Wuhan Leishenshan Hospital was built within 12 days during the key period of fighting against coronavirus disease 2019 (COVID-19) in Wuhan. It was a field infectious disease hospital with 1500 beds. Due to the emergency of the epidemic situation, the operation mode of “parallel of construction, acceptance, training and treatment” was employed. During the peak period, nearly 3000 medical workers and 13000 builders worked on the same site. In 67 days, 2 011 patients with COVID-19 were treated. Through the bundle infection prevention and control (IPC) measures, Wuhan Leishenshan Hospital achieved zero infection, zero accident, and low level pollution of SARS-CoV-2 (0.3%) by environment monitoring. The bundle IPC measures of Leishenshan Hospital not only provided prevention and control experience for other field infectious disease hospitals at domestic and abroad during the period of COVID-19, but also put forward ideas and work flow for other medical institutions to deal with emerging infectious diseases.
Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
Objective To understand the influence of organisational support and professional identity of hospital infection prevention and control (HIPC) practitioner in public hospitals. Methods HIPC practitioner of the public medical institutions secondary level and above in Neijiang City, Sichuan Province were used as the research object. A questionnaire survey was used to analyze their organizational support and professional identity in May 2022, to compare the differences in organizational support and professional identity among HIPC practitioner with different positions, working ages, and majors, and analyze the correlation between organizational support and professional identity among HIPC practitioner. Results A total of 90 valid questionnaires were retrieved from investigation. The average scores for organizational support and professional identity among HIPC practitioner were (3.409±0.625) and (2.518±0.504) points. Among them, the organizational support of intermediate professional title personnel [(3.155±0.785) points], personnel with 5-10 years of service [(3.071±0.696) points], and clinical physicians [(3.342±0.860) points] were the lowest; the professional identity of personnel with intermediate professional titles [(2.357±0.477) points], those with more than 10 years of service[(2.431±0.454) points], and other professionals [(2.471±0.260) points] were the lowest. The Pearson correlation analysis results showed that there was a positive correlation between organizational support and professional identity (r=0.490, P<0.05), self-identity and work support (r=0.364, P<0.05), and environmental identity and relationship interests (r=0.698, P<0.05). Conclusions Due to the low level of organizational support, there is a decrease in professional identity and significant job burnout, which in turn leads to an increase in the turnover rate of infection control professionals. Therefore, it is necessary to enhance the sense of organizational support for specialized personnel in infection control to promote their professional identity and stabilize the infection control team. Suggest providing necessary support at the organizational level and self-improvement at the individual level.
Objective To investigate the current status of occupational environment support, occupational satisfaction, and job competence of hospital infection prevention and control personnel, and to explore the mediating effect of occupational satisfaction on the relationship between occupational environment support and job competence, in order to provide reference and guidance for effectively improving the job competence of hospital infection prevention and control personnel. Methods A survey questionnaire was distributed to various levels and types of medical institutions in Shanghai through the platform of the Shanghai Hospital Infection Quality Control Center. The questionnaire included the Occupational Environment Support Scale, Occupational Satisfaction Scale, and Job Competency Assessment Scale. The mediating effect of occupational satisfaction on the relationship between occupational environment support and job competency of hospital infection prevention and control personnel was analyzed. Results A total of 1027 hospital infection prevention and control personnel from 728 medical institutions participated in this survey, with 989 valid questionnaires and an effective response rate of 96.3%. There were statistically significant differences in the job competency scores of hospital infection prevention and control personnel based on gender, years of experience in infection control work, professional background, highest education level, professional title, job nature, type of medical institution, and annual income (P<0.05). The total score of job competence for hospital infection prevention and control personnel was 301.0 (267.5, 326.0), the total score of occupational environment support was 21.44±3.66, and the total score of occupational satisfaction was 19.25±2.78. The occupational environment support of hospital infection prevention and control personnel was positively correlated with occupational satisfaction and job competence (r=0.373, 0.339; P<0.001), and occupational satisfaction was positively correlated with occupational environment support (r=0.547, P<0.001). The mediating effect of job satisfaction on the occupational environment support and job competence was 0.085, accounting for 22.8% of the total effect. Conclusion Occupational satisfaction partially mediates the relationship between occupational environment support and job competence, and the mediating effect is significant.
ObjectiveTo study the changes of bacterial flora after a series of preoperative oral disinfection and the postoperative recovery of patients with craniovertebral junction disorders who were treated with transoral approach operations. And to provide a theoretical basis for the prevention of postoperative complications such as infection.MethodsThe clinical data of 20 cases with craniovertebral junction disorders and treated with transoral approach operations between October 2009 and May 2010 were analyzed. There were 8 males and 12 females, aged 2-66 years (median, 34.5 years). According to the classification of American Spinal Injury Association (ASIA), there were 4 cases of grade B, 8 of grade C, 6 of grade D, and 2 of grade E. The Japanese Orthopedic Association (JOA) score was 10.3±3.0. The mucosa samples of the posterior pharyngeal wall were sent for bacteria culture. These samples were collected by sterile cotton swabs at four crucial points including 3 days before operation/before gargling (T1), 3 days after continuous gargling by chlorhexidine acetate/after anesthesia intubation on the day of operation (T2), after intraoperative cleaning and washing of the mouth (T3), and after intraoperative iodophor immersion for 5-10 minutes (T4). The microflora was stained by means of smear and further counted after an investigation by microscope. The ASIA classification and the JOA scores were applied to evaluate the postoperative nerve function of the patients. A regular reexamination of cervical vertebra with X-ray film, CT, and MRI was conducted after operation to evaluate the reduction of atlantoaxial dislocation, internal fixation position, bone graft fusion, inflammatory lesion, and tumor resection in the craniovertebral junction.ResultsAfter a series of oral disinfection, the mucosa of the posterior pharyngeal wall of all the patients was in a sterile state, which was considered as type Ⅰ incision. All these 20 patients were treated with successful operations, without any intraoperative injury in vertebral artery and spinal cord, or any postoperative complications such as plate loosening, incision infection, or intracranial infection. All the patients were followed up 3-23 months, with an average of 5.15 months. The symptoms such as neck pain, limb numbness and weakness, neural symptoms, etc. were improved to different degrees after operation. The JOA score was improved to 13.4±1.9 at 3 months after operation, showing significant difference when compared with preoperative score (t=8.677, P=0.000); and the atlantoaxial joints had been fused. At last follow-up, the ASIA grades were improved when compared with those before operation. ConclusionIt is safe and effective to cut the posterior pharyngeal muscle layer and implant internal fixation by means of transoral approach in the treatment of craniovertebral junction disorders.
Currently, there is a lack of guidelines and consensuses on hospital infection prevention and control for continuous renal replacement therapy (CRRT) at home and aboard. Given that in-hospital infection control for CRRT differs from that for intermittent hemodialysis, the Nephrology Brunch of Sichuan International Medical Exchange & Promotion Association, in collaboration with West China Hospital of Sichuan University, has established an expert consensus group for CRRT hospital infection prevention and control. The group conducted systematic retrieval, data analysis, and expert consultation on the thematic content, and developed five topics: occupational protection for CRRT healthcare personnel, CRRT catheter-related infections, collection of CRRT blood/waste specimens, disinfection of CRRT machines, and utilization and disposal of CRRT consumables and waste. The aim is to standardize clinical practices, prevent nosocomial infections, and enhance awareness among healthcare personnel regarding infection prevention and control in CRRT settings.
Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
Methicillin-resistant Staphylococcus aureus is one of the important pathogens of healthcare-associated infections. In order to prevent and control the transmission of the drug-resistant organism in healthcare facilities, the Healthcare Infection Society and the Infection Prevention Society jointly conducted the guidelines for the prevention and control of methicillin-resistant Staphylococcus aureus in 2021. This article introduces the guide from the background, preparation process, main prevention and control measures and further studies, and compares the guidelines with the current prevention and control measures in China, so as to provide a methodological reference for preparation of the guide for domestic infection prevention and control practitioners, and provide evidence-based prevention and control strategies for clinical practice.
In recent years, the prevalence of carbapenem-resistant Enterobacterales (CRE) has been remarkably increasing. Infections caused by CRE have significantly increased the burden on patients both medically and economically, and the CRE often leads to outbreaks of healthcare-associated infections. It has now become a global public health concern. Consequently, international organizations and academic societies/associations, including the World Health Organization, have developed corresponding prevention and control guidelines. This article provides a detailed introduction to the background, principles, key understandings, and implementation recommendations of China’s Standard for Prevention and Control of Carbapenem-resistant Enterobacterales (WS/T 826－2023). The aim is to enhance the recognition of healthcare workers and medical administrators to prevent and control CRE and to provide detailed technical guidance for healthcare facilities in responding to the spread of CRE, thus ensuring medical quality and patient safety.
Ventilator-associated pneumonia (VAP) is a kind of pneumonia that occurs when artificial airway (tracheal intubation or tracheotomy) is established and mechanical ventilation is accepted. The occurrence of VAP will significantly prolong the ventilation time and hospitalization time of patients, increase the mortality rate and the medical burden. In order to effectively prevent and reduce the occurrence of VAP, the Society for Healthcare Epidemiology of America released the Strategies to Prevent Ventilator-Associated Pneumonia, Ventilator-Associated Events, and Nonventilator Hospital-Acquired Pneumonia in Acute-Care Hospitals: 2022 Update, which is an update of the 2014 version. In order to facilitate the reading and understanding of the medical workers, this article will interpret the infection prevention and control strategies of adult VAP and ventilator-related events.
