监狱医院感染预防的应用概要.ppt

额外预防的PPE应用 □ 额外预防包括 ■ 接触隔离 ■ 飞沫隔离 ■ 空气隔离 PPE Use in Healthcare Settings 接触隔离PPE的应用 接触隔离 – 接触患者或环境治理(如,医疗设备,环境物表) 时,穿戴隔离衣和手套 在标准预防基础上，潜在体液溅出时使用面部防护 在某些场合下,进入病人的环境时,也需穿戴上述PPE 飞沫隔离 – 离病人3英尺之内戴外科口罩 患者单间；同一病种的患者可在同一病房内，但病床间距＞1m 飞沫隔离PPE的应用 空气隔离PPE的应用 □空气隔离 – 呼吸防护器 USA NIOSH(美国国家职业安全和卫生 研究所)-certified N95 EU FFP2(94%)，或其他类型呼吸器 建议使用负压病房 * 2009.3.30卫生部组织召开的电视电话会 * 自 Semmelweis 坚持实施医生与实习生在两个病人间采用生石灰水清洗双手，第一组的产妇死亡率下降了. 第一组产妇的死亡率显著下降，并多年维持在较低水平。 这是临床的第一个证据表明，在两个病人之间，医务人员双手去污，并消毒手可以减少医院获得性感染的发生，其效果明显优于采用普通肥皂和水洗手。 * * * * * * * When you are selecting PPE, consider three key things. First is the type of anticipated exposure. This is determined by the type of anticipated exposure, such as touch, splashes or sprays, or large volumes of blood or body fluids that might penetrate the clothing. PPE selection, in particular the combination of PPE, also is determined by the category of isolation precautions a patient is on. Second, and very much linked to the first, is the durability and appropriateness of the PPE for the task. This will affect, for example, whether a gown or apron is selected for PPE, or, if a gown is selected, whether it needs to be fluid resistant, fluid proof, or neither. Third is fit. (optional question) How many of you have seen someone trying to work in PPE that is too small or large? PPE must fit the individual user, and it is up to the employer to ensure that all PPE are available in sizes appropriate for the workforce that must be protected. (Segue to next slide) With this as background, let’s now discuss how to select and use specific PPE. After that we’ll talk about which PPE is recommended for Standard Precautions and the various Isolation Precaution categories. * * In some instances, healthcare personnel are required to wear PPE in addition to that recommended for Standard Precautions. The three Expanded Precaution categories (formerly called Transmission-Based Precautions) where this applies are Contact and Droplet Precautions