TOPIC: SANITARY – ANTI-EPIDEMIC REGIME IN HOSPITAL. TASKS. REQUIREMENTS
1. Lead. WBI statistics.
2. Regulatory documents governing the work on sanitary
epidemiological regime in UZ.
3. Anti-epidemic measures.
4. Prevention of nosocomial infections during nursing interventions.
1. It is conditionally possible to distinguish three types of nosocomial infections:
– in patients infected in hospitals;
– in patients infected while receiving outpatient care;
– among medical workers who became infected while providing medical care to patients in hospitals and clinics.
All three types of infections are united by the place of infection – a medical institution. Nosocomial infection – any clinically recognizable infectious disease that affects a patient as a result of his admission to the hospital or seeking treatment, or an infectious disease of a hospital employee as a result of his work in this institution, regardless of the appearance of symptoms of the disease. VBI is a collective concept that includes various nosological forms.
Analysis of the available data shows that in the structure of nosocomial infections detected in large multidisciplinary health facilities, purulent-septic infections (PSIs) occupy a leading position (up to 75-80% of the total). The main risk factors for the occurrence of GSI are: an increase in the number of carriers of resident chip strains among employees, the formation of hospital strains, an increase in the contamination of air, surrounding objects and personnel hands, diagnostic and therapeutic manipulations, non-compliance with the rules for placing patients and caring for them, etc. Another large group of nosocomial infections is intestinal infections (up to 7-12% of the total). Salmonellosis predominates among intestinal infections. Salmonellosis is recorded mainly (up to 80%) in debilitated patients of surgical and intensive care units who have undergone extensive abdominal operations or have severe somatic pathologies. Salmonella strains isolated from patients and from environmental objects are characterized by high antibiotic resistance and resistance to external influences. The leading routes of transmission of the pathogen in health care facilities are contact-household and air-dust.
A significant role in nosocomial pathology is played by blood-borne viral hepatitis B, C, D (6-7% in the total structure). A special category of risk is represented by medical personnel whose duties include performing surgical procedures or working with blood. During examinations, it is revealed that up to 15-62% of the personnel are carriers of markers of blood-borne viral hepatitis.
The share of other infections recorded in US accounts for up to 5-6% of the total morbidity. Such infections include influenza and other acute respiratory infections, diphtheria, tuberculosis, etc.
Normative documents regulating the work on the sanitary and anti-epidemic regime in UZ.
1. Decree of the Chief State Sanitary Doctor of the Republic of Belarus No. 71 of July 11, 2003 “On the Enactment of Sanitary Rules for the Arrangement, Maintenance, and Operation of Medical and Preventive Organizations”.
2. Decree of the Chief State Sanitary Doctor of the Republic of Belarus No. 88 dated 04.08.05 – “On approval of sanitary rules and norms “organization and implementation of sanitary and hygienic, anti-epidemic measures for the prevention of purulent-septic infections in surgical departments”.
3. Decree of the Chief State Sanitary Doctor of the Republic of Belarus No. 272 of December 28, 2005 on the approval of the instruction “Organization of centralized sterilization departments in healthcare organizations”.
4. Decree of the Chief State Sanitary Doctor of the Republic of Belarus No. 40 of July 27, 2000 on the approval of the sanitary rules “Safety of working with microorganisms of 3-4 pathogenicity groups and helminths”.
5. Order No. 165 dated November 25, 2002 “On disinfection and sterilization by healthcare institutions”.
6. Order No. 167 of October 23, 2003 “On approval of instructions for the prevention of infectious diseases during endoscopic manipulations.”
7. Order No. 351 dated 16.12.98. “On the revision of departmental regulations governing issues related to the problem of HIV, AIDS.”
8. Clinical standards for antiretroviral therapy for HIV infection.
9. Order of the Ministry of Health No. 66 dated September 2, 1993 “On measures to reduce the incidence of viral hepatitis in the Republic of Belarus”.
10. Order of the Ministry of Health of the Republic of Belarus dated August 29, 2005 No. 477 “On strengthening measures for the prevention of epidemic typhus and the fight against pediculosis”.
11. Order No. 536 dated September 10, 2004 “On improving the system of accounting, registration and analysis of nosocomial infections in health care facilities in Minsk”.
12. Order No. 429 dated July 20, 2005 “On improving measures to prevent hospital infections in intensive care and surgical departments” of Minsk.
13. “Instructions for performing injections and intravenous infusions in health facilities and at home.”
14. Letter from the Chief State Sanitary Doctor of the Republic of Belarus “On the storage of cleaning equipment in health care facilities”.