護(hù)理部沙龍課件——講義ICU

1、護(hù)理部沙龍課件講義ICUCENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIA

2、TED TO SHENYANG MEDICAL COLLEGE家家政政人人員員3 3% %呼呼吸吸科科醫(yī)醫(yī)師師2 2% %靜靜脈脈切切開開者者8 8% %實實驗驗室室技技師師1 10 0% %醫(yī)醫(yī)師師（包包括括內(nèi)內(nèi)、外外、口口腔腔、實實習(xí)習(xí)同同學(xué)學(xué)）1 14 4% %護(hù)護(hù)士士6 63 3% %沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE醫(yī)護(hù)人員職業(yè)暴露的原因(n=1891)沈陽

3、醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED

4、 TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE每30秒鐘 每30秒鐘 每30秒鐘一次 職業(yè)暴露，中國現(xiàn)狀近似1992年前的美國沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILI

5、ATED TO SHENYANG MEDICAL COLLEGE 聯(lián)合國艾滋病規(guī)劃署發(fā)布年度報告,全球2010年艾滋病病毒（HIV）攜帶者大約3400萬人，比2009年增加70萬。我國目前乙肝病毒攜帶者已有1.3億（相當(dāng)于每10個中國人就有1個是HBV病毒攜帶者）。沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 實踐證明針刺傷時只要0.004ml帶有HBV的血液足以使傷者感染HBV，其概率為6%30%。而感染HIV概率是0.3。病毒感染后到發(fā)生血轉(zhuǎn)化有一定期限，HBV、HCV為8周，HIV為6個月。感染到發(fā)病

6、又有一定的潛伏期，前兩個為4560天，艾滋病為12年。這段時間傷者本身也是病毒攜帶者的危險因素之一。 不要認(rèn)為只有在血液中檢測到病原體的個體才具有傳染性。很可能，一個被感染的人看上去和健康人一樣。10-15%AIDS明確診斷85-90%AIDS感染者未被診斷沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED

7、TO SHENYANG MEDICAL COLLEGE0.33%發(fā)生了就是100% 案例 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICA

8、L COLLEGE建立銳器傷防護(hù)制度，提高自我防護(hù)意識 1）強化與完善制度建設(shè) 2）戴手套與洗手 3）規(guī)范操作 4）正確處理使用過的銳器 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFIL

9、IATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE2000.11.6簽署，OSHA在2001.1.18發(fā)布修正標(biāo)準(zhǔn)法案在2001.4.18正式生效，7.17開始執(zhí)行。內(nèi)容包括：銳器傷登記、評估/選擇安全醫(yī)療器械介入、要求使用安全的醫(yī)療器械我國尚未相關(guān)立法，但我院護(hù)理部是沈陽地區(qū)最早倡導(dǎo)和應(yīng)用安全裝置的醫(yī)院，由此可見我院對護(hù)士安全的重視。沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICA

10、L COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 詳細(xì)記錄事故發(fā)生的時間、地點及經(jīng)過、暴露方式、損

11、傷的具體部位、程度；接觸物種類（培養(yǎng)液、血液或其他體液）沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 無論事故大小，均應(yīng)對職業(yè)暴露者的個人情況進(jìn)行保密。沈陽醫(yī)學(xué)院附屬中心醫(yī)院CENTRAL HOSPITAL AFFILIATED TO SHENYANG MEDICAL COLLEGE 醫(yī)療機構(gòu)的醫(yī)務(wù)人員處于醫(yī)院感染和社會感染性疾病的雙重威脅下，