医务人员职业暴露应急处置流程图.doc

医务人员发生锐器刺伤应急处置流程图医务人员被锐器刺伤用肥皂液和流动水清洗污染皮肤 用生理盐水冲洗粘膜 在伤口旁端轻轻挤压 （尽可能挤出损伤处的血液、 禁止进行伤口的局部挤压） 用肥皂液和流动水冲洗用75%或者0.5%碘伏消毒包扎伤口pipe and the metal structure installation part main including Yunnan province tengchong County yongxing River primary and secondary hydropower station in the of pressure pipe and the power station metal structure, which level power station pressure pipe total about 562t (containing annex); II level power station pressure pipe about 733 t (containing annex); level power station metal structure about 52.5 t, containing discharge Gate 2 hole, rushed sand Gate 1 hole, water mouth work door and the stopped dirt gate the 1 hole, Qian pool work door and the stopped dirt gate the 1 hole; Secondary power station metal junction at about 19.5 t, containing sand Gate 1 hole, water inlet water gate and trash the 1 hole; their auxiliary hoist equipment and electrical equipment. Concrete pressure pipe, gate, trash and hoisting device project property list 1-11-3. Table 1-1 the main characteristics of the penstock number item parameter type controller size head a long pipe diameter pipe length 11 hydropower station penstock open-air exposed pipe, single pipe joint water supply 1.3M 931m 0.8M 8.3*2m 22 hydropower station penstock open-air exposed pipe, single pipe joint water supply 1.4m 1063.506 m 0.8M 10*2m table 1-2 hydropower station Main characteristics of hydraulic metal structure number project name gate, trash rack, door (gate . Pressure pipe and the metal structure installation 9.1 main engineering profile yongxing river level hydropower station pressure pipe pipeline plane Shang along Ridge is line layout, and slope surface contour close vertical, Guan Po with original ground line changes, used open type Ming tube, single tube joint water way, competent diameter 1.3M, long 931.00m, two root non-symmetric Bu type support tube, diameter 0.8M, single root long 8.3M. Competent to establish 12 town Pier, 107 buttress, telescopic section 11. Support Pier spacing 8M, side-sliding bearing. Town pier for the closed-end structure of gravity, base surface into bedrock, pipe excavation slope 1:0.75 with M5 grouted rubble slope protection, 0.3M, bottom side sewer, 0.25m wide, deep 0.3m,M5 grouted rubble masonry, set maintenance step ladder on the left side, 1.0M wide. Yongxinghe- hydropower station penstock pipes arranged along the ridge line on the plane, and nearly vertical slope contour lines, Guan Po changes with the original ground line, with shallow backfill-pipe, single-pipe water supply, the competent 1.4m, long 1063.506m, two asymmetric y pipe, diameter 0.8M, single 10m. Competent to establish 12 town Pier, 8 expansion joint. Town pier for the closed-end structure of gravity, placed on soft rock base surface, pipe concrete C20 on a pedestal. Pipe trench excavation slope 1:0.75, after the installation of steel tube, compacted gravel backfill material to the surface, and 1:100 slope drainage to gutters. Gutter width 0.5M depth 0.5m,M5 grouted rubble masonry. 9.2 main engineering content this standard pressure pipe and the metal structure76医务人员职业暴露报告流程图医务人员职业暴露报告科主任、护士长报告医院感控办经开区疾病预防控制中心 医务人员发生锐器刺伤后报告、登记和应急处置流程图医务人员被锐器刺伤立即采取相应局部保护性措施 了解锐器污染源 报告科主任、护士长1.用肥皂液和流动水清洗污染皮肤、 对污染物来源患者 材料报告医院院感办 用生理盐水冲洗粘膜 进行抗体检测2.在伤口旁端轻轻挤压， 尽可能挤出损伤处的血液、 禁止进行伤口的局部挤压3. 用75%或者0.5%碘伏消毒根据污染源的不同采取相应预防措施医院感染暴发事件卫生应急处置流程短期内发生3例以上同种同源感染病例报告院感染科、医务科、护理部流行病学调查证实医院感染暴发查找感染原因， 报告给主管院长制定防控措施，写出调查报告。 上级卫生行政部门5.传染病患者处置流程图科室发现疑似病人上报院感办、医务部防控领导小组(组织专家会诊)确定疑似病例经开区疾病控制中心 转运病人至定点医院 院内终末消毒隔离 进行网络直报6.医疗废物收集运送流程图产生单位 防鼠、防蚊蝇、防蟑螂 固定存放 防盗、防儿童接触 医疗废物分类包装 损伤性利器盒 液体废物瓶 黄色垃圾袋 锐利器具 化学液体性废物 感染性废物、病理性废物、药物性废物科室护理人员 移交（当日内）专职运送员（填写医疗废物交接登记本或单，资料保存三年）按转运路线转运 移交医疗废物处置单位（移交手续保存三年）7.病房保洁员清洁工作流程1. 病房每个床单位的清洁流程 抹布（500mg/l优氯净浸泡30分钟）清水漂洗（保持湿润）擦拭床头柜、床单位抹布（500mg/l优氯净浸泡30分钟）2. 病房物体表面的清洁流程抹布（500mg/l优氯净浸泡30分钟 ）清水漂洗（保持湿润）门、窗台抹布（500mg/l优氯净浸泡30分钟）3. 卫生间的清洁流程抹布、刷子 （两套，500mg/l优氯净浸泡30分钟）清水漂洗（保持湿润）病房卫生间（镜子、水池）更换抹布、刷子刷便池抹布、刷子 （两套，500mg/l优氯净浸泡30分钟）8.供应室医院感染管理流程 污物回收，车辆“洁”、“污”分开 分 类 清 洗 消 毒 包 装高压灭菌 灭菌合格 灭菌不合格专室专柜存放超过有效期每周生物监测化学监测（指示卡每包内）化学指示胶带（包外）登记备查资料至少保存三年下送临床科室，有效期内使用9.换药室医院感染管理流程 医 护 人 员 个人准备洗手、穿工作服、戴帽子、口罩（必要时穿隔离衣） 用物准备备换药车、治疗盘、弯盘等，查用物有效期、包装完整与否。 病人准备先普通病人后传染病人；先清洁伤口后污染伤口；再隔离伤口。 普通病人 特殊感染患者用后物品分类医疗废物用后物品分类清洗置单层黄袋中置双层黄袋中清洗消毒液浸泡医疗废物 专人回收焚烧 消毒、灭菌备用 消毒、灭菌备用 手术室医院感染管理流程手术病人（术前准备结束）医务人员术前准备（严格落实手卫生）手术室对病人实施手术手术室消毒处理术后病人观察使用后物品分类打包医疗废物分类，包装回病房治疗供应室灭菌、消毒处理医疗垃圾处理11.医院感染病例目标性监测流程监测：感染忽视或感控医师发现住院病人有感染迹象时，对病人进行检测。报告：每天填写感染病人调查表，报送感染管理科。督导：感染管理科每周到病区进行调查，了解感染情况。改进：感染管理科每季对感染情况进行汇总分析，并与感染管理小组共同提出改进措施。医院感染患者隔离流程 对感染患者置于隔离病房治疗（同源病人条件不允许时可同处一室），患者病历注明感染病例。对感染患者进行检查时要带手套、穿隔离衣，戴口罩、护目镜或面罩（检查不同患者应更换手套）。一般医疗器械，如听诊器、体温表、血压器等应专用、用后进行消毒处理。患者周围物品、环境，必须每天清洁消毒。检查工作结束，医务人员脱手套隔离衣后，需用抗菌皂液洗手，或用快速手消毒液擦手。 治疗室、注射室、换药室、处置室医院感染管理流程 清 洁 区 污 染 区 严格无菌技术 污染物品处置 治疗室、注射室、换药室、处置室 严格操作规程 医疗废物分类物表清洁、