Establishment Of Evaluation Criteria For Prevention Of Hospital Infections In Laboratories Of Large Hospitals

Hospital infection, a public health problem not to be ignored, has become an important research field in modern medicine. The risk of laboratory staff to expose to various viruses and microorganisms in their working environment is increasing because hospital is a place where many pathogenic microorganisms exist and laboratory staff would not only contact with patients but also with different kinds of sample. Inappropriate disposal of the medical wastes generated in laboratories can result in infection, contamination of environment and water source, and outbreak of infectious diseases. However,there are still a number of problems in prevention and control of hospital infections in laboratories, such as unrational design of laboratory which cannot meet the standards for the management of hospital infections, imperfect regulations and rules, ineffective supervision and management of hospital infections, taking diagnosis and treatment of diseases seriously rather than their prevention, insufficient training of laboratory professionals that leads to hospital ionfection, inappropriate sterilization and disinfection as well as inappropriate disposal of medical wastes that can easily result in contamination of environment. It has been proved that hospital loboratory is one of the high risk departments in hospital infections. It is, therefore, of great importance to study the current management state of hospital infection and its control strategies in laboratories. Study on the evaluation criteria for the control of hospital infections in laboratories of large hospitals can improve their laboratory work, medical service, and promote their construction and development. Since no evaluation criteria are available for the prevention of hospital infections in laboratories, how to construct an evaluation criterion system for the prevention of hospital infections in laboratories of large hospitals was studied.The principles and main steps of constructing a standard evaluation laboratory system for infections in large hospitals were studied, and the components of such a preliminary system were proposed, based on the infections occurring in lobaboratories of large hospitals and their prevention, by using the methods of literature analysis, discussion with experts, questionnaire investigation, and data analysis, etc.The system consists of three levels. The first level comprises organization management, implementation process, supervision and monitoring. The second level is composed of (1) organization management including regulations and rules, personeels and and environment fatalities concerning the requirements put forward by the leaders and administrative staff, (2) implementation process in laborary staff including education and training, prevention awareness, sterilization and disinfection management, dispoal of medical wastes, hand washing and disinfection, laboratory management, (3) supervision and monitoring including supervision and monitoring, result feedback and archival management in an attempt to strengthen hospital infection management and implement measures for the prevention of hospital infections. The third level is the further division of the inexes in level two with 60 subindexes included in the first run discussion with experts,and is, therefore, of rather good operability.The specific items in the Table were carefully selected after discussion with experts. The results obtained from the first run disussion with experts were analyzed, and revised with certain addtions and deletions following the opinions of experts. Then, the second run anonymous investigation was performed.A stardand evaluation system for the prevention of hospital infections in large hospital laboratories was established, which consists of three levels including 3, 12 and 55 indexes, respectively, according to the results of the 2 investigations. The weight coefficients of the included indexes were calculated.For the 2 investigations, the coeeficient of expert activity was 97.96% and 93.88%, respectively, the total coefficient of expert authority was 0.9293,the coeeficient of expert coordination was 0.8056 (χ2test,P<0.01),indicating that expert consultation is of very high authority and expert opinions are good in coordination, thus confirming the rather good confidence of this study.The stardand evaluation system for the prevention of hospital infections in large hospital laboratories, established in this study, is scientific,integrative, practical and prospective, and can thus improve the ability of laboratories to prevent hospital infections, hospital management and medical sevice, and promote the overall construction and development of hospitals.The system also has rather good social and economic cost-effect, and cab therefore be used in prevention of hospital infections in laboratories as a comprehensive and standard evaluation system.