医院隔离技术规范

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,哈医大二院,医院隔离技术规范,哈尔滨医科大学附属第二医院,穆锦江,国内隔离技术的现状,通常是针对确诊传染病患者后采取隔离预防，标准预防观念差；,对经接触传播疾病患者，尤其是多重耐药菌感染患者的隔离认识不足；,各医院采取的隔离预防措施多种多样，有些措施缺乏科学依据；,个人防护用品的使用不正确：过度、不足；种类的选用不妥；方法不当；,分区布局不合理：大环境的布局，病区内的布局。,隔离技术的目的,应用最新、最科学的隔离预防和方法，预防医院感染的发生和暴发流行；,中华人民共和国卫生行业标准,（WSIT 311-2009）,医院隔离技术规范,医院感染流行三环节,传(感)染源,传播途径,宿主,病人,医务人员,病人,医务人员,空气、飞沫、接触,术语和定义,感染源,传播途径,易感人群,标准预防 standard precaution,术语和定义,传播途径：,1、空气传播 airborne transmission,2、飞沫传播 droplet transmission,3、接触传播 contact transmission,感染链 infection chain,术语和定义,个人防护用品：,1、纱布口罩 mask,2、外科口罩 surgical mask,3、医用防护口罩 respirator,4、护目镜 protective glass,5、防护面罩（防护面屏）face shield,6、手套 gloves,7、隔离衣 isolation gowns,8、防护服 disposable gown,隔离的管理要求,在新建、改建与扩建时，建筑布局应具备隔离预防的功能，区域划分应明确、标识清楚。,应根据国家的有关法规，结合本医院的实际情况，制定隔离预防制度并实施。,隔离的实施应遵循“标准预防” 和“基于疾病传播途径的预防”的原则。,应加强传染病患者的管理，包括隔离患者，严格执行探视制度。,应采取有效措施，管理感染源、切断传播途径和保护易感人群。,应加强医务人员隔离与预防知识的培训，为其提供合适的、必要的防护用品，掌握常见传染病的传播途径、隔离方式和防护技术，熟练掌握操作规程。,医务人员的手卫生应符合WS/T313。,隔离区域的消毒应符合国家有关规定。,建筑布局与隔离要求,根据患者获得感染危险性的程度，应将医院分为4个区域：,1、低危险区域,2、中等危险区域,3、高危险区域,4、极高危区域,建筑布局与隔离要求,1、呼吸道传染病病区的建筑布局,与隔离要求,2、负压病室的建筑布局与隔离要求,3、感染性疾病病区的建筑布局,与隔离要求,4、普通病区的建筑布局与隔离要求,5、门诊的建筑布局与隔离要求,6、急诊科(室)的建筑布局与隔离要求,医务人员防护用品的使用,防护用品应符合国家相关标准，,在有效期内使用；,1、口罩的使用,2、护目镜、防护面罩的使用,3、手套的使用,4、隔离衣与防护服的使用,5、鞋套的使用,6、防水围裙的使用,7、帽子的使用,个人防护用具,正 确 的 佩 戴 口 罩,戴口罩的程序,先将鼻夹帖在鼻梁上；,将口罩上端的系带系在头后或耳后；,拉下口罩的下部遮盖住口和下巴；,系下端系带系于颈后；,将鼻夹压向鼻梁，使紧贴面部直至舒适,口罩变潮湿、难呼吸和有破损时更换；,接触或摘除口罩前要洗手；,离开房间前将用过的口罩放入医疗垃圾桶内。,PPE,护目镜/面罩,护目镜, 安全的玻璃来防护眼睛,面罩需要保护整个面部皮肤,不同传播途径疾病的隔离与预防,接触传播的隔离与预防,空气传播的隔离与预防,飞沫传播的隔离与预防,不同传播途径疾病的隔离与预防,其他传播途径疾病的隔离与预防,常见多重耐药菌感染患者的隔离,急性传染性非典型肺炎，人感染高致病性禽流感的隔离,谢谢！,G*jI)lK-nM0pO2rQ4tR6vT8xVazXcAZeC!gE%iG*jI)lK+nM0pO2rQ4tS6vT8xVazXcBZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vU8xVazXcBZeD!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xWazXcBZeD!gF%iG*kI)mK+nM1pO3rQ5tS6vU8xWazYcBZeD!gF%iH*kI)mK+oM1pO3rQ5tS7vU8xWazYcB#eD!gF%iH*kI)mK+oM1qO3rQ5tS7vU9xWazYcB#eD$gF%iH*kJ)mK+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oM1qO3sQ5uS7vU9xWbzYdB#eD$gF&iH(kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#fD$gF&iH(kJ)mL+oN1qP3sQ5uS7wU9yWbzYdB#fD$hF&iH(kJ-mL+oN1qP3sR5uS7wU9yWbAYdB#fD$hF&jH(kJ-mL0oN1qP3sR5uT7wU9yWbAYdC#fD$hF&jH(kJ-mL0oN2qP3sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yXbAYdC#fE$hG&jH(lJ-nL0oN2qP4sR6uT7wV9yXbAZdC#fE$hG&jI(lJ-nL0pN2qP4sR6uT8wV9yXbAZdC!fE$hG&jI(lJ-nL0pN2rP4sR6uT8wVayXbAZdC!fE%hG&jI(lK-nL0pN2rP4tR6uT8wVayXcAZdC!fE%hG*jI(lK-nM0pN2rP4tR6vT8wVay#fD$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-nL0oN2qP4sR6uT7wV9yXbAYdC#fE$hG&jH(lJ-nL0pN2qP4sR6uT8wV9yXbAZdC#fE$hG&jI(lJ-nL0pN2rP4sR6uT8wVayXbAZdC!fE$hG&jI(lK-nL0pN2rP4tR6uT8wVayXbAZdC!fE%hG&jI(lK-nM0pN2rP4tR6vT8wVayXcAZdC!fE%hG*jI(lK-nM0pO2rP4tR6vT8xVayXcAZeC!fE%hG*jI)lK-nM0pO2rQ4tR6vT8xVazXcAZeC!gE%hG*jI)lK+nM0pO2rQ4tS6vT8xVazXcAZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vU8xVazXcBZeC!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xWazXcBZeD!gE%iG*kI)mK+nM1pO3rQ5tS6vU8xWazXcBZeD!gF%iG*kI)mK+oM1pO3rQ5tS7vU8xWazYcBZeD!gF%iH*kI)mK+oM1qO3rQ5tS7vU9xWazYcB#eD!gF%iH*kJ)mK+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF%iH*kJ)mL+oM1qO3sQ5uS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#eD$gF&iH(kJ)mL+oN1qP3sQ5uS7wU9yWbzYdB#fD$gF&iH(kJ-mL+oN1qP3sR5uS7wU9yWbAYdB#fD$hF&iH(kJ-mL0oN1qP3sR5uT7wU9yWbAYdB#fD$hF&mK+oM1qO3rQ5tS7vU9xWazYcB#eD$gF%iH*kJ)mL+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oN1qO3sQ5uS7vU9xWbzYdB#eD$gF&iH(kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#fD$gF&iH(kJ-mL+oN1qP3sQ5uS7wU9yWbzYdB#fD$hF&iH(kJ-mL0oN1qP3sR5uS7wU9yWbAYdB#fD$hF&jH(kJ-mL0oN2qP3sR5uT7wU9yWbAYdC#fD$hF&jH(lJ-mL0oN2qP3sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-nL0sQ5uS7vU9xWbzYdB#eD$gF&iH*kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#fD$gF&iH(kJ)mL+oN1qP3sQ5uS7wU9yWbzYdB#fD$gF&iH(kJ-mL+oN1qP3sR5uS7wU9yWbAYdB#fD$hF&iH(kJ-mL0oN1qP3sR5uT7wU9yWbAYdC#fD$hF&jH(kJ-mL0oN2qP3sR5uT7wV9yWbAYdC#fD$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yXbAYdC#fE$hF&jH(lJ-nL0oN2qP4sR6uT7wV9yXbAZdC#fE$hG&jH(lJ-nL0pN2qP4sR6uT8wV9yXbAZdC!fE$hG&jI(lJ-nL0pN2rP4sR6uT8wVayXbAZdF&iH(kJ-mL0oN1qP3sR5uS7wU9yWbAYdB#fD$hF&jH(kJ-mL0oN2qP3sR5uT7wU9yWbAYdC#fD$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-nL0oN2qP4sR5uT7wV9yXbAYdC#fE$hG&jH(lJ-nL0pN2qP4sR6uT7wV9yXbAZdC#fE$hG&jI(lJ-nL0pN2rP4sR6uT8wV9yXbAZdC!fE$hG&jI(lK-nL0pN2rP4tR6uT8wVayXbAZdC!fE%hG&jI(lK-nM0pN2rP4tR9yWbAYdC#fD$hF&jH(kJ-mL0oN2qP3sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yXbAYdC#fE$hG&jH(lJ-nL0oN2qP4sR6uT7wV9yXbAZdC#fE$hG&jH(lJ-nL0pN2qP4sR6uT8wV9yXbAZdC!fE$hG&jI(lJ-nL0pN2rP4sR6uT8wVayXbAZdC!fE%hG&jI(lK-nL0pN2rP4tR6uT8wVayXfD$hF&jH(kJ-mL0oN2qP3sR5uT7wU9yWbAYdC#fD$hF&jH(lJ-mL0oN2qP4sR5uT7wV9yWbAYdC#fE$hF&jH(lJ-nL0oN2qP4sR6uT7wV9yXbAYdC#fE$hG&jH(lJ-nL0pN2qP4sR6uT7wV9yXbAZdC#fE$hG&jI(lJ-nL0pN2rP4sR6uT8wV9yXbAZdC!fE$hG&jI(lK-nL0pN2rP4tR6uT8wVayXbAZdC!fE%hG&jI(lK-nM0pN2rP4tR6vT8wVayXcAZdC!fE%hG*jI(lK-nM0pO2rP4tR6vT8wVayXcAZeC!fE%hG*jI)lK-nM0pO2rQ4tR6vT8xVayXcAZeC!gE%hG*jI)lK+nM0pO2rQ4tS6vT8xVazXcAZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vU8xVazXcBZeC!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xVazXcBZeD!gE%iG*kI)mK+nM1pO3rQ5tS6vU8xWazXcBZeD!gF%iG*kI)mK+oM1pO3rQ5tS7vU8xWazYcBZeD!gF%iH*kI)mK+oM1qO3rQ5tS7vU9xWazYcB#eD!gF%iH*kJ)mK+oM1qO3sQ5tS7vU9xWazYcB#eD$gF%iH*kJ)pO2rQ4tS6vT8xVazXcBZeC!gE%iG*kI)lK+nM1pO2rQ4tS6vU8xVazXcBZeD!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xWazXcBZeD!gF%iG*kI)mK+nM1pO3rQ5tS6vU8xWazYcBZeD!gF%iH*kI)mK+oM1pO3rQ5tS7vU8xWazYcB#eD!gF%iH*kJ)mK+oM1qO3rQ5tS7vU9xWazYcB#eD$gF%iH*kJ)mK+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oM1qO3sQ5uS7vU9xWbzYdB#eD$gF&iH(kJ)mL+oN4tS6vU8xWazXcBZeD!gE%iG*kI)mK+nM1pO3rQ5tS6vU8xWazXcBZeD!gF%iG*kI)mK+oM1pO3rQ5tS7vU8xWazYcBZeD!gF%iH*kI)mK+oM1qO3rQ5tS7vU9xWazYcB#eD!gF%iH*kJ)mK+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF%iH*kJ)mL+oM1qO3sQ5uS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#eD$gF&iH(kJ)mL+oN1qP3sQ5uS7wU9yWbzYdB#fD$gF&iH(kJ-mL+oN1qP3sR5uS7zYcBZeD!gF%iH*kI)mK+oM1pO3rQ5tS7vU8xWazYcB#eD!gF%iH*kJ)mK+oM1qO3rQ5tS7vU9xWazYcB#eD$gF%iH*kJ)mL+oM1qO3sQ5tS7vU9xWbzYcB#eD$gF&iH*kJ)mL+oN1qO3sQ5uS7vU9xWbzYdB#eD$gF&iH(kJ)mL+oN1qO3sQ5uS7wU9xWbzYdB#iG*kI)mK+nM1pO3rQ5tS6vU8xWazYcBZeD!gF%iG-nM0pN2rP4tR6vT8wVayXcAZeC!fE%hG*jI)lK-nM0pO2rP4tR6vT8xVayXcAZeC!gE%hG*jI)lK+nM0pO2rQ4tR6vT8xVazXcAZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vT8xVazXcBZeC!gE%iG*kI)lK+nM1pO2rQ4tS6vU8xVazXcBZeD!gE%iG*kI)mK+nM1pO3rQ4tS6vU8xWazXcBZeD!gF%iG*kI)mK+oM1pO3rQ5tS6vU8xWazYcBZeD!gF%iH*kI)mK+oM1qO3rQ5tS7vU8xWazYcB#eD!gF%iH*kJ)mK+oM1qO3rQ5tVazXcAZeC!gE%hG*jI)lK+nM0pO2rQ4tS6vT8xVazXcBZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vU8xVazXcBZeD!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xWazXcBZeD!gE%iG*kI)mK+nM1pO3rQ5tS6vU8xWazYcBZeD!gF%iG*kI)mK+oM1pO3rQ5tS7vUcAZeC!fE%hG*jI)lK-nM0pO2rQ4tR6vT8xVayXcAZeC!gE%hG*jI)lK+nM0pO2rQ4tR6vT8xVazXcAZeC!gE%iG*jI)lK+nM1pO2rQ4tS6vT8xVazXcBZeC!gE%iG*kI)lK+nM1pO3rQ4tS6vU8xVazXcBZeD!gE%iG*kI)mK+nM1pO3rQ4tS6vU8xWazXcBZeD!gF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