Analysis And Management On Nosocomial Infection Of Gynecology And Obstetrics In One Of Hospitals Of Daqing

Purpose The nosocomial infection is the serious problem that the medical treatment units of all levels universally exist at present. The nosocomial infects controlling have been had in the 50's last century in the abroad, begins mentioned in the 80's last century in our country , and still belongs to the new and developing branch of learning in our country. Nosocomiology is a synthetically branch of learning. The full-time personnel who is engaged in the nosocomial infection not only possess the administration functions such as the nosocomial infects managements and control etc, and possesses the technology specialty guidance function again, and needs to control concerning clinical medicine , the infectious disease , epidemiology , microbiology , pharmacology , the nursing , the public health , Laboratory Medicine , hospital architecture as well as specialty knowledge of law , the hygienic regulations and computer . In our country ,the work of nosocomial infects department is still stay around to statistics the infection incidence of disease , and some the effect evaluation with the disinfect work , the great problems such as that building design to the hospital , purchase of antibiotic drug use and infection control on hospital management etc , act on very limited. Our hospital is a second class second grade hospital , has 120 hospital beds, and has four department for internal,surgical,gynecology and obstetrics and pediatrics. By the way of analysis the whole 6437 case of leaving our hospital in 2003.1～2004.12, we find that nosocomial infection rate of gynecology and obstetrics is more than other department in hospital the notable corresponding period. As for this phenomenon , the focal point is studied the characteristic that the gynecology and obstetrics nosocomial infects case; combine the real circumstances of our hospital, inquires into easy infection factor and weak point in the management , and puts forward the corresponding control management. In the hope of can effectively reduce the occurring rate of nosocomial infection . The nosocomial infects is seriously restricting raising of medical treatment quality , and is the big obstacle on modern medical treatment technology and hospital developed; and looked protruding increasingly along with the medical treatment technology speedily developments and used the antibiotic non-standard. How to prevent and control nosocomial infection effectively has become the important research subject in medical science and medical science management. Material and methods Material: All 6437 of hospital discharge cases of our hospital in 2003.1～2004.12. Methods: Adopt the review investigation method . check the hospital discharge case of this period, case of occurrence nosocomial infection fill in the investition table designed in advanced . Pass to carry on the chi-square test to jud ge occurring rate of nosocomial infection of each department have difference or not. Diagnosis standard : The case is diagnosed according to 《thestandard of nosocomial infects diagnosing ( trys out ) 》what the hygiene ministry issued on January 3 in 2001. Results Total occurrence in whole hospital nosocomial infection number is 157, the occurrence rate of nosocomial infection is 2.4%, but the gynecology and obstetrics total occurrence nosocomial infection number is 67, the occurrence rate of nosocomial infection is 4.1%, have 42.7% of the infection case of the whole hospital number. Through statistics, the occurring rate of nosocomial infection of gynecology and obstetrics is more than other hospital department in the corresponding period , and has statistics meaning. With infection part counts , episiotomy infection occupies 31.3%,upper respiratory tract infection occupies 25.4%, amount to 56.7%, occupies the overwhelming majority. Discussion 1. Episiotomy infection analyzing : During in 2003.1～2004.12, the gynecology and obstetrics total 1648,obstetrics patient 1324, adopt episiotomy accouche 721, among them 21 inpatient occur episiotomy wound infection. The vagina has the certain defense function, including the vagina to have the clean function, the liquid of cervix to bolt and fill and the liquid of cervix uteri and amniotic fluids to put out the function to the kill of bacteria in the anti-virus material contain. But lower or broke the defense function because of the childbearing, the uterine cavity, cervix uteri , vagina and the vulva all left unequal wound. These all increased the germs to invade to grow the opportunity of the way. Therefore, to reduce episiotomy infection, we should strengthen health care, and strengthen the asepsis concept, handlechildbirth correctly, avoid the product way to be harmed, and must keep the vulva clean. 2. Upper respiratory tract infection analyzing: Our hospital is a basic hospital, not enough strict in the system of visiting and accompanies .The visit accompanies the personnel many and miscellaneous; as a result, the opportunity of cross infection is more. Moreover, the pregnant woman's mucous membrane of upper respiratory tract increase thick, and the hyperemia edema makes the part resisted power to weaken, this is also one of the reason that the pregnant woman takes place upper respiratory tract infection easily. If we can formulate a ground of visit with reasonable establishment to accompany the system and carry out strictly, and the air is disinfected regularly, cutting off up the dissemination path, the occurrence rate of the upper respiratory tract infection can be reduced greatly. 3. Urethra infection analyzing: The gynecology and obstetrics surgical operation almost all must be laid up catheterization pipe. Through the investigation, urethra infection majority have catheterization history, and keeping 3 days the shortest, 7 days the longest. The catheterization belongs invading operation, general 1 day before the surgical operation or that very day. Keeping urine pipe after operation can result in the urethra glue the membrane injury easily. This is the major factor that infection occurs and the long keeps urine pipe, the more urethra infection will occur. So the prevention infection on the urine is being applied catheterization. It need medical personnel strict of asepsis concept, and control the standard of catheterization, shortens the pipe's detention time as far as possible. 4. Gastrointestinal infection analyzing: Gastrointestinalinfection has the close relation to the hygienic installation, crowd of the hospital habit and health publicity educates. The man who abuses antibiotic leads to bacterium imbalance will in trouble with gastrointestinal infection. The rate of antibiotic utilization of the gynecology and obstetrics is 56.1%, the hospital is 71.2%. There is no difference between them. Prevent gastrointestinal infection depends on that forming good hygiene accustomed , and rice front then behind wash hands, keep good environmental hygiene etc. 5. Using antibiotic reasonably: After the episiotomy, we often use antibiotic to prevent infection. It having acted the effect to restraining episiotomy infection. It is a very important principle for us to reduce antibiotic used in prevention. How to use antibiotic reasonably is putting at an important subject on us. 6. Disinfect air safe and effective: It is one of the major ways of nosocomial infection that through the air propagate disease. We use the ultraviolet ray of tradition to shine and cross oxygen ethanoic acid spray to disinfect air in our hospital. But it isn't fit for maternity, because these two kinds of method have bad influence to human health, and unsuitably is in progress under someone's state. It is an urgently problem to seek a quick and simple and convenient and safe and effect method to disinfect air, and needn't to soar the sickroom. Conclusion The nosocomial infection rate of gynecology and obstetrics is more than other department in the corresponding period, have something to do with the physiology characteristics of pregnant woman's oneself, also have the very big relation with the hospital management. Be dead against weak point and adopting measureto strength the sickroom man agent can reduce our nosocomial infection rate effectively.