1.Investigation and Ethical Countermeasures for Blood-borne Occupational Exposure in Medical Workers in General Hospitals
Xiaoyan WANG ; Baohua PING ; Yongjie LIN ; Xianhua GUAN ; Shaoying LU
Chinese Medical Ethics 2015;(3):308-311
Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .
2.Cognitive status and influencing factors for hand hygiene among health care workers in a general hospital
Xiaoyan WANG ; Baozhen LI ; Baohua PING ; Xianhua GUAN ; Shaoying LU ; Liang JI ; Qian LI
Chinese Journal of Infection Control 2015;(11):776-779
Objective To investigate cognitive status and influencing factors for hand hygiene(HH)among health care workers(HCWs),and provide basis for scientific management of HH.Methods In April 2013,HCWs in a general hospital were selected by randomly sampling method,questionnaires were used to survey the implementation of HH in recent one month and HCWs’cognition on knowledge about HH.Results A total of 750 HCWs were in-vestigated,652 available questionnaires were collected.The frequency of hand washing and hand disinfection per day among most HCWs were 10 - 19 times,accounting for 46.62% and 47.85% respectively;30.52% of HCWs washed their hands for ≥30 seconds each time,60.58% of HCWs dried hands with paper towel after washing hands,57.21 % of HCWs abided by six-step hand washing method.The overall correct rate of cognition on ten op-portunities that requiring HH in clinical practice was 68.68%.The main factors influencing the implementation of HH were as follows:skin irritation of hand sanitizer and hand disinfectant subjectively considered by HCWs (63.34%),inadequate hand washing facilities(41 .10%);high cost of hand sanitizer ,hand disinfectant,and dry paper towel (38.96%),et al.Conclusion In addition to intensifying education on HH,installing rational HH facili-ties and improving HH standard are key points in strengthening HH in general hospital.
3.Impact of pre positioned nasopharyngeal airway combined with high head pre inhalation of oxygen on lung oxygenation and blood gas analysis in morbid obesity patients underwent laparoscopic weight loss surgery
Zehua TU ; Zhida LIAO ; Zhimin HE ; Jie GUAN ; Xianhua LU
China Journal of Endoscopy 2024;30(2):41-48
Objective To explore the impact of pre positioned nasopharyngeal airway combined with high head pre inhalation of oxygen on lung oxygenation and blood gas analysis indicators in morbid obese patients undergoing laparoscopic weight loss surgery.Methods 100 morbid obesity patients from January 2020 to April 2022 planned to undergo elective laparoscopic weight loss surgery were selected as the study subjects.All the patients were divided into two groups according to the random number table method:group A with a head height of 25° and a pre installed nasopharyngeal airway;group B with a head height of 25° and no pre installed nasopharyngeal airway,with 50 patients in each group.Two groups were pre oxygenated for 3 min before undergoing intravenous anesthesia to induce tracheal intubation.Observe and record the pH value,partial pressure of oxygen in arterial blood(PaO2),partial pressure of carbon dioxide(PCO2),partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen(PaO2/FiO2)as well as the ratio of arterial pressure to alveolar oxygen partial pressure(a/APO2)of the two groups of patients who breathed air(T0)after entering the room,ventilated with mask positive pressure for 3 min(T1),and intubated with trachea for 3 min(T2).Record plateau pressure(Pplat),peak airway pressure(Ppeak),and dynamic lung compliance(Cdyn)at T1,T2,and 5 min after pneumoperitoneum(T3).Record the time for percutaneous arterial oxygen saturation(SpO2)to decrease to 92.0%under different artificial ventilation after tracheal intubation,the time for SpO2 to recover to 96.0%after resumption of ventilation,and the occurrence of adverse reactions.Results Compared with Group B,at time point T1,Group A showed a decrease in PCO2 and an increase in PaO2,with statistically significant differences(all P<0.05);Compared with T0,at time points T1 and T2,PaO2/FiO2 and PCO2 in the two groups were increased,while a/APO2 decreased(all P<0.05).At T1 time point,Pplat and Ppeak in Group A were lower than those in Group B,while Cdyn was higher than that in Group B,with statistical significance(P<0.05);Compared with T1 time point,at T2 and T3 time point,Pplat and Ppeak in Group A increased,while Cdyn decreased,with statistically significant differences(all P<0.05);Compared with T1,Ppeak increased in B groups at T2 time point(P<0.05),while Pplat and Ppeak increased in T3 time point,and Cdyn decreased in B group,with statistical significance(all P<0.05).Compared with Group B,Group A had a longer time for SpO2 to decrease to 92.0%and a shorter time for SpO2 to recover to 96.0%(P<0.01).Conclusion The combination of pre positioned nasopharyngeal airway and high head pre inhalation of oxygen can effectively improve acute respiratory obstruction during induction of general anesthesia insertion in morbid obesity patients,and extend the duration of no ventilation.