Hepatitis C virus(HCV)is a blood-borne pathogen that has a worldwide distribution and infects millions of people.Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminate...Hepatitis C virus(HCV)is a blood-borne pathogen that has a worldwide distribution and infects millions of people.Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health.The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified:(1)infected patient to non-infected patient;(2)infected patient to non-infected health careworker(HCW);and(3)infected HCW to non infected patient.For each condition,the circumstances of contamination are described together with the means to prevent them.As a whole,the more important risk is represented by unsafe practices regarding injections,notably with the improper use of multidose vials used for multiple patients.The questions of occupational exposures and infected HCWs are also discussed.In terms of prevention and surveillance,the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares,with training programs and audits to verify their good application.HCWs must be sensitized to the risk of blood-borne pathogens,notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures.The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay.With the need to stay vigilant because HCV infection is often a hidden risk,it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.展开更多
医源性感染(health care-associated infection)是威胁病人安全的主要问题,世界病人安全联盟会议制定2005～2006年度全球病人安全挑战的主题是“清洁卫生更安全(clean care is safer care)”,目的在于在全球推行使用成本低、操作简便和...医源性感染(health care-associated infection)是威胁病人安全的主要问题,世界病人安全联盟会议制定2005～2006年度全球病人安全挑战的主题是“清洁卫生更安全(clean care is safer care)”,目的在于在全球推行使用成本低、操作简便和卓有成效的方法控制医源性感染,其核心思想是在卫生保健中开展“手部清洁(hand hygiene)”运动。文章介绍此次全球病人安全挑战的主要工作目标和内容。展开更多
[目的]检索分析并总结重症监护室(ICU)病人皮肤清洁相关证据,为临床护理人员对ICU病人擦浴提供依据。[方法]应用循证护理的方法,针对成人ICU病人擦浴提出问题,并检索近10年内的相关研究,检索数据库依次为:Best Practice、Up to Data、...[目的]检索分析并总结重症监护室(ICU)病人皮肤清洁相关证据,为临床护理人员对ICU病人擦浴提供依据。[方法]应用循证护理的方法,针对成人ICU病人擦浴提出问题,并检索近10年内的相关研究,检索数据库依次为:Best Practice、Up to Data、美国指南网(NGC)、苏格兰学院间指南网(SIGN)、澳大利亚循证卫生保健中心(JBI)证据总结数据库、Cochrane Library,并补充了检索原始文献数据库PubMed、Web of Science、Science Direct数据库和中国生物医学文献数据库及中国知网数据库。采用英国2012年更新的《临床指南研究与评价系统》AGREE Ⅱ、JBI的文献质量评价工具对各类研究进行文献质量评价及证据级别评定。[结果]包括指南4篇、证据总结2篇、专家共识2篇、系统评价4篇、随机对照试验10篇、类实验研究6篇,前瞻性队列研究1篇。最终从适宜人群、不同部位的清洁、洗浴用品的选择、洗浴用品的浓度、洗浴的频率和总时长、卫生经济评价、安全性评价7个方面进行了证据总结,形成了17条最佳证据。[结论]建议临床使用证据时充分考虑可行性及适宜性,由于最佳证据会随着时间的推移不断更新,应用者还需持续对证据进行更新以应用最佳证据。展开更多
文摘Hepatitis C virus(HCV)is a blood-borne pathogen that has a worldwide distribution and infects millions of people.Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health.The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified:(1)infected patient to non-infected patient;(2)infected patient to non-infected health careworker(HCW);and(3)infected HCW to non infected patient.For each condition,the circumstances of contamination are described together with the means to prevent them.As a whole,the more important risk is represented by unsafe practices regarding injections,notably with the improper use of multidose vials used for multiple patients.The questions of occupational exposures and infected HCWs are also discussed.In terms of prevention and surveillance,the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares,with training programs and audits to verify their good application.HCWs must be sensitized to the risk of blood-borne pathogens,notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures.The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay.With the need to stay vigilant because HCV infection is often a hidden risk,it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.
文摘医源性感染(health care-associated infection)是威胁病人安全的主要问题,世界病人安全联盟会议制定2005～2006年度全球病人安全挑战的主题是“清洁卫生更安全(clean care is safer care)”,目的在于在全球推行使用成本低、操作简便和卓有成效的方法控制医源性感染,其核心思想是在卫生保健中开展“手部清洁(hand hygiene)”运动。文章介绍此次全球病人安全挑战的主要工作目标和内容。
文摘[目的]检索分析并总结重症监护室(ICU)病人皮肤清洁相关证据,为临床护理人员对ICU病人擦浴提供依据。[方法]应用循证护理的方法,针对成人ICU病人擦浴提出问题,并检索近10年内的相关研究,检索数据库依次为:Best Practice、Up to Data、美国指南网(NGC)、苏格兰学院间指南网(SIGN)、澳大利亚循证卫生保健中心(JBI)证据总结数据库、Cochrane Library,并补充了检索原始文献数据库PubMed、Web of Science、Science Direct数据库和中国生物医学文献数据库及中国知网数据库。采用英国2012年更新的《临床指南研究与评价系统》AGREE Ⅱ、JBI的文献质量评价工具对各类研究进行文献质量评价及证据级别评定。[结果]包括指南4篇、证据总结2篇、专家共识2篇、系统评价4篇、随机对照试验10篇、类实验研究6篇,前瞻性队列研究1篇。最终从适宜人群、不同部位的清洁、洗浴用品的选择、洗浴用品的浓度、洗浴的频率和总时长、卫生经济评价、安全性评价7个方面进行了证据总结,形成了17条最佳证据。[结论]建议临床使用证据时充分考虑可行性及适宜性,由于最佳证据会随着时间的推移不断更新,应用者还需持续对证据进行更新以应用最佳证据。
