课件：新生儿院内感染.ppt

* * These recommendations will improve hand hygiene practices of HCWs and reduce transmission of pathogenic microorganisms to patients and personnel in healthcare settings. When decontaminating hands with an alcohol-based handrub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry. When washing hands with soap and water, wet hands first with water, apply the amount of soap recommended by the manufacturer, and rub hands together for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water, dry thoroughly with a disposable towel, and use the towel to turn off the faucet. * * 9 1 * * * * * * * * One strategy to promote improved hand hygiene behavior is to monitor healthcare worker adherence with recommended hand hygiene practices and to give feedback. Strategies to improve adherence to hand hygiene practices should be both multimodal (i.e. use several different methods or strategies) and multidisciplinary (i.e. involve several different areas of the institution, and types of HCWs). Patients and their families can be involved in reminding HCWs to wash their hands. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 暖箱消毒（强调） 1、暖箱污染原因 2、暖箱常见菌 3、暖箱的消毒 （1）日常消毒 （2）终末消毒 暖箱污染原因 1、通过医务人员手带入。 文献[2]：护士操作前洗手后采样细菌含量少于5cfu/cm2，暖箱操作后细菌培养严重超标，且与物体表面检出细菌相一致。 2、暖箱内空气的含菌量与物体表面污染程度有关。 3、暖箱储水槽可引起铜绿假单胞菌感染。 暖箱常见菌 物体表面： 除枯草杆菌外，以金黄色葡萄球菌、克雷伯菌、草绿色链球菌多见。 暖箱湿化液： 以嗜麦芽假单胞菌、类白喉杆菌、金黄色葡萄球菌、表皮葡萄球菌多见。 暖 箱 消 毒（日常消毒） 必须重视！ 每日用消毒液擦拭，特别是操作窗口，有污染随时擦拭； 医务人员每在一个暖箱操作前后均要手消毒； 减少暖箱内物品，进入暖箱内物品必须消毒； 储水槽每日消毒，24h更换无菌蒸馏水（有建议8h更换）。 暖 箱 消 毒（终末消毒） 1、消毒期限（有争议）：３天 2、消毒要求：暖箱使用3日后终末消毒1次，消毒时应卸下一切可卸部件，用无菌布仔细擦抹干净。暖箱消毒前后做细菌培养对照。 3、暖箱后面的过滤装置不可忽视：空气过滤器定期更换，如有感染病人时随时更换。 呼吸机的消毒（强调） 1、准备呼吸机备用管道 2、呼吸机管道每日更换（有争议） 3、正确处理管道中冷凝水 4、专业人员做终末消毒 呼吸机相关性肺炎的预防 — 湿化装置 冷凝水 产生量 20 - 40 ml/