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😷 | Kumamoto City's infection risk, the highest "level XNUMX" new corona, prefecture "level XNUMX"


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Kumamoto City's infection risk, the highest "level XNUMX" new corona, prefecture "level XNUMX"

 
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Mayor Kazufumi Onishi said, "I want you to stay alert and try to prevent infections such as avoiding three stakes."
 

On the XNUMXth, Kumamoto City raised the infection risk level (XNUMX levels) of the new coronavirus in the city from level XNUMX (warning) to the highest level ... → Continue reading

 Kumamoto Daily Newspaper

The Kumamoto Nichinichi Shimbun is a local newspaper in Kumamoto. Full of information about Kumamoto such as news and sports.


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Infection control

Infection control(Kansenkanri), or medical epidemiology,Medical facilityWithininfectionRefers to efforts aimed at preventing epidemics, with an emphasis on practiceEpidemiologyIs a field.public healthActivities and infection control/medical epidemiology have a lot in common, the former is aimed at society as a whole, while the latter generally deals with problems limited to a specific medical institution (group). Also known as "infection control activities," "infection prevention and management activities," and "infection control activities."Infection control teamIt is counted as one of the basic medical safety management systems of hospitals as an activity that many occupations in the facility work together.

Infection control can be roughly divided into two.

  • Preventive activity
  • Trend measures
    • Investigation activities and countermeasures (eg outbreak countermeasures) that are targeted at outbreaks that have occurred or are suspected to have occurred in a specific medical institution.

Infection control in medical institutions

Occurrence monitoring

Surveillance refers to grasping the occurrence status of infectious diseases on a daily basis. To facilitate comparison between facilities and regions,Bloodstream infection-Urinary-tract infectionThe criteria of the National Nosocomial Infections Surveillance System (NNIS) are used to define the main nosocomial infections.

actually,Infection control teamStaff ofpatientData is collected by directly observing and determining the presence or absence of symptoms and signs peculiar to infectious diseases. Bacterial laboratory data from the bacteriological laboratory is also an important source of information. In recent years, automation of bacterial laboratory data andElectronic medical recordAutomation is increasing the automation of data extraction, enabling staff to spend more time collecting clinical data. Nosocomial infectionAbout 1/3 of these are preventable[1]Infection surveillance and prevention activities are becoming increasingly important by hospital staff. According to the CDC Nosocomial Infection Control Project (SENIC), by focusing on infection surveillance and prevention activities, the incidence rate of nosocomial infections could be reduced by about 32%.

Preventing the spread of infection

Nosocomial infectionOf each pathogen to prevent transmission and protect health care workers themselves from infectionTransmission routeIt is necessary to take measures according to the situation and make the procedure known.

Standard precautions centered on hand washing

Vienna OfSemmelweiss( 1847) AndDuffel Bag OfOliver W. Holmes( 1843), the unique research published byNosocomial infectionRelated to[2].Center for Disease Control and PreventionIn response, the (CDC) reported that "the most important way to prevent the spread of pathogens was effective hand washing".[3].

Handwashing is compulsory at most medical institutions, and in the United States it is not simply a matter of common sense, but is also compulsory by various local and local governments. Occupational Safety and Health Administration (OSHA) standards in the United States[4]Requires employers to have hand-washing equipment available at all times, and wash their hands and other skin with soap and water or run mucous membranes under running water if they come into contact with blood or other potentially infectious substances. We are asking you to guarantee that you can wash.

In Japan, “National University Hospital Hospital Infection Control Guidelines” by the National University Hospital Infection Control Council[5]And other guidelines were formulated in 2002.

  • It is recommended to wash your hands and wear gloves before and after touching the patient's blood, body fluids, secretions, excretions, damaged skin and mucous membranes regardless of known infections. Depending on the procedure, masks, goggles, face shields, and gowns are also used.
  • Calls for the prohibition of recaps to avoid punctures and cuts due to needles, scalpels and other sharp instruments, proper placement of medical waste containers for safe disposal immediately after use, and the adoption of needles with safety devices. ..
  • When environmental surfaces such as floors and walls are contaminated, wear gloves and wipe with a paper towel and disinfectant. Store contaminated linen properly until cleaning to prevent contamination of the environment.
  • Patients who may be contaminated with blood should be kept in a private room.

Isolation precautions

In addition, if the causative pathogen is known, it is unique to each.Transmission routeTake appropriate quarantine precautions accordingly.

Air (spray nucleus) infection isolation

  • Healthcare workers wear N95 masks.
  • In the patient's individual room environment, operating room, bronchoscopy room, and respiratory function testing room, forced more than 1 times per hourventilationKeep the negative pressure. Exhaust out of the hospital through a HEPA filter. If structurally impossible, use a portable HEPA filter built-in air purifier instead, and perform ventilation 12 times.
  • Wear a surgical mask when passing through public areas to transfer patients, or wear an exhalation filter during endotracheal intubation.

Isolation of droplet infection

  • A surgical mask is worn for activities within a radius of 1 m from the patient.
  • When separating individual rooms and groups, beds are placed 2m apart.
  • Wear a surgical mask when passing through public areas to transfer patients.

Contact infection isolation

  • Wash hands and wear gloves before and after contact with the patient and contaminated surfaces.
  • Wear gowns where there is potential for full body contact with the patient or contaminated surfaces.
  • Medical equipment used in private rooms should be dedicated as much as possible.

Cleaning/disinfection/sterilization

The contact surface of the patient's room and common areas touched by the patient's hands is cleaned by daily wiping. Clean walls and floors that are not touched once a day. In areas where MRSA, VRE, and Clostridium difficile carriers come into contact, daily sterilization is performed by wiping with a quaternary ammonium salt or alcohol. Of reusable medical equipmentdisinfection-SterilizationThe method must be selected according to each possible pathogen.

Personal protective equipment

(Personal protective equipment, PPE) is clothing and equipment worn by medical personnel to protect themselves from danger. What is the danger in the medical field?Viral hepatitis,HIVBlood, saliva, and other body fluids that may contain pathogens such asaerosolExposure to. Personal protective equipment aims to prevent exposure by creating a physical barrier between those infectious agents and health care workers.

In the United States, OSHA standards require health workers to wear protective equipment to protect themselves from bloodborne pathogens when their exposure to blood and other infectious agents is adequately predicted.[6]

Protective equipment: hats, shoe covers, face shields (for mouth-to-mouth breathing)MASKS-goggles・There are types such as. Which combination and how to use is usually determined by the rules set for each medical institution. Most instruments are completelydisinfection-SterilizationConsidering the high cost of doing so, it is designed to be disposable. OSHA standards require that protective equipment be immediately removed and disinfected or disposed of upon leaving a site exposed to infectious agents.[7]

Vaccination of medical staff

Healthcare workers who may be exposed to infectious diseases during work should:vaccineCan be used to protect yourself from infection. Usually usedHepatitis B-influenza-Mixed three(Measles/varicella/rubella)New three kinds of mixture(Diphtheria/Tetanus/Pertussis)Meningococcus・Medical workers and paramedics are being vaccinated with such vaccines according to the rules of the facility, recommendations, occupations, and individual wishes. In general, the preventive effect of vaccines cannot be said to be perfect, but on the other hand, side effects are also seen, so judgment of vaccination should be made based on sufficient information.[8]

Survey during an epidemic

When infection monitoring finds that the incidence of infections is higher than normal, the infection control team will investigate to determine (1) whether it is a real epidemic or (2) a false epidemic due to contamination of the bacterial testing process. Or (3) determine whether the normal incidence just happened to rise randomly. If it is (1), it will be necessary to investigate the factor that triggered the fashion and eliminate it in order to stop the fashion. It is usually due to lack of correct procedures, but sometimes other factors such as construction work are involved.

Infection control and medical epidemiology training system

There are several educational systems to acquire infection control. The occupational background is often nurses, sometimes clinical laboratory technicians (especially clinical microbiology), and doctors (usually infectious disease physicians). Training courses specialized in infection control and medical epidemiology are offered by the following professional organizations: Those who want to be involved in infection control as a doctor often go through clinical training in the department of infectious diseases.

In the United States,CBIC) Examines the professional background and work experience of health care workers, checks the level of knowledge through standardized departmental examinations, and then licenses infection control personnel. Two years of activity experience is required for application, and renewal of qualification is required every five years.

In the United States, CDC and the American Society for Medical Epidemiology (SHEA) have jointly conducted hospital epidemiology (infection control in hospitals).course Is held every year, and there is also a course from the Association of Infectious Control Practitioners (APIC).

Infection Control Team and Infection Control Committee

  • The infection control team is the actual work force in a medical institution, and the infection control committee is in charge of managing the infection control team (Fig. 1).

Infection control profession

footnote

  1. ^ Weinstein et al
  2. ^ CDC Guideline for Hand Hygiene in Health-Care Settings
  3. ^ CDC General information on Hand Hygiene
  4. ^ OSHA Bloodborne Pathogens Regulations 1910.1030
  5. ^ Guidelines for Nosocomial Infection Control at National University Hospitals (pdf 5.2MB)
  6. ^ OSHA Bloodborne Pathogens Regulations 1910.1030 (d) (2) (i)
  7. ^ OSHA 1910.1030 (d) (3) (vii)
  8. ^ CDC Vaccine Site
  9. ^ Norihito Sato, Akari Watanabe, Susumu Kokoguchi, Kazuhiro Fukui “Infection Control Professional Qualification and Organizational Awareness Survey on Dental Clinical Trainees” INFECTION CONTROL (Medica publishing), Vol.16 (6), p.97,2007, XNUMX.

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