ObjectiveTo evaluate the dynamic disinfection effect of the upper-room 222 nm ultraviolet radiation on the air in different areas of the emergency department, and to provide references for a new solution of air disinfection that man-machine coexisted in the medical and healthcare institutions.MethodsThe upper-room 222 nm ultraviolet radiation air sterilizers were installed at a height of 2.3‒2.6 m from the ground in the observation room, computed tomography (CT) scanning room, rescue room and consulting room of the emergency department in Beijing Tiantan Hospital, Capital Medical University . The test area was divided into a 222 nm ultraviolet group and a control group according to whether the 222 nm ultraviolet germicidal air disinfection was conducted or not. The experimental group started air disinfection at 8:00 a.m., and the air sampling was conducted from 9:00 a.m. to 16:00 p.m., with a 10 min sampling interval of every 1 hour. While the control group only collected air sample with the same air sampling method used in the experimental group, without air disinfection. The air microbial sampler with six-level sieve impingement was used for the air sampling, and the differences in the total number of airborne bacterial colonies were compared between the two groups.ResultsA total of 128 air samples were collected in the trial, of which 64 were from the experimental group and 64 from the control group. The total number of airborne bacterial colonies in the experimental group was lower than that in the control group (all P<0.001), and was maintained at a lower level throughout the entire period. The killing rate of 222 nm ultraviolet radiation to airborne microorganisms was approximately 55.76% to 76.33% in different sampling areas. The qualified rates of the total number of dynamic airborne bacterial colonies in the observation room, rescue room and consulting room were improved from 12.50%, 37.50% and 25.00% to 81.25%, 100.00% and 100.00%, respectively (all P<0.001). Over 62.50% of the time, the air quality in the consulting room and CT room in the 222 nm ultraviolet group met the environment standards for airborne bacterial colony criteria of class Ⅰ or class Ⅱ.ConclusionThe upper-room 222 nm ultraviolet radiation germicidal disinfection can effectively reduce the total number of airborne bacterial colonies and improve the environment for emergency department, and the continuous using of it is helpful for keeping the air safe and clean.

目的 分析乳腺手术部位感染的影响因素,制定相应的感染控制措施,总结并评估感染控制效果.方法 对2014年1月1日至2020年12月31日在首都医科大学附属北京天坛医院乳腺外科接受乳腺手术患者的临床资料进行分析,探讨乳腺手术部位感染的影响因素;在2014-2020年每年度结束时回顾性分析乳腺手术部位感染情况,对于乳腺手术部位感染率较高的年度,分析可能导致感染率升高且可实施感染控制干预措施的因素,并依据该结果在下一年度进行特异性感染控制及持续监测,形成监测-感染控制-再监测-再感染控制的模式,并对感染控制效果进行评价.结果 2014-2020年共实施了Ⅰ类切口手术7588例,发生手术部位感染41例,感染率为0.54％.年龄、手术级别、手术持续时间、失血量、引流管引流时间、放置植入物、接受术前化疗、高血压、糖尿病、高脂血症等是乳腺手术部位感染的影响因素.2014年、2016年、2018年乳腺手术部位感染率处于较高水平,2014年、2016年、2018年末对乳腺手术部位感染病例进行分析,发现其影响因素主要包括治疗方式、病种构成及医疗技术操作;实施针对性感染控制措施后,2015年、2017年、2019年、2020年乳腺手术部位感染发生率明显下降.结论 对患者临床特征进行深入分析有助于发现乳腺手术部位感染的影响因素,对于手术部位感染的长期目标性监测可明确不同时期的影响因素,据此进行精准化感染控制可有效降低医院感染事件的发生.

目的 调查北京市医院门诊区环境表面洁净度情况,为有效防控医院感染提供参考.方法 采用ATP生物荧光检测法对22家三级医院门诊区自助设备和诊室内高频接触物体表面采样.比较不同类型医院的不同物体表面洁净度合格率差异,分析门诊量与物体表面洁净度的相关性.结果 医院门诊区高频接触物体表面总合格率为84.60%,其中诊室洁净度合格率最高(88.65%),自助售卖机和自助挂号机的合格率较低,分别为76.47%和82.23%.综合医院洁净度合格率高于专科医院(92.07%vs 79.20%).物体表面洁净度合格的医院门诊量较大,综合医院门诊自助挂号机和专科医院门诊检验结果打印机洁净度与门诊量的关联性最强(Eta2=0.592和0.524).结论 医院应提高门诊区卫生消毒管理水平,根据门诊量调整高频接触物体表面消毒频次,并加大环境卫生监测力度.

目的 了解2012-2020年北京市某三级综合医院医护人员锐器伤职业暴露的特征及影响因素,为制定职业暴露防护策略提供参考依据.方法 采用回顾性调查方法,对北京市某三级综合医院2012年1月—2020年12月登记的医护人员锐器伤职业暴露资料进行分析.结果 发生锐器伤的49名医生和67护士均以工作5年以下的新员工为主,分别有41人(83.67％)和46人(68.66％);医生锐器伤的主要原因是手术缝合时被缝合针扎伤,占55.10％,护士主要在病房抽血和输液时被注射器针头扎伤,占55.20％.医生和护士锐器伤的暴露源均主要是乙型病毒性肝炎(viral hepatitis type B,简称乙肝或HBV),分别占59.18％和41.79％(P＞0.05).医生对患者血源性疾病的了解(77.60％)比护士(49.30％)多(P＜0.05).暴露后护士正确处理的比例(65.70％)较医生(26.50％)高(P＜0.05).部分科室医护人员工作强度与暴露次数呈现正相关(P＜0.05).结论2012-2020年北京市某三级综合医院锐器伤主要发生在低年资医护人员,应加强对低年资医护人员的职业暴露防护培训.医生锐器伤的高危因素是手术缝合,且暴露后正确处理的比例较护士低,需加强医生暴露后正确处理方法的培训.护士暴露的高危因素是抽血和输液,且护士对患者血源性疾病的了解较医生少,需加强护士对患者血源性疾病情况的了解.同时应合理安排医护人员的工作量,避免因超负荷导致锐器伤发生.

目的 探讨急性卒中患者住院期间感染的临床特征及危险因素,为制订感染预防策略提供思路.方法 连续纳入2019年6月-2021年6月首都医科大学附属北京天坛医院神经内科收治的缺血性卒中(ischemic stroke,IS)、脑出血(intracerebral hemorrhage,ICH)及蛛网膜下腔出血(subarachnoid hemorrhage,SAH)患者,对其临床资料进行回顾性分析.根据患者住院期间是否发生感染分为感染组和非感染组,比较2组的临床特征、感染部位及时间分布,采用单因素及多因素logistic回归分析感染的危险因素.结果 共纳入2884例急性卒中患者,男性2138例(74.1％),IS 2049例,ICH 531例,SAH 304例.426例患者住院期间出现感染,发生率为14.8％,感染发生的中位时间为卒中后4(1～7)d.IS、ICH及SAH患者的感染率分别为10.8％、21.3％和29.9％,呈逐渐升高趋势.肺脏为急性卒中后感染率最高且最早出现的感染部位.多因素分析显示,年龄增长(OR 1.038,95％CI 1.026～1.050,P<0.001)、合并心力衰竭(OR 2.339,95％CI 1.197～4.572,P=0.013)、慢性阻塞性肺疾病(OR 3.297,95％CI 1.676～6.486,P=0.001)、卒中类型为脑出血(OR 2.162,95％CI 1.548～3.021,P<0.001)或蛛网膜下腔出血(OR 8.271,95％CI 5.591～12.236,P<0.001)、入院NIHSS升高(OR 1.162,95％CI 1.132～1.193,P<0.001)及住院时间延长(OR 1.138,95％CI 1.109～1.168,P<0.001)为急性卒中患者住院期间发生感染的独立危险因素.结论 感染是急性卒中患者常见的并发症之一,其中肺部感染发生率高且发病时间早.年龄升高、合并心力衰竭或慢性阻塞性肺疾病、神经功能损伤较重的患者感染发生率升高,与IS相比,ICH和SAH患者的感染发生率升高.

Objective:To study the differences in the fit factors of two commonly used types of medical respirators and the influences on the fitness by different characteristics of the population, so as to provide guidance for scientific selection and wearing protective medical respirators.Methods:A total of 350 medical workers from 10 medical institutions of different levels and types in Beijing were selected to collect basic information. The fit factors of 2 types of medical protective respirators, type 9132 from 3M and type D918 from Beijing Sinovo, were tested using a TSI instrument for the evaluation of the influence on fitness by different populational characters.Results:The pass rates of the two types of respirator, 3M 9132 and Sinovo D918 in the fitness test were 25.43% and 81.14%, respectively. The influences on fitness by the actions between the two respirators were different. Head moving up and down showed the lowest pass rate (27.71% for 3M and 16% for Sinovo). For 3M 9132 respirator, the differences in fit factors caused by BMI and gender were statistically significant ( P<0.01). Conclusions:Different types of medical protective respirators had different fit factors for different individuals and related to population characteristics. Individual BMI could be a criterion for selecting medical protective respirators. The choices should be made after fitness evaluation.

目的 为援助新型冠状病毒肺炎的抗疫工作,北京市卫生健康委和医院管理中心牵头组成了138人的北京市属医院援鄂医疗队(简称援鄂医疗队),前往武汉协和医院西院区参加重症患者救治工作.在工作中充分发挥医院感染防控专家作用,确保严格落实医护人员防护等医院感染防控要求.方法 援鄂医疗队到达武汉后,明确了任务,建立感染控制的规章制度,对全体队员和武汉协和医院西院区的医护人员进行了规范化流程和防护培训.用24 h的时间完成了病区的改造,建成了合理布局的"北京标准"的示范病区,并开始收治新型冠状病毒肺炎患者.在迅速开展工作的同时,加强病区和驻地的消毒,为医疗和护理安全奠定了基础.结果 援鄂医疗队连续工作50天,累计收治患者341例,其中重症患者216例,危重症患者83例,治愈142例.截至2020年3月16日,在院患者逐渐减少,床位使用率从100.00％(150/150)下降到70.67％(106/150).重症、危重症患者的比例从最高时的98.00％(147/150)下降到74.67％(112/150),治愈出院患者显著增加.实现了医护人员零感染.结论 援鄂医疗队感染控制小组在疫情防控中采取的一系列防控措施,为突发传染病疫情的防控提供了宝贵的经验.

中国有组织开展医院感染控制工作始于1986年,至今已经34年.本文回顾了我国出版的和医院感染控制相关的期刊演变状况.《中华卫生杂志》创刊于1953年10月1日,1959年与《中华医学杂志》、《医学史与保健组织》合并,改名为《人民保健》;1978年8月25日复刊时更名为《中华预防医学杂志》.《消毒与灭菌》创刊于1984年3月15日,1990年改为《中华消毒学杂志》.1986年北京医科大学开始出版《医院感染管理》杂志,为《中华医院感染学杂志》的前身.《中华医院感染学杂志》创刊于1991年8月15日,原刊名《中国医院感染学杂志》,1994年改用现名.《医院感染》1987年出版第1卷第1期,由第三军医大学创办,现已停刊.《中国感染控制杂志》创刊于2002年10月15日.这些期刊伴随着中国医院感染控制的发展,已经成为发表医院感染控制学术研究成果的重要阵地.

新型冠状病毒肺炎(简称“新冠肺炎”)流行期间,综合医院内高风险区域(接诊新型冠状病毒肺炎确诊或疑似病例区域)空气和物体表面终末消毒成为确保医院环境安全的重要手段,实施有效的终末消毒可以降低医院内病毒传播风险.根据新冠肺炎相关规范和指南规定,含氯消毒剂、二氧化氯、过氧化氢和过氧乙酸为四类对新型冠状病毒有效的常用消毒剂.

为了解新型冠状病毒感染肺炎疫情期间医院终末消毒情况及其实际意义,普及不同类型空气和物体表面消毒设备适用条件,提高新型冠状病毒肺炎期间医院消毒设备使用效率,减少医院内病毒传播风险,本文总结了消毒设备发展情况及医院现有消毒效能,以期让更多的医务人员了解和掌握消毒实施方法和注意事项. 此次疫情中,医院环境终末消毒常用过氧化氢、二氧化氯气体,以及超紫光消毒设备进行空气消毒;用含氯消毒剂或二氧化氯液体擦拭,以及便携式喷雾设备进行物体表面消毒.

Objective: To assist the prevention and treatment of COVID-19 in Wuhan city, Beijing municipal health commission and Beijing hospitals authority set up a medical team of 138 experts from 13 Beijing municipal hospitals, which was dispatched to Wuhan union hospital west campus to participate in the treatment of severe patients We will give full play to the role of hospital infection prevention and control experts in our work and ensure the strict implementation of hospital infection prevention and control requirements such as the protection of medical staff Methods: After arriving in Wuhan, Beijing aid medical team of Hubei province defined the mission, established the rules and regulations for infection control, and conducted standardized procedures and protection training for all the team members and the medical staff in the west hospital of Wuhan union hospital It took 24hours to complete the transformation of the ward, build a reasonable layout of the demonstration ward of Beijing standard, and start the treatment of COVID-19 confirmed patients While the work was carried out rapidly, the disinfection of the ward and residence was strengthened, which laid the foundation for medical and nursing safety Results: At present, the medical team has been working continuously for 50 days, receiving and treating 341patients including 216 severe patients, 83 critically ill patients and 142 cured At present, the number of patients in the hospital is gradually decreasing, with the utilization rate of beds dropping from 100 00% (150/150) to 70 67% (106/150) The proportion of critically ill patients dropped from a peak of 98 00% (147/150) to 74 67% (112/150), and the number of patients cured and discharged increased significantly Zero infection was achieved for all health care workers Conclusion: This paper summarizes a series of prevention and control measures taken by the infection control team during the work in prevention and control of Novel coronavirus pneumonia in Wuhan union hospital west campus, which provides a reference for the prevention and control of the outbreak of infectious diseases

2020年是弗洛伦斯·南丁格尔(Florence Nightingale)(1820.5.12-1910.8.13)诞辰200周年.她是第一个收集医院疾病数据,系统审视疾病在群体中传播的人,她认为医院应该具备井然有序的管理和良好的卫生条件.她改变了人们对护士的偏见,开创了现代医疗和护理观念的先河,让护士成为受人尊敬的职业.她不愧为近代护理学的先驱.

2020年8月19日是第3个中国医师节,节日主题是"弘扬抗疫精神,护佑人民健康".本文以邮品来缅怀中国古代医学家,传扬中华医药文化,纪念中国医师节. 在中国的远古神话中,记载着神农尝百草的故事.宋代郑樵的《通志》讲:神农尝百药之时,"……皆口尝而身试之,一日之间而遇七十毒,其所得三百六十物……"后世承传为书,谓之《神农本草》.神农创立了我国中草药治病的先河.

2019年12月以来,湖北省武汉市部分医院陆续发现不明原因肺炎病例,经对病毒全基因序列分析证实为一种新型冠状病毒,2020年1月10日确定了病原体为新型冠状病毒(2019-nCOV).2020年1月20日我国宣布将该病纳入《中华人民共和国传染病防治法》规定的乙类传染病,并采取甲类传染病的预防控制措施.

Objective? To explore the knowledge level of hospital infection control in nurses of key clinical departments and to provide a reference for providing more targeted hospital infection training. Methods? The nurses of key clinical departments in Beijing Tiantan Hospital, Capital Medical University in December 2017 were selected by convenient sampling and investigated with the self-designed hospital infection knowledge questionnaire. t test and variance analysis were used to compare the knowledge level of hospital infection between nurses with different characteristics. Results? The score for hospital infection knowledge in the 872 nurses from key clinical departments was (20.34±3.21), and the score in 61.58% of them was ≥20;the highest scoring rate was found in hand hygiene, while the lowest scoring rate was found in infectious disease knowledge and diagnosis; and there were statistical differences in knowledge level of hospital infection between nurses from different departments and with different professional title, educational background and students to teach or not (F/t=4.39, -3.69, -3.13, 5.24; P＜0.05). Conclusions? The knowledge level of hospital infection control in nurses of key clinical departments stands at a low level. Targeted training should be provided to nurses with different characteristics. Multiple management measures need to be taken to strengthen the supervision and monitoring over these departments, enhance the infection control ability in nurses from key departments, and prevent hospital infection.

我们免不了受伤,然后是红肿、发炎,甚至化脓,这是由于细菌的缘故.感染对现代医学来说,我们有很多种方法或药物可以治疗.但是,在19世纪以前,一提到伤口化脓,人们想到的却是死亡.是一名英国外科医生为我们首先打开了消毒这扇窗,他就是约瑟夫·李斯特.

邮票是一个国家的名片,新中国成立70年来,党和政府非常重视人民群众的健康工作.医疗卫生工作取得的瞩目成就在新中国的邮票上得到很多体现,虽然不能反映全貌,但也能从中反映医疗事业取得的成绩.本文通过国内外邮品来展示新中国70年来卫生健康事业取得的部分巨大成就.

目的 中国有组织开展的医院感染控制工作始于1986年.自2003年抗击SARS以后,国家及卫生部对医院感染控制工作逐步重视.笔者回顾2003年之前我国出版的医院感染书刊状况.在1986年之前,我国主要翻译了英 、德 、美等国专家的工作手册,为开展工作打下了基础.80年代以来,我国医务界对医院感染的认识不断提高并加强研究.卫生部医政司1983年成立"院内感染监控协调小组",1986年将医院感染的研究列入重要议事日程并作为综合医院分级管理标准的重要指标之一,在全国组织17家单位率先开展医院感染监测工作.1987年9月由王枢群执笔完成《院内感染的监测》作为培训教材,此书为油印本,印量较少.1989年王枢群等编著的《医院感染监测指南》成为全国100余所医院感染监测系统的指导手册,发行数千册,有不同的版本.我国第一部《医院感染学》于1990年10月出版,在国际上首次提出"医院感染学"的概念.全国各地陆续出版各种专著数十种.历经30年的发展,我国的医院感染控制工作已经提高到一个新的水平.

目的 了解开展医院感染防控知识培训在提高医学生医院感染防控能力的作用.方法 于2017年9－12月对将进入临床实习或规培的医学生开展医院感染防控知识培训,比较培训前后医院感染防控知识的掌握情况.结果 培训前医院感染防控知识掌握正确率为43 .00%(2 206／5 130)低于培训后58 9.5%(3 024／5 130 )( P＜0 0.01) .培训后,医学生在医院感染概念、医院感染诊断、医院感染暴发、手卫生、职业防护技术、医疗废物管理、合理应用抗菌药物、多药耐药菌、传染病方面的知识掌握率分别为57 4.1%(155／270) 、58 5.2%(158／270) 、59 0.1%(239／405) 、69 7.8%(471／675) 、64 8.1%(700／1 080 ) 、61 .98%(251／405 ) 、59 .81%(323／540 ) 、66 4.2%(269／405 ) 、50 6.2%(205／405)较培训前提高(P＜0 0.01) .结论 培训可提高医学生医院感染防控知识水平,从而保护患者和医护人员的健康,有效降低医院感染的发生.