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Hospital consciousness management in laminar flow operating room
(1) When the medical staff entered the operating room, the surgical cap was completely covered with hair and the mask was completely covered with nose and mouth. Reduce unnecessary conversations during surgery. Medical staff who are prone to sweating should be prepared to prevent sweating before operation and wrap their foreheads with wet gauze to prevent sweat from polluting sterile areas. Participants enter the operating room after taking a bath the day before the operation, and their clothes cover the whole body skin as much as possible to reduce the exposed area of skin, prevent the spread of dander and control the number of people in the operating room. (2) Try to avoid long-term reuse of the surgical gown, replace it in time if it is used too often, and it is forbidden to sew the surgical gown. Non-woven surgical gown is the most commonly used in orthopedic surgery. The research shows that using disposable non-woven surgical gown can reduce the infection rate of surgical patients by 2.5 times compared with using cotton surgical gown, and can obviously reduce the air bacterial pollution.

The measures to improve the cleanliness of air and articles in laminar operating room are: (1) air purification to improve the cleanliness of air in laminar operating room. The air purification system of laminar flow operating room itself has no sterilization function, and the air purification effect can be achieved by filtering dust to eliminate bacterial adhesion carriers to the maximum extent. The laminar flow grades of operation in our hospital are (100), 10000 and 100000 respectively (i.e. Grade I-especially clean operating room; Level 2-standard clean operating room; Class iii-clean operating room). The preoperative air purification was ≥ 65438 0 5 min, 25 min and 30 min respectively. Clean the air inlet filter and air return filter regularly. Keep the operating room closed during the operation and try to reduce the number of opening doors. It is forbidden to open the door leading to the dirt channel to reduce the amount of air particles and dust in the operating room. (2) improve the cleanliness of the operating lamp and the surface of the object; Wipe the operating lights and articles with water every morning. In particular, the surgical lamp reduces the air dust and microorganisms near the surgical lamp and keeps the surface of the object clean and dry. Because cleaning and drying can not only remove the influence of bacteria and viruses, but also destroy the environment on which bacteria depend. After the operation, clean up the items, minimize the storage of items in the operating room, and make the laminar air barrier-free. After the hygienist finishes cleaning, the air is purified for 30 minutes.

Reduce the bacterial content of patients' skin and mucosa. Tell the patient not to take a bath before the operation to reduce dandruff. After anesthesia, the hair, upper urinary catheter and gastric tube are removed with disposable cutter head or electric scissors. Reduce mucosal damage, reduce the chance of infection, and relieve the pain of patients. When the surgical area was shaved the night before the operation, the damage caused by shaving promoted the growth of bacteria, and the infection rate increased by nearly 100% compared with scissors cutting or not shaving. There is no need to shed a lot of hair. Therefore, don't shave the day before the operation.

The specific measures to avoid pollution in surgical operation are: (1) sharp instruments penetrate sterile towels to cause pollution; The sewing needle should be correctly placed on the instrument table; The needle holder should be clamped at the middle and back 1/3 junction of the needle, with the needle tip facing down and a certain distance between the needle tip and the cloth, or the blade, needle holder and needle should be placed on the curved plate. The towel holder can only hold the surgical towel around the surgical incision, but not the sterile items on the sterile list. In the operation that is easy to be affected with damp, the sterile cloth can be protected by protective film, and it should be replaced after wetting to keep the sterile cloth on the operating table dry. Operators should avoid hand pollution in the process of laying sheets, and disinfect their hands again if there is pollution. (2) The instrument dressing for cutting skin and tissues and organs should be used separately, and the instrument dressing for cutting solid organs and cavity organs should be used separately. Sterile cloth, gloves and surgical gowns should be replaced after suturing the hollow organs. Because there are a certain amount of bacteria in skin and viscera, aseptic technology should be strictly implemented in cleaning and polluting operations to reduce infection. (3) Prevention of glove contamination: With the extension of operation time, the number of bacteria will also increase. The safest way is to wear two pairs of gloves, which can reduce the blood pollution of patients and effectively prevent bacteria from entering the incision of patients. If the operation takes a long time, gloves should be changed within 2 hours.

Accurately use preventive antibiotics according to the doctor's advice, and continue to use antibiotics before and during the operation, so that the blood antibiotic concentration can reach the therapeutic level during the whole operation. Obviously, this preventive antibiotic treatment is more effective. This can achieve the therapeutic concentration of antibiotics in any surgical site that may form seroma and hematoma. It is worthless to start using antibiotics after bacterial contamination 1 ~ 2 h, so after the patient enters the operating room, it is necessary to arrange the use of preventive antibiotics reasonably in an accurate time so that antibiotics can play a bactericidal role during the operation. With the development of medical model and the appearance of advanced technology, the application of various new surgical implant materials, the excessive dependence on preventive antibiotics, and the causes of hospital infection are various. Only by taking measures from all aspects to prevent and control hospital infection can the safety of patients be guaranteed.