医院合理布局和有效清洁可以预防耐药感染的传播
医院合理布局和有效清洁可以预防耐药感染的传播原创 2017-10-19 翻译：张菊 SIFIC感染官微file:///C:/Users/lenovo/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif检索：陈志锦
翻译：张菊审核：周超群、陈志锦瑞典隆德大学的最新一篇论文指出，医院场所的设计，其感染控制的程序应适应不再具备有效抗生素的社会的需求，并且考虑到易受全球流行病快速蔓延的“攻击”。隆德大学的博士生、斯科纳大学医院感染诊所的医学顾问Torsten Holmdahl说，“瑞典和世界上的许多医院都变得陈旧不堪，因此，我们现在有机会从感染控制的角度去规范地修建医院。”Torsten Holmdahl的论文包括了位于马尔默的斯科纳大学医院新感染诊所的规划和建设过程。作为诊所的前任主任，他也参与了这个过程。Torsten Holmdahl表示：“在我看来，感染控制应该是新建医院最优先考虑的事项之一，因而我意识到马尔默的新感染诊所是一个不容错过的机会。”因此，诊所的所有专业人员均参与了新建诊所的布局规划。此外，还建立了一个完整的、设备齐全的病房模型，在那里进行了广泛的感染安全和工作方法的试验。医院决定将抗生素用于医疗保健之前的建筑知识与医院现代化运作良好的最新要求相结合。最终建成了一幢具有非常高感染安全标准的建筑物，所有房间都有外部入口和独立的电梯或走廊进入诊所。通风要求、隔离间标准、工作人员的工作模式和与相邻急诊室的互动，所有这些都对最终设计产生了重大影响。该论文还指出，他们设法通过广泛的标准化管理方法降低建造成本。在他的结论中，强调在规划和建设过程中优先考虑感染控制和疾病控制专家参与的重要性，是成功的重要因素。感染传播的另一个重要因素是清洁。传统的医院清洁主要靠人工完成，之前有几项研究指出了它的缺陷：“国际研究发现，在新近清洁过的病房中，新入院患者感染前一个患者疾病的风险是原来的两倍，或者说它们成了耐药菌携带者的**人。”根据论文得知，其中一个解决方案包括使用各种自动清洗方法。这意味着工作人员首先应清除任何可见的污垢，然后再使用机器或清洁机器人进行更有效的清洁操作。Torsten Holmdahl发现使用过氧化氢进行清洁可以获得最好的清洁效果。过氧化氢在清洗后可释放进入空气，并分解成环保产物。目前，感染诊所将继续研究新的清洁方法。来源：http://www.lunduniversity.lu.se/article/hospital-design-and-innovative-cleaning-can-protect-patients-from-resistant-bacteria 原文：Hospitaldesign and effective decontamination can prevent spread of antibiotic-resistantinfectionsHospitals should design premises andadapt their infection control routines to a society that no longer haseffective antibiotics, and that is vulnerable to fast-spreading globalpandemics. This is argued in a new dissertation from Lund University in Sweden."Many hospitals in Sweden and theworld are becoming old and worn out. Therefore, we now have the chance to buildproperly from an infection control point of view", says Torsten Holmdahl,doctoral student at Lund University and medical consultant at the infectionclinic at Skåne University Hospital.Torsten Holmdahl's dissertation includesstudies on the planning and construction process of the new infection clinic atSkåne University Hospital in Malmö. As the former director of the clinic, hewas also involved in this process."In my opinion, infection controlshould be one of the highest priorities when building new hospital premises. Irealised that the new construction in Malmö was an opportunity that should notbe missed", says Torsten Holmdahl.As a result, all occupational categoriesat the clinic were involved in the planning. In addition, a full-scale,fully-equipped model of a patient room was also built, where extensive tests ofinfection safety and working methods were conducted.The hospital decided to combineknowledge about construction from the time before antibiotics were used inhealthcare with the latest requirements for a modern and well-functioninghospital. The end result became a building with very high standards of infectionsafety, with external entrances to all rooms and separate lifts/walkways to theclinic. The ventilation requirements, single-room standards, work patterns ofthe staff and the interaction with the adjacent emergency room, have all had amajor impact and affected the final design.
The thesis also shows that they managedto keep construction costs down through extensive standardisation. In hisconclusion, the importance of prioritising infection control and theparticipation of experts in disease control in the planning and constructionprocesses are emphasised as factors for success.
Another aspect of major significance forthe spread of infection is cleaning. Traditional hospital cleaning is donemanually and several previous studies have pointed to deficiencies:"Accordingto international studies, in a newly cleaned space there is twice the risk thatthe newly admitted patient becomes infected with the previous patient'sdisease. Or that they take over as carriers of resistant bacteria", saysTorsten Holmdahl.
According to the thesis, one solutioninvolves different automated cleaning methods. It means that the staff start byremoving any visible dirt, after which a machine or cleaning robot performs amore efficient decontamination.
Torsten Holmdahl found that the bestresults were obtained using hydrogen peroxide which, after cleaning, is airedout and broken down into eco-friendly end products. The research studies on newcleaning methods now continue at the infection clinic.
从老师分享的资料可以看出合理布局多么重要！ 谢谢老师分享的资料！学习了。 谢谢老师的资料分享，学习了。 学习了，感谢老师分享！ 其实过氧化氢气雾消毒方法在各种场合都看过哦，还有紫外线的发生器那种，建筑布局可能感控介入容易，想决定就很难，特别还是我国这种医疗环境，大量的患者，很多的布局真正面对每天上万的门诊患者或者几千住院患者时候往往都变得很难落实 谢谢老师分享的资料！学习了。 这个事情目前在我们这里是没有办法办到的，如果是那样的话，这个医院是永远也建不起来的。 学习了，谢谢老师的分享 谢谢老师分享学习了，我们确实做不到。
路过学习，谢谢分享给大家！ 布局合理真的很重要。但现实却很纠结，现在我们改建病区，就存在这个困惑。
路过学习了，谢谢老师的分享！ 谢谢老师的分享，好好学习了。 布局和清洁，哪一个属于院感人能左右了哪！难难难 谢谢老师分享的资料！学习了。 感控雏鹰 发表于 2017-10-23 10:18
其实过氧化氢气雾消毒方法在各种场合都看过哦，还有紫外线的发生器那种，建筑布局可能感控介入容易，想决定 ...
有些是条件限制，我们结合医院实际，努力去做，相对合理。
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