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Nosocomial Infection ----Prevention and control

Nosocomial Infection ----Prevention and control. Wang kefang （ 王克芳 ） wangkf@sdu.edu.cn. 你知道吗？ 从 2008 年起， 10 月 15 日是个 ____ 日吗 ?. 10 月 15 日是“ Global Handwashing Day ” 2005 年世界卫生组织提出， 2008 年正式设立 　　　　　　　　　　　　　　＿＿ 2008 年 10 月 15 日的＜ 健康报 ＞. 3. Hand Hygiene. Clean Hands are

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Nosocomial Infection ----Prevention and control

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  1. Nosocomial Infection----Prevention and control Wang kefang（王克芳） wangkf@sdu.edu.cn

  2. 你知道吗？ 从2008年起，10月 15日是个____日吗? 10月 15日是“Global Handwashing Day” 2005年世界卫生组织提出，2008年正式设立 　　　　　　　　　　　　　　＿＿2008年10月15日的＜健康报＞

  3. 3 Hand Hygiene Clean Hands are Safer Hands SAVE LIVES: Clean Your Hands

  4. 何谓手卫生(hand hygiene)? • A general term referring to any action of hand cleansing，including handwashing, antiseptic handrubbing and surgical hand antisepsis --WHO hand hygiene guideline

  5. 洗手（hand washing） 用普通肥皂/液和流动水洗手,去除手部皮肤污垢、碎屑和部分致病菌的过程。 • 卫生手消毒(antiseptic handrubbing) 指用速干消毒剂擦搓手的过程。 • 外科手消毒(Surgical hand antisepsis) 外科手术前医护人员用肥皂/液和流动水洗手，再用手消毒剂清除或杀灭暂住菌和减少常居菌的过程。

  6. Today’s topics • Why is hand hygiene important for health care workers(HCWs)? • When should hand hygiene be performed? • How to perform hand hygiene?

  7. Hand Washing HabitsHow often do you wash your hands ……(Americans,2005 ) – Total Sample – After petting a dog or cat 42%(16%) After using the Bathroom in your home 83%(10%) Always wash my hands (Usually wash my hands) Before handling Or eating food 77%(14%) After changing a diaper 73%(4%) After coughing or sneezing 32%(23%) After handling Money 21%(18%) After using a public restroom 91%(6%)

  8. Why is hand hygiene important? 1 • Germs are present on patient skin and surfaces in the patient surroundings

  9. 人体不同部位皮肤细菌量 Percent of Patients with MRSA （耐甲氧西林金黄色葡萄球菌） 腋下 13-25% 40% 30-39% 手、手腕 腹股沟

  10. Why is hand hygiene important? 2 • By direct and indirect contact, patient germs contaminate health-care workers' hands • Germs survive and multiply on health-care workers' hands

  11. 某位护士的手印 培养24小时后

  12. 手部皮肤细菌类型 • 暂住菌 • 原皮肤不存在，主要通过接触而附在皮肤上，处于皮肤表面或角质下表皮细胞上 • 常住菌 • 寄宿于皮肤毛囊和皮脂腺开口处，种类、数量常恒定，多无致病性，占总菌量10～20% • 由于常居皮肤深层，肥皂搓刷不易将它们去除干净，需要用化学消毒剂才能将其杀死或抑制

  13. Why is hand hygiene important? 3 Defective hand cleansing results in hands remaining contaminated

  14. Intervention May 15, 1847 First Second Maternal Mortality Rates Hand Hygiene: Not a New Concept 18 16 14 12 10 Percentage 8 6 4 2 0 1841 1842 1843 1844 1845 1846 1847 1848 1849 1850 Semmelweis IP, 1861

  15. Impact of hand hygiene promotion

  16. Evidences… Hand hygiene is the single most effective measure to reduce HCAIs • Protect the patient，and Protect yourself

  17. When should hand hygiene be performed?

  18. Your 5 Moments for Hand Hygiene

  19. UseWhatto Perform Hand hygiene Plain soap 普通肥皂/皂液 Antimicrobial soap 抗菌肥皂/皂液 Alcohol-based handrub 酒精擦手液

  20. Time After Disinfection % log 0 60 180 minutes 99.9 3.0 99.0 2.0 Alcohol-based handrub (70% Isopropanol) Bacterial Reduction 90.0 1.0 Antimicrobial soap (4% Chlorhexidine) 0.0 0.0 Plain soap Baseline Ability of Hand Hygiene Agents to Reduce Bacteria on Hands

  21. Solid Soap Contamination of 63 Hospitals × 1×104-5个/g 1×106-7个/g

  22. 消毒液浸泡： 错误的手消毒方法

  23. Handwashing with soap and water when hands are visibly dirty or following visible exposure to body fluids Adoption of alcohol-based handrub is the gold standard in all other clinical situations

  24. How to perform hand hygiene?如何进行手卫生？

  25. HandwashingRub hands together for at least 15 seconds 40-60秒 Tips on washing hands with soap and water • Wet hands first with water (avoid HOT water); • Apply enough soap; • Rub hands together for at least 15 seconds; • Cover all surfaces of the hands and fingers; • Rinse hands with water; • Dry thoroughly with  a single use towel • Use towel to turn off water faucet

  26. handrubbing • Tips on using an alcohol-based hand rub • Apply 1.5 to 3 ml of an alcohol gel to the palm of one hand, and rub hands together; • Cover all surfaces of your hands and fingers, including areas around/under fingernails; • Continue rubbing hands together until alcohol dries (about 15-25 seconds). • Make sure your hands are completely dry prior to putting on gloves. 20-30秒

  27. To clean your hands, you should prefer handrubbing with an alcohol-based formulation, if available. Requires less time Acts faster More effective Better tolerated More accessible Handwashing 40-60 seconds Handrubbing20–30 seconds

  28. Hand Hygiene Scenarios • Scenario 6a6b • Scenario 7a7b • Scenario 8a8b

  29. 健康在你手中 请及时清洗你的双手

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