Disinfection and isolation measures for delivery room 1. Delivery room includes office, general waiting room, isolation waiting room, delivery room, isolation delivery room, emergency operating room and sterile goods storage room. Strictly distinguish between restricted areas, semi-restricted areas and non-restricted areas, and each area is clearly marked and strictly enforced? Level three? Management.
2. Before entering the delivery room, the staff must change their hats, masks and shoes (or shoe covers) at the designated place in the staff passage, and change their clothes and pants after washing their hands or disinfection before entering the semi-restricted area. After entering the semi-restricted area, they have to change their shoes and clothes for the second time before entering the restricted area. They must change their clothes and shoes when they go out. Non-staff members are not allowed to enter at will, and visitors should strictly abide by the above regulations.
3. When the parturient enters the delivery room, it is necessary to change the patient's clothes, slippers (or shoe covers) and enter through the patient passage. Personal belongings should not be brought into the delivery room. Accompanied into the delivery room, you must wear masks, hats, change clothes and pants, and wear slippers (or shoe covers) before entering.
4. The delivery room cleaning is managed by a special person, and the walls and floors are washed wet every day, and they are swept with the dirt. When there is blood, feces, body fluids and pathogenic bacteria infection, immediately wipe with chlorine-containing (500mg/L) disinfectant. Every day, the surfaces of the hand pool, faucet, delivery bed, docking car, radiation table, maternal and child monitor and other instruments and equipment are scrubbed, the sterile goods storage room, labor waiting room, delivery room and emergency operating room are disinfected once a day, and the surfaces are subjected to air culture and bacteriological monitoring once a month. Delivery room slippers are cleaned and disinfected every day.
5. Oxygen humidifying bottles, suction bottles, various catheters, connectors, atomizers, incubators and other instruments in contact with skin and mucous membranes should be disinfected by one person. The soft ruler and pelvic measuring instruments used by parturient should be soaked and disinfected with chlorine-containing (500mg/L) disinfectant, and then dried and stored for later use.
6. Carry out cuff cleaning and equipment maintenance once a week, and replace disinfectant and disinfection equipment twice a week.
7. Cleaning supplies in the delivery room (such as mops, rags, etc.) should be used in strict accordance with the zoning and marked.
8. Disinfect the bed units and articles to be delivered or delivered in strict accordance with the terminal conditions of discharged patients. The pregnant women with infectious diseases should be placed in the isolation waiting room or delivery room, and the articles and instruments used in the process of delivery or delivery should be treated in strict accordance with infectious medical waste.
9. Medical personnel should carry out occupational protection in strict accordance with the standards, and wear protective clothing and protective covers during childbirth.
10. Pathological wastes such as placenta should be treated in strict accordance with relevant regulations, and medical wastes should be transported through sewage channels.
1 1. Sterile goods are stored in the sterile goods cabinet in the sterile goods room, and the disinfection mark is clear, and the disinfection date and validity period are marked, and the shift is changed. All the instruments needed in the delivery room are autoclaved, and one person uses them once.
12. Articles (such as laryngoscope, tracheal intubation, etc.). ) Newborns should be used by one person after rescue and disinfected for later use.
13. The used LEEP knife instruments were strictly carried out by the delivery room midwife according to the cleaning process, and then soaked in glutaraldehyde for disinfection. After use, the bed unit shall be disinfected at the end.
Disinfection and isolation measures Objective: To effectively prevent and control nosocomial infection.
1, the nursing department is responsible for supervising and guiding the nursing staff to strictly implement the management system of disinfection, sterilization, isolation and disposable medical supplies, and assisting the hospital infection management department to train the nursing staff in hospital on the prevention and control of hospital infection.
2, the nursing unit set up hospital infection monitoring nurses, check and supervise the disinfection and isolation work of this department.
3, nursing staff to work clothes clean, don't wear a ring, don't wear work clothes to enter the canteen or leave the hospital.
4, nursing staff must abide by the principle of disinfection and sterilization, according to the Ministry of health "technical specification for disinfection", all highly dangerous goods, must choose the sterilization method; For moderately dangerous goods, you can choose intermediate disinfection method or high-efficiency disinfection method; All low-risk items can be disinfected inefficiently or cleaned only in general.
5. Choose the appropriate sterilization method according to the performance of the goods. Surgical instruments and supplies, various puncture needles, syringes, etc. Pressure steam sterilization is the first choice; Dry heat sterilization is the first choice for oil, powder and paste. Heat-resistant articles, such as various catheters, precision instruments, artificial implants, etc. Can be chemically disinfected.
6, nursing staff must understand the performance, function and usage of disinfectant.
7, factors affecting sterilization or disinfection effect, etc. Pay attention to the effective concentration during preparation and monitor it regularly. When replacing the sterilizing agent, the container in which the sterilized articles are soaked must be sterilized first.
8. Oxygen humidification bottles, atomizers, ventilator pipes, humidifiers and other equipment that are continuously used in the incubator for premature infants must be disinfected regularly and disinfected at the end of each use, and kept dry. The humidifying liquid in the oxygen humidifying bottle is sterilized water.
9. Wash your hands in the following situations: before and after touching the patient; Before and after aseptic operation; When entering or leaving key departments such as isolation ward, ICU, maternal and infant room, neonatal ward, burn ward and infectious disease ward; Wear a mask before and after, and a isolation gown. Wear gloves and wash your hands when touching blood, body fluids and contaminated items.
10, wards and diagnosis and treatment departments should be equipped with running water hand washing facilities, and the switches should be pedal, elbow or induction. Soap for hand washing should be kept clean and dry, and hand sanitizer should be used in hospitals where conditions permit. You can wipe your hands with paper towels, hair dryers and towels. Towels should be used once. When it is inconvenient to wash your hands, you should be equipped with a quick hand disinfectant.
1 1, sterile containers and dressings are disinfected 1-2 times a week; After use, the thermometer should be disinfected by two-step method with high-efficiency disinfectant (preferably one-time use or special use); Containers containing disinfectants such as iodine and alcohol should be kept closed and disinfected regularly; Inject one person, one needle, one tube, one belt and one pad.
12, outpatient and ward should be ventilated regularly, the ground should be cleaned and wet, bedside tables and chairs should be wiped and wet every day, kept clean and cleaned once a week. When there is blood, feces, body fluids and other pollution, it should be wiped immediately with an effective disinfectant. Wet wipes and mops should be used separately, disinfected, washed and dried after use.
13. After the patient leaves the hospital, the ward and indoor articles should be disinfected at last. Patients with infectious diseases should be carried out according to infectious disease management system and nursing routine. In addition to strict isolation, patients with special infections should be strictly disinfected, and used dressings and other items should be burned.
14. The patient's clothes, sheets, quilt cover and pillowcase should be changed at least once a week. If there are special circumstances, it should be replaced in time. Dirty clothes can't be counted in the ward and corridor.
15. The collection, storage, use, treatment and shape destruction of disposable medical consumables shall be strictly in accordance with the Management Specification for Disposable Medical Consumables in Provincial Medical and Health Institutions. Disposable medical supplies after use cannot be destroyed and soaked and disinfected under the premise of sealed preservation.
16, disinfection and isolation management of specific departments and key departments shall be implemented with reference to Hospital Infection Standard of the Ministry of Health and relevant department management regulations of this standard.
Disinfection and isolation requirements: 1, treatment room and dressing room (disposal room)
All the above rooms are sterile operation rooms, where operations such as dispensing, puncture and injection are carried out, so the management requirements for disinfection and isolation are as follows.
(1) Medical staff should wear clean clothes and masks when entering the room, and wash their hands before operation (1: 100? 84? ) Wipe your hands and towels every day.
With 1: 50? 84? Soak twice for 30 minutes each time.
(2) Each department strictly distinguishes between aseptic operation area and bacterial treatment area, between them? 1 m, clearly marked, and sterilized items with bacteria shall be placed separately.
(3) Strictly implement the system of one person, one needle, one tube, one use and one hand washing, and one person, one needle, one tube, one tourniquet, one dirty paper and one hand washing for blood collection, blood transfusion and infusion.
(4) Every room should be ventilated daily, irradiated by ultraviolet rays, mopped twice, fumigated once a day and cultivated once a month. Wipe disinfection rate 1: 50 1: 100? 84? Or 0.20.5% peracetic acid, air fumigation is 1g/m? Peroxyacetic acid, sealed for 2 hours, thoroughly cleaned once a day.
(5) The aseptic items in the aseptic cabinet should be sorted by sterilization date, with the nearest day far away and the farther day near. Sterile bags should be placed in sterile cabinets, 20㎝ from the ground, 50㎝ from the roof and 5㎝ from the wall. Check the sterilization date of the articles in the supply room, and indicate whether the tape is qualified and whether the cloth bag is wet (? 3%) The validity period of autoclaving is one week, and aseptic packaging is more than one week. Do you want to open the package? 24 hours or humidity should be re-sterilized. All the sterile items that have been taken out, although not used, should not be put back into the sterile container. The validity period of sterile items is 4 hours.
(6) Sterile holder is autoclaved twice a week, disinfectant is replaced twice a week (0.2% bromogeramine +0.5% sodium nitrite), and the container is capped. The dressing room and gynecological treatment room are replaced once a week, and a pair is placed in each container. When taking and placing sterile holding forceps, the tip should be closed, and the inner wall of the container above the liquid level should not be touched. Don't touch the soaked part with your fingers. When using, do not put the pen tip up, and put it back in the container immediately after use. If you take something far away, the sterile holding pliers should be moved to the sterile place together with the container. Sterile holder forceps shall not touch unsterilized articles, and shall not be used for dressing change and skin disinfection. If it is contaminated or suspected, it should be disinfected again.
(7) Bottles and medicine changing cans containing iodine, iodophor, alcohol and cotton balls for dressing change should be autoclaved 1-2 times a week, with clear labels and dates. The remaining articles in bottles (cans) are prohibited from being used or treated as bacteria.
(8) Everything in the dressing room must be kept sterile, and the system of one person, two boards and two pliers shall be strictly implemented. The dressing change operation should clean the wound at one time, infect the wound and isolate the wound. The solution for dressing change (physiological saline) has been left behind for more than 24 hours. The instrument was smashed to death after use 1: 100? 84? Soak the solution for 30 minutes, then refresh, dry and oil under high pressure. For patients infected with hepatitis B and Pseudomonas aeruginosa, 0.5- 1% peracetic acid or 1: 50 should be used for dressing change. 84? Soak the solution under high pressure for 60 minutes twice.
Operating room:
(1) Operating rooms are divided into sterile rooms, semi-sterile rooms and sterile rooms.
(2) When staff enter the operating room, they need to change their clothes, masks and shoes, and their personal clothes cannot be exposed. Go out and change clothes and shoes.
(3) Wipe the surface, operating table and ground of objects in the operating room with disinfectant before operation. Daily preoperative air disinfection, weekly cleaning, air closed fumigation 1 time.
(4) The slippers in each area shall be strictly distinguished and refreshed 1 time every week. Pollution is refreshed at any time.
(5) Patients who need surgery should have their liver function checked before operation, and those who are positive or have emergency operations should be treated according to the infectious disease isolation technology. The surfaces, floors and doorknobs used by patients with infectious diseases should be wiped and disinfected with peracetic acid, and the surfaces, objects, articles and air should be fumigated and disinfected with air. It can only be used if it is negative for three consecutive times (tetanus, gas gangrene, Pseudomonas aeruginosa infection, typhoid fever, hepatitis B, etc.).
(6) Sterilization, semi-sterilization, and carrier bacteria should be operated continuously. The operating table, object surface and ground should be wiped and disinfected with 0.5% peracetic acid before the next operation.
(7) The items of surgical patients are not allowed to be brought into the operating room. Before the operation, clean clothes should be replaced and hats should be worn. Wear as little clothes as possible. Non-staff members are not allowed to enter the operating room without authorization.
(8) The volume of the operating room is less than or equal to 30*30*25cm, the metal weight is less than or equal to 7kg, and the cloth is less than or equal to 5kg.
(9) Liquid excreta of patients with infectious diseases and drainage objects in drainage bottles of obstetrics and gynecology and operating rooms. I suspect that patients with infectious diseases use 1:50? 84? Mix the solution evenly and let it stand for 60 minutes, then pour it.
(10) The delivery room should be the same as the operating room.
Ward and observation room:
1. Patients admitted to the ward should be treated separately according to infectious diseases and non-infectious diseases.
2. The ward should open the window regularly for ventilation twice, each time for 30 minutes.
3. In the morning care, wet bed is used to sweep the bed, one bed is covered with a towel, and the bedside table is wiped with a towel. Is it 1: 200 after use? 84? Soak for 30 minutes, and apply on the surface of bedside table, door handle, window sill, bed pole, etc. 1: 100? 84? Wipe it twice.
4. The patient's clothes should be changed once a week, and the pollution should be changed at any time.
5. Wet-wash and mop the floor of the ward and corridor twice a day.
6. The patient's tableware, toilet and other supplies are fixed. Should the toilet be used after 1: 50? 84? Soak for 30 minutes and clean for later use.
7. Patients discharged from hospital, transferred to another hospital, changed their major and died need terminal disinfection. First, ultraviolet radiation for 60 minutes. 1:50? 84? Disinfectant wipes the bed, bedside table, stool and floor.
8. For the bedside of patients with hepatitis B, the list card with H indicates bedside isolation to prevent cross infection.
9. If there is a spittoon, should it be filled with 1: 200? 84? Liquid, change at any time.
10. Items such as peels used by patients should be placed in domestic garbage bags, and they are not allowed to be thrown on the ground or in the corridor, and are not allowed to be thrown outside along the window.
Management requirements for the use of common items
1 and thermometer 1: 20? 84? 75% alcohol for 30 minutes
2. Atomizer nozzle, mask aspirator bottle and gastric lavage tube 1: 50? 84? 30 minutes
3. tourniquet1:200 (1:100)? 84?
4. Balloon hot water bottle, ice pack, cuff and sphygmomanometer cuff are used 1: 200? 84?
5. Humidifying bottle 1: 200
disinfection by ultraviolet light
At 220W, the relative humidity is 60% and the temperature is 2040℃. Otherwise, if the irradiation time is prolonged, the radiation intensity will not be lower than 70W/cm2, and the lifetime will be 1000.
The irradiation distance is 2m+-0.2m.
Installation wattage? 1.5W/m3 volume
The doors and windows of injection room must be closed.
Wipe with alcohol 1 time every week.
Hygiene and cleaning are prohibited before irradiation.