高雄縣境內長期照護機構感染管制現況調查分析

Survey of Infection Control Practices in Long-Term Care Facilities in Kaohsiung County

蘇麗香(Li-Hsiang Su) ； 劉碧隆(Pi-Long Liu) ； 劉建衛(Jien-Wei Liu)

《感染控制雜誌》 16卷2期 (2006/04) Pp. 69-76

https://doi.org/10.6526/ICJ.200604_16(2).0001

摘要

本研究目的爲瞭解高雄地區長期照護機構投入感染管制工作之人力、防範感染及設備、機構內建立的感染資料、員工與住民健康飾選項鏖及執行週期等。我們於2004年3月19日至同年5月27日，以上述內容製訂之勾稽表，分批實際查訪高雄縣境內十所養護機構及八所護理之家。每所被重核的長期照護機構，皆屬於40至80床規模的小型機構，住民健康照護主要由護理人員進行。在感染管制業務方面，除一所護理之家由兼任感染管制師負責，其餘由負責人視需要指定人員辦理。六所機構訂有感染管制手冊。新住民入住評估以轉入前之醫院開出的出院摘要爲主，已入住之住民每年最少安排一次胸部X光篩檢，員工及住民每年常規注射流行性感冒疫苗。六所機構每年力自行常規檢驗B型肝炎病毒表面抗原(HBsAg)及抗體(anti-HBsAb)。依據法規，所有機構定期安排廚師接受檢驗。洗手設備皆不符合要求。十七所機構清楚區分一般性或感染性廢棄物並正確歸類，且由機構訂有合約的特約醫院帶回處理感染性廢棄物。三所未設有需被隔離傳染病患之空間。所有機構皆備有一般口罩、外科口罩、N95口罩等，五所備有防水抛棄式隔離衣，皆無購置配備可重複使用之隔離衣。十七所機構以漂白水爲環境消毒劑，一所機構選擇95%酒精。使用漂白水機構中，九所機構按疾病管制局網站公告方式正確泡製。所有機構的高壓滅菌鍋，均只以化學測試進行滅菌品質監視。本調查顯示，長期照護機構在感染管制措施方面，仍有許多有待改善的空間。本調查的結果應可作爲衛生主管機間推動長期照護機構的感染管制政策之參考。

關鍵字

長期照護機構 ； 住民 ； 感染管制

並列摘要

The objective of this study was to evaluate tie infection control practices in long-term care (LTC) facilities in Kaohsiuug County. A total of 18 MC facilities with the capacities ranging from 40 to 80 beds were surveyed during March-May. 2004 Nurses were responsible for the majority of healthcare activities One facility has employed a part time infection control practitioner (ICP), while the others assigned non-ICPs to be responsible for infection control measures Six facilities have established infection control documents New residents were evaluated according to the medical summaries released by hospitals where the resident stayed shortly before. Every resident was routinely checked with chest X-ray at least once per year. Both residents and employees were vaccinated to prevent from influenza infection every year. None of the facilities bad standardized hand-washing equipments. Staff in 17 facilities was able to differentiate between infectious and non-infectious wastes. Three facilities did not equip with isolation rooms. Disposable paper masks, surgical masks and N95 masks were readily available in all facilities. Water-proof disposable protective gowns were available hi only 5 facilities. One of the facilities used 95% ethanol for environment disinfection,, while the others elected hypochlorite solutions Only 9 facilities diluted the hypochlorite solution properly. All facilities used autoclaving to sterilize reusable items, and only chemical indicators were employed to monitor the effective ness of sterilization Our results indicated that the infection control measures among the LTC facilities require lots of improvement. Results in the present study may be helpful to the associated health departments in the future establishment of appropriate infection control policies for LW facilities.

並列關鍵字

Long-term care facility ； resident ； infection control