5.2 Use necessary protective equipment and implement standard prevention. In view of hospital infection, the Centers for Disease Control and Prevention of the United States has formulated a series of standard preventive countermeasures. The new 1996 hospital isolation prevention guideline formulated by CDC in the United States is different from the ICT hospital infection control guideline of the British Ministry of Health (1995), which is a practical supplement to the latter and is called "standard prevention" scheme. The United States CDC 1987 promulgated national protection measures [27]. Some studies believe that [28], comprehensive protective measures can prevent more than 30% of acupuncture injuries, and the proportion of infection through skin and mucous membrane contact will also be significantly reduced.
Standard prevention integrates many characteristics of systemic prevention and isolation of substances in the body, and ensures that the patient's blood, body fluids, secretions and excreta are contagious and must be isolated. No matter whether there is obvious blood pollution or incomplete contact with skin and mucosa, people who come into contact with the above substances must take protective measures to prevent the spread of blood-borne diseases and non-blood-borne diseases. It is emphasized that two-way protection is the main strategy for successful, effective and economical hospital infection control, and it is also the most powerful measure for medical staff's occupational protection. The specific measures are as follows: ① Wash your hands. The purpose of hand washing is to remove pathogenic microorganisms from hands and cut off the spread of infectious diseases through hands. Proper hand washing can reduce 1.03 cfu/cm2 of bacteria [29]. Li Fang reported [30] that among 90 clinical nurses, 52.2% missed the tip of hand washing, 43.8% missed the back of hand washing, and the time for hand washing was not enough. The over-standard rate of sampling and monitoring immediately after hand washing reached 24.44%. Hand hygiene is related to medical safety and occupational safety of medical staff. Therefore, the Ministry of Health issued the Manual of Hand Hygiene for Medical Staff in Medical Institutions (draft) in 2006. It is necessary to wash your fingers clearly, master the correct hand washing methods, and regularly monitor hand hygiene. ② Wear gloves. It has been reported [3 1] that the chances of medical staff wearing gloves being injured by medical devices and directly contacting with patients' blood are obviously less than those of medical staff not wearing gloves, indicating that wearing gloves can reduce the times of skin contacting with blood without increasing skin damage. The infection rate was only 0.20% ~ 0.25% [365,438+0] when the needle was inserted into the glove, passed through the elastic double-layer rubber glove and then penetrated into the skin. So wearing two pairs of gloves can effectively prevent infection and reduce the infection rate. Some studies have also shown that [15], if a steel needle contaminated with blood pierces a layer of latex gloves or polyethylene gloves, the amount of blood that medical personnel may contact will be reduced by more than 50% compared with that without gloves. (3) Wear masks, goggles, masks, isolation gown, isolation measures, etc. During the SARS period, several medical workers in a province treated a patient with atypical pneumonia, and dozens of medical workers were infected because they did not take correct protective measures. After the patient was transferred to the Eighth People's Hospital, the medical staff put on protective articles such as isolation gown and 12 cotton mask for treatment and nursing according to the medical routine of infectious diseases department. No one was infected in this hospital. It can be seen that it is very necessary to provide adequate safety protection equipment and working environment for medical staff. At the same time, medical personnel should master the correct use of protective equipment, pay special attention to the correct use and preservation of masks, and wash their hands thoroughly before wearing and taking off masks. ④ Environmental control. Ensure that the hospital has proper daily cleaning standards and sanitary treatment procedures. On the basis of thorough cleaning, the bed units, equipment and environmental surfaces (bed railings, bedside equipment, wheelchairs, washbasins and door handles) shall be properly disinfected, and the implementation of this procedure shall be ensured. ⑤ Dispose of contaminated clothes correctly. When contacting and transporting clothes contaminated by blood, body fluids, secretions and excreta, in a sense, in order to prevent skin and mucous membrane exposure and clothing pollution, we should avoid counting and interfering with operations to prevent microorganisms from polluting other patients and the environment. Be careful not to pollute the surrounding environment when polluting, and pay attention to fashion bags. At this time, it is best to use a water-soluble bag, so that it can be put into the washing machine for heating and disinfection without additional disinfection. ⑥ Disinfect reusable equipment. Used reusable equipment is contaminated by blood, body fluids, secretions and excreta. In order to prevent the skin and mucous membrane from being exposed to danger and contaminating clothes or spreading microorganisms in patients and the environment, it should be ensured to be cleaned and properly disinfected before the next patient uses it. Disposable parts should be discarded. When operating, it is necessary to prevent the contaminated instruments from polluting mucous membranes, clothes and the environment again, and ensure that they are cleaned and disinfected in advance when used again. ⑦ Occupational health and safety. Standardize and popularize relevant knowledge education and establish and improve relevant systems; Strengthen the supply of protective equipment and the improvement of protective facilities; Do a good job in the prevention and treatment of occupational injuries.
5.3 Standardize the treatment of medical wastes, collect, store and treat them in accordance with the Regulations on the Management of Medical Wastes, use sharp boxes correctly, and set warning signs (yellow) for dangerous goods. The puncture-proof sharps collection box is considered as the most ideal method to reduce sharps injuries, which can reduce sharps injuries by 50% [32].
5.4 Improve the rules and regulations and management measures, formulate the occupational protection system and specific measures for medical personnel, as well as the reporting system and remedial measures for occupational exposure. In 2004, the Ministry of Health issued the "Guiding Principles for the Protection of Medical Staff from Occupational Exposure to HIV (Trial)", which provided a basis for medical institutions and medical staff to prevent and deal with occupational exposure to HIV. In a word, occupational protection is a long-term systematic project. At present, we should formulate occupational safety education norms for medical staff suitable for China's national conditions as soon as possible, incorporate occupational safety education into teaching materials and courses of nursing and medical colleges, strengthen management, implement effective protective measures, and actively participate in the work of medical staff to ensure the occupational safety of medical staff.