the First Clinic dropped. Maternal mortality rate in the First Clinic dropped dramatically and remained low for years. This is the first evidence indicating that cleansing heavily contaminated hands with an antiseptic agent between patient contacts may reduce healthcare-associated transmission of contagious diseases more effectively than handwashing with plain soap and water. * Liquid dispensers should be used rather than bars Level 1 lab - a non antiseptic soap can be used Level 2 lab - requires antiseptic hand washing solutions Arguments that using antiseptic solutions cause pathogen resistance? * * * * Handwashing with soap and water when hands are visibly dirty Adoption of alcohol-based hand rubas the gold standard Use multi-modal strategies including education leadership patient participation Released in May 2006 * * * * * * * * * * * 指甲 指甲是手“工作平台”的一部分 人造指甲被证明容易造成细菌定植并引发感染 Pottinger J AJIC 1989 长指甲和人造指甲容易造成手套的破损Olsen RJ, JAMA 1993 指甲油 ?? Baumgardner CS AORN J 1983 戒指 戒指下的皮肤更容易发生严重的细菌定植Hoffman PN BMJ 1985 一项研究发现戒指是携带GNB的危险因素 Hayes RA Abst 1333, 41st ICAAC, 2001 但是还没有研究证明戒指与感染有关 Stategies for successful promotion of hand hygiene in hospitals Education Routine observation and feedback Engineering control Make hand hygiene possible, easy, and convenient Make alco