With the continuous development of medical technology, ambulatory surgery or day surgery is becoming a new and very efficient medical service model in China. However, infection prevention and control in ambulatory surgery center has not yet attracted the attention of infection control practitioners. This paper analyzes the necessity, status quo, and entry point of infection prevention and control work in ambulatory surgery centers. Recommendations in the field of risk assessment, engineering control, behavior management, surveillance, and antimicrobial stewardship are provided to infection control practitioners as well.
Objective To investigate and analyze the epidemic characteristics and factors of pulmonary tuberculosis (PTB) to provide foundation and make prevention and treatment policy. Methods Statistical analysis was conducted to analyze the current existing PTB prevention and control data in the Center for Disease Control and Prevention of Zhushan County and corresponding prevention and treatment policy was proposed. Results Since 1997 when PTB was included into B infectious diseases in Zhushan County, 4 431 cases of PTB had been reported by the end of 2009. Annual reported incidence rate was 74.73 per 100 000 and the disease was found in 17 towns. All seasons witnessed the incidence but winter and summer had more sufferer. The youngest patient was 4 months whereas the oldest was 86 years old. The majority of the patients were from 20 to 59 years old, peasants were the main patients, and the incidence of male was higher than that of female. The use of chemotherapy resulted in a significant decline of PTB death rate. Poor immunity of elder group, population flow caused by poverty, low detection rate of patients and AIDS were the major causes to PTB epidemic. A lack of prevention and treatment in the grassroots hospital and difficulty to fully implement the Directly Observed Treatment, Short-course (DOTS) strategy in remote areas were also bottlenecks to PTB control process. Conclusion The followings should be performed to improve the quality of DOTS strategy implementation: strengthen the government’s commitment, provide policy and funding safeguard, conduct health education and health promotion widely, reinforce management according to the law, fully implement the DOTS strategy, and fortify the prevention and control construction.
To analyse the causes of biliary injuries and summuarize the experience of prevention of biliary injury during laparoscopic cholecystectomy (LC). Twenty-three patients with biliary duct injury were diagnosed and treated at our center between September 1992 and August 1998. The main causes were either misidentification of the bile duct or aberrant right duct as the cystic or injudicious use of thermal energy (cautery) to dissect, control bleeding, or divide tissue. Conclusion: The causes of biliary duct injury are complex. Training and experience of sugeon, the meticulous dissection of the calot′s triangle and preoperative or operative cholangiography are three key factors in prevention of biliary duct injury during LC.
ObjectiveTo analyze the status and influencing factors of awareness of diabetic retinopathy (DR) knowledge in diabetics in Funing County, Jiangsu Province. MethodsThis is a cross-sectional study. In 2021, a total of 2 125 residents with diabetes in Funing County, Jiangsu Province were recruited using cluster random sampling methods. General examinations were performed and ophthalmological evaluation were conducted including visual acuity in daily life, slit lamp microscope with preset lens, digital non-mydriatic fundus photography. Clinical assessment and classification of DR were according to the international standard clinical classifications of diabetic retinopathy in 2019. DR was classified into no obvious DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR). Field questionnaire surveys were conducted to show the awareness rate of DR knowledge. Then Chi-square test and Logistic regression analysis were used to investigate influencing factors. ResultsAmong 2 125 subjects, 762 (35.86%, 762/2 125) residents were male and 1 363 (64.14%, 1 363/2 125) residents were female. A total of 444 (20.89%, 444/2 125) subjects were diagnosed as DR. Among which, 438 (20.61%, 438/2 125) subjects were NPDR, 6 (0.28%, 6/2 125) subjects were PDR. A total of 419 (19.72%, 419/2 125) subjects were diagnosed as cataract. The topic awareness rates were all below 45.00%. The overall population awareness rate was 19.45% (4 959/25 500). Awareness rate was correlated with age, visual acuity in daily life, education level, family history of diabetes, diabetic retinopathy grades and the type of treatment for diabetes (P＜0.001). Logistic regression analysis showed that the knowledge rate of prevention and treatment of DR Decreased significantly in patients aged 60-79 compared with those aged under 50 (P＜0.05). Compared with those with visual acuity＜0.1 in daily life, the knowledge rate of DR prevention and treatment in those with visual acuity≥0.1 was significantly decreased (P＜0.05). While primary school to college education, with family history of diabetes, with DR, oral hypoglycemic agents and/or insulin treatment were associated with higher awareness rate (P＜0.05). ConclusionsThe DR knowledge level is low among diabetics in Funing County, Jiangsu Province in 2021. Age, visual acuity in daily life, education level, family history of diabetes, with DR and receiving drug treatments are main influencing factors for diabetic’s awareness.
According to the requirements for the “three districts and two channels” in the sanitary industry standard Technique Standard for Isolation in Hospitals, combining with the spirit of current documents related to the prevention and control of coronavirus disease 2019, in order to guide medical institutions at all levels to conduct standardized design of fever clinics in accordance with the principle of “combining normal time and epidemic period”, this article explains the design points of the fever clinics for the prevention and control of coronavirus disease 2019, introduces the specific methods for the fever clinics to achieve “three districts and two channels”, draws a schematic diagram of the fever clinics in general hospitals, and explains the functional layout and medical procedures of the clean area, potential contaminated area, and contaminated area in detail; at the same time, a schematic diagram of the change of fever clinics from “normal” to “during the epidemic” is drawn, and the ideas for the conversion and the process after the conversion are introduced. It proposes design ideas and drawing references for the construction, transformation, and expansion of fever clinics.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.
Objectives To analyze the effect of improved oven for defluorination in coal-burning endemic fluorosis areas in China, and to provide evidence for the prevention and control of fluorosis. Methods Electronic databases including CNKI, CBM, VIP and CDMD-D (1989 to 2005), were searched. We also checked the reference lists of relevant articles. We selected relevant articles according to the predefined inclusion and exclusion criteria. The methodological quality was assessed . Data on room heat preservation and the effect of improved oven for defluorination were collected in the surveillance spots of Three Gorges Reservoir. Correlation analyses were conducted between the improved oven and its effect parameters. Results Twelve articles of low quality met the selection criteria, of which 9 were graded C and 3 were graded D in terms of the methodological quality. A negative correlation was found between the decreasing rate of normal oven use and the decreasing rate of dental fluorosis as well as of urine fluorine (Pearson correlation coefficient r = – 0.87, – 0.63, Plt;0.01, lt;0.05, respectively). Analysis also revealed a positive correlation between room heat preservation and the decreasing rate of dental fluorosis as well as of normal oven use (the two Spearman correlation coefficients and P values were the same: r = –1.00, Plt;0.01). Conclusion High-quality studies on the effect of improved oven for defluorination in China are not available. Based on the current evidence, the improved oven for defluorination and the correct use, maintenance and house rebuilding for heat preservation may help to prevent fluorosis.
ObjectiveTo explore the effect of case-based learning combined with scenario exercise on nosocomial infection prevention and control training.MethodsClinical nursing students who entered the Department of Western & Traditional Chinese Medicine between September 2018 and November 2019 were selected. These students entered in groups. According to the entry number, the groups were divided into trial group and control group by odd or even numbers. The two groups of nursing students were trained by the infection prevention and control nursing group of the department to prevent nosocomial infection on the first day of entering the department. The trial group adopted case-based learning combined with scenario exercise, while the control group adopted traditional lecture-based learning. The two groups were compared by hand hygiene compliance rate, hand hygiene accuracy rate, clinical waste classification and disposal accuracy rate, occupational exposure, nosocomial infection prevention and control assessment scores, and teaching method satisfaction.ResultsA total of 63 nursing students from 10 groups were enrolled. There were 32 students from 5 groups in the control group and 31 students from 5 groups in the trial group. The hand hygiene compliance rate (χ2=8.434, P=0.004), clinical waste classification and disposal accuracy rate (χ2=4.196, P=0.041), nosocomial infection prevention and control assessment scores (t=3.145, P=0.003) and satisfaction scores of teaching methods (t=2.446, P=0.017) in the trial group were all higher than those in the control group. There was no occupational exposure in the trial group, but 1 case in the control group. The correct hand hygiene rates of the two groups were both 100%.ConclusionCase-based learning combined with scenario exercise can effectively improve the awareness of nosocomial infection prevention and control, improve the knowledge and skills of nosocomial infection prevention and control, improve the effectiveness of nosocomial infection prevention and control training, and increase the satisfaction of clinical teaching.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
ObjectiveTo analyze the relevant factors for surgical site infection. MethodsA total of 677 cases of surgery in one hospital from July 1 to December 31 in 2012 were surveyed (not including implant and cardiac intervention surgeries), which were divided into different groups according to the preoperative incision contamination level, and the postoperative healing of incisions were observed closely. After the patients were discharged, we investigated the situation of incisions by phone or periodic review, and forms were filled in on schedule. ResultsBy follow-up evaluation of the 677 cases, the incisions in 12 cases were infected and the infection rate was 1.77%. Polluted and infected (14.28%, 30.76%) incisions caused more infection than the clean and clean-polluted incisions (0.00%, 0.59%). The patients who stayed in hospital for 4 or more than 4 days before surgeries (infection rate was 4.55%) took more risk of infection than the patients whose preoperative time in hospital were 2-3 days (infection rate was 0.60%) and 1 or shorter than 1 day (0.68%). Perioperative use of antibiotics for longer than 72 hours will increase the risk of incision infection than those within 48 hours (7.69%, 0.00%; P=0.002). ConclusionSurgical site infection is related to the incision type. Shortening the preoperative in-hospital time will reduce the risk of infection. Long time use of antibiotics in perioperative period cannot prevent the postoperative infection effectively, but may increase the risk of infection.