tailieunhanh - Non-pulmonary Critical Care - part 10

Thực vật thoáng qua là được mua lại bởi liên hệ với bệnh nhân hoặc từ môi trường vô tri vô giác, lỏng lẻo gắn vào da, và tuân theo loại bỏ bằng tay Những sinh vật có ý nghĩa bệnh viện và bao gồm MRSA, Enterococcus kháng vancomycin | 316 SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE VOLUME 27 NUMBER 3 2006 pathogenic they are of nosocomial significance when introduced to the patient by invasive procedures and indwelling devices. Transient flora are acquired by patient contact or from the inanimate environment are loosely attached to the skin and are more amenable to removal by hand These organisms are of nosocomial significance and include MRSA vancomycin-resistant Enterococcus VRE and multiple drugresistant gram-negative rods. Nosocomial pathogens can be recovered from multiple hospital scenarios. Patient contact including contact with wounds and intact skin can result in health care worker hand Areas of high nosocomial pathogen concentration on patient skin include the axillae trunk perineum inguinal region and 117 118 Hand hygiene should be practiced by health care workers before and after all patient contact. Several methods of hand hygiene exist and include washing with plain soap and water or using an antibacterial agent such as alcohol chlorhexidine gluconate or triclosan as either detergent washes or waterless hand rubs. Soap and water can remove loosely adherent transient skin however these agents have minimal antimicrobial For effective reduction of bacterial count a 30-second hand rub is recommended. Several factors should be considered when choosing a hand hygiene agent for the ICU including microbicidal effect skin irritability ease of use and staff acceptance. With respect to skin irritability several studies have demonstrated that hand washing with both plain soap and water can result in skin irritation dryness and a paradoxical increase in microbial counts on the 120 Medicated hand washing agents are bactericidal alcohol chlorhexidine gluconate triclosan and effectively reduced bacterial counts on the hands. Moreover chlorhexidine has the advantage of producing a residual antibacterial effect thereby limiting