Effect and Significance of Comprehensive Training in Infection Prevention and Control on the Psychological Health of Oral Health Staff

Background:Oral health staff have close contact with patients in the process of diagnosis and treatment,and it is inevitable for them to come into contact with patients’secretions.Therefore,oral health staff are at greater risk of infectious diseases in their daily work,and their psychological health is also greatly challenged.Objective:To study the effect and significance of comprehensive training in infection prevention and control on the psychological health of oral health staff.Methods:We selected 400 oral health staff from a tertiary stomatological hospital in Guangzhou,China in this study.The respondents were randomly divided into an intervention group and a control group.After the first round of investigation,the intervention group received comprehensive training in prevention and control of infection for three months,while the control group received no intervention.Results:The comprehensive training in infection prevention and control improved the respondents’psychological health and job satisfaction.Further strengthening infection prevention and control training for oral health staff will increase their self-confidence,improve their mental health,and increase their job satisfaction.Conclusion:For oral health staff,it is particularly important to formulate an effective and operable preventive and control training program and then implement it in a standardized manner.

Scenario of Infection Prevention and Control Measures for Tuberculosis in Tuberculosis Inpatient and Outpatient Department in Tertiary Care Hospital

Tuberculosis is one of the most important infectious diseases in our country. Also nosocomial infection by tuberculosis can occur, which can be prevented by implementing simple, effective and affordable tuberculosis infection control measures in health care facilities. To evaluate the effectiveness of infection control measures, such study was planned. Questionnaires were administered to all doctors, healthcare workers and servants working in outdoor and indoor department of tuberculosis at tertiary care hospital to assess the knowledge, attitudes and practices on prevention and control of Tuberculosis infection. A scoring system was devised to grade them. One-time audit was also done in outpatient and inpatient department. The analysis showed scoring of poor for doctors, good for nurses and poor forward aids. There is a need to develop strategies for training of health care workers on regular basis in order to reduce the incidence of nosocomial infections. Audit result shows a good level of environmental control measures. Better knowledge, attitude and practices are helpful for the prevention and control of tuberculosis. Also environmental control measures are helpful to prevent infection.

健康教育在学校结核病防控中的价值研讨

目的研究学校结核病防控中应用健康教育的效果。方法于2021年1月—2022年12月时间段对某高中学校进行调查,选择该校三年级400名进行研究,其中1~5班采用常规校园疾病防控管理(200名),6~10班采用健康教育疾病防控管理模式(200名),观察指标为健康知识水平、防控措施落实情况、新发结核病发生情况。结果6~10班学生结核病防控知识高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生防控措施落实情况高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生新发结核病发生为0,低于1~5班学生3例(1.50%),但差异无统计学意义(P>0.05);6~10班学生结核病主动汇报15例(7.50%),高于1~5班学生4例(2.00%),差异有统计学意义(P<0.05)。结论学校结核病防治过程中采用健康教育模式可以提升学生的健康知识水平,强化结核病防治措施落实效果,有效预防新发结核病发生,并提高其主动汇报率,改善学生预后效果。

The strategic framework of tuberculosis control and prevention in the elderly:a scoping review towards End TB targets

With the rapid pace of population ageing,tuberculosis(TB)in the elderly increasingly becomes a public health challenge.Despite the increasing burden and high risks for TB in the elderly,targeted strategy has not been well understood and evaluated.We undertook a scoping review to identify current TB strategies,research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets.Databases of Embase,MEDLINE,Global health and EBM reviews were searched for original studies,review articles,and policy papers published in English between January 1990 and December 2015.Articles examining TB strategy,program,guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria.Most of them were qualitative studies,issued in high-and middle-income countries and after 2000.To break the chain of TB transmission and reactivation in the elderly,infection control,interventions of avoiding delay in diagnosis and containment are essential for preventing transmission,especially in elderly institutions and aged immigrants;screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people;optimizing early case-finding with a high index of suspicion,systematic screening for prioritized high-risk groups,initial empirical and adequate follow-up treatment with close monitoring and evaluation,as well as enhanced programmatic management are fundamental pillars for active TB elimination.Evaluation of TB epidemiology,risk factors,impacts and cost-effectiveness of interventions,adopting accurate and rapid diagnostic tools,shorter and less toxic preventive therapy,are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway.The framework and principals identified in this study will help to evaluate and improve current program,develop targeted strategy,as well as raise more discussions on the research priority settings and policy transitions.Given the scarceness of policy and evaluated interventions,as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries,the increasing need of a ready TB program for the elderly warrants further research.

Identification and attribute analysis of key stakeholders who influence multidrug-resistant tuberculosis prevention and control in China

Background There could be various stakeholders who influencing multidrug-resistant tuberculosis(MDR-TB)policy development and implementation,yet their attributes and roles remain unclear in practice.This study aimed to identify key stakeholders in the process of policy-making for MDR-TB control and prevention and to analyse the attributes and relationships of the stakeholders,providing evidence for further policy research on MDR-TB control.Methods This study was conducted from October 2018 to March 2019 and applied the stakeholder analysis guidelines and domestic stakeholder analysis.An initial candidate stakeholder list was developed by policy scanning.Ten experts were invited to identify these candidate stakeholders.The major attribute of these stakeholders were analysed using the Michell scoring method.Based on these results,the intertwined relationships among groups of stakeholders were analysed and mapped through a systematic scan of the policy and literature on MDR-TB control,as well as information obtained from the interviews.Results A list of 21 types of candidate stakeholders was developed after a literature review and policy scanning,of which 11 received 100%approval.After expert evaluation and identification(the total expert authority was 0.80),19 categories of stakeholders were approved and included in the stakeholder analysis.We categorized all of the stakeholders into three groups:(i)definitive stakeholders who are mainly involved in administrative departments and the Provincial Center for Disease Control and Prevention(CDC);(ii)expectant stakeholders who are mainly involved with MDR-TB patients,clinical departments of TB hospitals at different levels,community health care facilities,prefectural CDC and charity organizations;and(iii)latent stakeholders who mainly involved family members and neighbours of MDR-TB patients and TB related products manufacturers.Government departments and higher-level CDCs have strong decision-making power in developing MDR-TB control policies whereas the recommendations from service providers and the concerns of patients should be considered.Conclusions The MDR-TB prevention system was a multistakeholder cooperation system that was mainly led by government stakeholders.Enhancing communications with front-line service providers and patients on their unmet needs and evidence-based suggestions would highly benefit policy-making of MDR-TB prevention and control.

Tuberculosis infection prevention and control:why we need a whole systems approach

Infection prevention and control(IPC)measures to reduce transmission of drug-resistant and drug-sensitive tuberculosis(TB)in health facilities are well described but poorly implemented.The implementation of TB IPC has been assessed primarily through quantitative and structured approaches that treat administrative,environmental,and personal protective measures as discrete entities.We present an on-going project entitled Umoya omuhle(“good air”),conducted in two provinces of South Africa,that adopts an interdisciplinary,‘whole systems’approach to problem analysis and intervention development for reducing nosocomial transmission of Mycobacterium tuberculosis(Mtb)through improved IPC.We suggest that TB IPC represents a complex intervention that is delivered within a dynamic context shaped by policy guidelines,health facility space,infrastructure,organisation of care,and management culture.Methods drawn from epidemiology,anthropology,and health policy and systems research enable rich contextual analysis of how nosocomial Mtb transmission occurs,as well as opportunities to address the problem holistically.A‘whole systems’approach can identify leverage points within the health facility infrastructure and organisation of care that can inform the design of interventions to reduce the risk of nosocomial Mtb transmission.

Investigation and analysis of the biosafety awareness of laboratory staff involved in the detection of pathogens in seven provincial Centers for Disease Control and Prevention in China

This study aims to evaluate the biosafety awareness of laboratory staff working on pathogens detection in seven Centers for Disease Control and Prevention and support these staff's biosafety management and training.A total of 208 laboratory staff from seven provincial CDCs were chosen by stratified random sampling to undergo a self-administered questionnaire survey.The collected data were analyzed using SPSS 22.0.The overall average biosafety awareness of the CDC laboratory staff involved in pathogen detection was 82.5 points.The average biosafety awareness score was the highest in health monitoring(92.63 points)and the lowest in risk assessment and control(41.6 points).Among the seven provincial CDCs,the Guizhou Provincial Center for Disease Control and Prevention laboratory staff showed the lowest average biosafety awareness score(74.3 points).The team who worked for 5–14 years were more likely to score above the passing score(≥88 points;corrected OR 0.400,95%CI:0.168–0.951)than the staff with less than five years of work experience.In addition,the mid-level and junior-level staff,as well as the lower position ones were more likely to score below the passing score(<88 points;junior level and lower:corrected OR 3.473,95%CI:1.028–11.737;mid-level:corrected OR 2.797,95%CI:1.027–7.618)compared with the senior-level staff.Among the surveyed team,66.3%identified a lack of specific funds related to work,61.5%identified a lack of designated personnel for the laboratory biosafety management.The biosafety awareness in CDC laboratory staff involved in pathogen detection is low,especially regarding risk assessment and control.The biosafety awareness in Guizhou and Guangxi Provincial CDC laboratory staff is also low.Laboratory funding,job title,and years of experience in a laboratory influence biosafety awareness in CDC laboratory staff.The biosafety knowledge,education,and training of CDC laboratory staff involved in pathogen detection need to improve by paying attention to the content and coverage of biosafety training,exploring new training modalities,and increasing funding for activities related to biosafety in CDC.

2005—2022年上海市青浦区肺结核时空特征分析

目的:通过分析上海市青浦区2005—2022年的肺结核疫情,旨在发现区域内肺结核发病的空间聚集性及时空特征,为相关部门制定防控策略提供参考依据。方法:从中国疾病预防控制信息系统中筛选2005年1月1日—2022年12月31日上海市青浦区肺结核登记报告资料,进行空间全局自相关分析、空间局部自相关分析和时空扫描分析。结果:2005—2022年上海市青浦区男性肺结核患者数量多于女性患者,20~39岁年龄段肺结核患者数量最多。从时间上看,2013—2015年青浦区各街(镇)的发病率普遍上升,大部分街(镇)在此期间达到历年发病峰值,2015年之后各街(镇)的发病率呈逐步下降趋势。从空间上看,青浦区东部和西部地区整体发病率高于中心地区。2011年、2013年、2016年、2017年、2020年青浦区肺结核发病在空间上存在显著正相关性,呈现明显的空间集聚趋势,2010年青浦区肺结核发病的空间分布呈现负相关性。2005—2022年青浦区各街(镇)肺结核患者年均登记率的空间分布不均衡。2015—2022年青浦区肺结核患者呈现出明显的时空聚集特征。结论:2005—2022年青浦区肺结核病例男性显著多于女性,肺结核患者主要集中在20~39岁年龄段人群,且呈现时空聚集性,高发病率区域主要集中在青浦区西南部地区。相关部门应针对高发病区域和高风险人群加强筛查,制定分类分时的防控措施,从而有效防控肺结核疫情。

基于JD-R模型的我国东北地区疾病预防控制中心人员职业认同感现状及其影响因素甄别

目的:明晰东北地区疾病预防控制中心人员职业认同感现状及其影响因素,为疾控人才队伍建设和疾控事业发展提供有益的参考和建议。方法:基于JD-R模型,对黑龙江省、吉林省、辽宁省、内蒙古自治区各级的疾控中心人员进行问卷调查,探究职业认同感现状及驱动因素。结果:65.8%的调查对象对职业认同感评价较低。拥有较强的公共卫生专业能力(OR=3.348),避免工作倦怠(OR=1.196)和角色超载(OR=1.499),开展令人满意的岗位培训(OR=1.588),疾控人员的职业认同感将可能更高。此外,学历低(OR=1.331)、工作年限长(OR=1.492)、职业发展机会多(OR=1.161)、领导支持多(OR=1.084)、单位基础设施条件好(OR=1.065)、工作成就感高(OR=1.212)也是保持或提升职业认同感的促进因素。结论:为疾控人员提供高效的岗位培训、保障其工作回报、减轻其工作负荷、改善其工作条件、给予其组织支持是提升疾控人员职业认同感的有力举措。

2014-2020年广东省不同年龄段结核病患者耐药特征及应对防治策略

目的 探究2014-2020年广东省期间各年龄段结核病患者的耐药特征与应对防治策略。方法 以2014-2020年广东省32个结核病耐药监测点中,确诊结核病患者的39 048株结核分枝杆菌(mycobacterium tuberculosis, MTB)临床分离株为研究对象,回顾性分析耐药结核病患者及实验室相关资料,并以年龄、地区进行分组,探讨MTB临床分离株对药物的耐药性趋势、耐药结核病(包括单耐药结核病(monodrug-resistant tuberculosis, MR-TB)、多耐药结核病(poly-resistant tuberculosis, PDR-TB)、耐多药结核病(multidrug-resistant tuberculosis, MDR-TB)和广泛耐药结核病(extensively drug-resistant tuberculosis, XDRTB)的发病率差异,以及MTB临床分离株对重点药物(利福平和氧氟沙星)的耐药情况。结果 2014-2020年广东省32个结核病耐药监测点患者MTB临床分离株对9种抗结核药物在不同年度间、不同年龄段间的耐药率差异均无统计学意义(均P> 0.05)。MTB临床分离株的单耐药率、多耐药率、耐多药率、广泛耐药率和总耐药率分别为14.46%、5.16%、4.58%、1.29%。儿童组患者MTB临床分离株单耐药率(15.4%)高于青壮年组及老年组;青壮年组(5.0%)和老年组(5.0%)患者MTB临床分离株耐多药率高于儿童组患者;老年组患者MTB临床分离株广泛耐药率(2.1%)高于儿童组及青壮年组,差异均有统计学意义(P <0.001)。来自珠三角地区的患者MTB临床分离株的单耐药率(14.8%)、多耐药率(5.3%)、耐多药率(4.7%)、广泛耐药率(1.4%)、耐氧氟沙星率(11.33%)和耐利福平率(6.92%)明显高于非珠三角地区,差异均有统计学意义(P <0.001)。结论 根据监测点数据,2014-2020年间,广东省耐药结核病的流行趋势平缓。但在特定人群(如儿童和老年人)中,耐药结核病的发病率较高,且珠三角地区的耐药结核病发病率和重点药物耐药率均高于广东省其他地区,值得进一步关注和采取防控策略。

进贤县2021—2023年肺结核流行病学特征及其防控措施探讨

目的分析进贤县2021—2023年肺结核流行病学特征,并探讨其防控措施。方法收集整理2021年1月至2023年12月期间进贤县报告记录的肺结核患者734例为研究对象,基于描述性流行病学方法,统计分析进贤县2021—2023年肺结核流行病学发展状况,就不同发病年份、月份、性别、年龄、职业特征等开展研究,提出针对性预防控制对策,帮助易感人群防控感染,降低肺结核发病率。结果2021—2023年进贤县共报告肺结核患者734例,2021—2023年进贤县肺结核年平均发病率逐年降低,其中2021年肺结核发病人数最多,2022年次之,2023年肺结核发病人数最少,在报告的进贤县肺结核患者734例中,男性患者为433例,女性患者为301例,男女比例为1.44∶1,男性肺结核发病率远远高于女性肺结核发病率(P<0.05);从肺结核患者年龄方面分析,患者发病年龄段广泛,多集中于15岁以上,其中0~14岁年龄组发病率为2.45%,15~64岁年龄组发病率最高,为65.53%,>65岁年龄组发病率为32.02%;发病时间分布方面分析,肺结核在1~12月各月份均有发病情况,其中肺结核发病率最高的3个月份分别是3月份11.85%、9月份10.35%和5月份9.26%,1月份肺结核发病率最低为5.31%;发病职业特征方面分析,734例肺结核患者中,农民、工人、学生发病率分别为42.78%、16.76%、10.35%,其他职业由高到低依次为家政服务人员、民工、医务人员、教师、商业服务人员、待业、离退休人员以及其他。结论进贤县2021—2023年肺结核流行病学特征呈现出显著的发病时间、年龄、性别、职业等差异,发病整体趋势逐年降低,针对肺结核流行病学特征制定切实可行防控措施,能在肺结核疾病防控中发挥积极作用,提高公共卫生安全。

护理人员传染病突发事件防控能力的研究进展

介绍护理人员传染病突发事件防控能力的内涵及现状,其主要能力有临床实践能力、学习与教育能力、心理抗压能力;总结影响护理人员传染病突发事件防控能力的主要因素,包括个人因素(如性别、年龄、学历、参与培训的个人意愿等)、工作因素(如工作满意度、工作年限、职业角色、是否参加培训演练、是否具备相关救援经历等)及组织因素(如医院级别和组织支持等);采用的评估工具有葛森医院安全氛围量表、护士重大传染病疫情应急能力调查问卷等。提出提升护理人员传染病突发事件防控能力的相关策略,以期为提升护理人员传染病突发事件防控能力提供参考。

2015-2021年新疆和田地区新冠疫情前后肺结核发病趋势分析

目的分析新疆和田地区肺结核发病特征及疫情前后发病趋势,为和田地区肺结核防控措施制定和效果评价提供参考依据。方法收集2015-2021年和田地区肺结核报告发病数据,建立连接点回归模型(JPR)和中断时间序列模型(ITS),分别探索肺结核的发病特征及新疆新冠肺炎疫情防控措施对和田地区肺结核发病趋势的影响,并分析不同性别和年龄亚组发病差异。结果JPR模型结果显示,2015-2021年和田地区肺结核报告发病率总体呈先升后降趋势,转折点出现在2018年12月;男性发病率略高于女性,转折点和发病趋势与总体一致;各年龄亚组≥60岁组发病率最高,发病趋势也呈先上升后下降趋势,≤18岁年龄组发病率在2021年6月出现转折点,但趋势无统计学意义(P>0.05),19~59岁组与≥60岁组转折点与总体一致;ITS模型结果显示,自2020年1月起和田地区肺结核发病率明显下降,从2019年的319.28/10万下降到2021年的155.88/10万,同比下降51.16%,月均下降0.049/10万。结论2018年新疆将结核病筛查工作纳入全民健康体检,大量结核病例被发现,和田地区肺结核的报告发病数在2018年12月达到峰值,随后开始下降,而2020年1月起在新疆新冠疫情隔离措施的影响下,报告发病率呈现明显下降。随着疫情结束应关注可能涌现的潜伏结核患者,做好防疫工作。

某院医务人员血源性职业暴露调查与防控探讨

目的了解某院医务人员血源性职业暴露发生现状,分析其发生原因及特点,探讨减少职业暴露的有效措施。方法回顾性分析某三级甲等专科医院2019年1月1日至2022年12月31日医务人员上报的血源性职业暴露资料,分析其发生的原因、暴露源、发生场所及随访情况等。结果共发生114例血源性职业暴露,2022年实施干预后血源性职业暴露例次率为1.45%,低于干预前2019年—2021年的平均值3.72%,差异有统计学意义(P<0.05)。发生血源性职业暴露的工作岗位主要为医师(42.98%),其次为护士(36.84%),男性为主(53.51%),以工龄<5年员工最多(62.28%),发生地点以手术室(57.90%)和病区(33.33%)为主。暴露方式主要为针刺或锐器割伤(86.84%)。暴露发生环节主要为术中操作(39.47%)。引起针刺或锐器割伤的器具主要为手术缝合针及刀片(50.51%)。暴露源病原体主要为乙型肝炎病毒(59.41%)。乙肝表面抗体阴性或抗体滴度低于10mIU/mL的医务人员占17.54%。所有医务人员经随访无暴露后感染发生。结论加强教育培训,规范操作规程,可以有效降低医务人员血源性职业暴露发生率。医务人员应加强乙肝免疫接种。发生血源性职业暴露后应规范暴露后处置流程,避免发生感染。

疫情防控工作对药学人员感控理念的影响

目的 了解参与新型冠状病毒感染疫情防控对药学人员的影响,探索药学人员在感控中的价值。方法 采用问卷调查法,对医疗机构内药学人员院感防控态度、知识、行为方面进行调查。结果 共223人参与问卷调查,疫情后药学人员的院感防控态度、行为、知识各维度有显著提高,其中是否参与疫情防控督察工作在疫情后对院感防控行为的差异具有统计学意义;是否在发热门诊药房工作或者轮转、是否参与外派支援武汉或者泉州等地疫情防控一线工作在疫情前后对院感防控行为和感控整体情况的差异具有统计学意义(P<0.05)。结论 疫情后药学人员的感控观念有所增强,但仍存在短板,应鼓励药学人员参与到感控多学科协作中,以应对今后可能发生的突发公共卫生事件。

基于LSPI质量改进框架的压力性损伤临床防治国际指南的应用与评价

目的分析基于LSPI[领导力(Leadership)、护士培训(Staff)、临床实践优化(Performance Improvement)和信息技术(Information Technology)]质量改进框架的压力性损伤临床防治国际指南的应用效果,以期为促进相关防治实践指南向临床转化提供新方法。方法应用前-后对照研究方法,选择2019年7月—2020年6月就诊于本院的住院患者101005例设为对照组,选择2020年7月—2021年6月就诊于本院的住院患者110824例设为试验组。比较实施前后院内压力性损伤首次风险评估及时率、首次风险评估准确率、高危患者预防措施落实率与压力性损伤发生率。结果首次风险评估及时率从干预前86.73%上升至干预后96.25%,首次风险评估准确率从干预前93.46%上升至干预后98.69%,高危患者预防措施落实率从干预前94.21%上升至干预后98.15%,院内压力性损伤发生率从干预前0.77‰下降至干预后0.29‰,前后比较,差异均具有统计学意义(均P<0.05)。结论基于LSPI质量改进框架的压力性损伤临床防治国际指南的应用可提高压力性损伤过程管理质量,从而降低院内压力性损伤的发生率,促进实施以指南为依据的实践规范。

Achievements and challenges of the World Bank Loan/Department for International Development grant-assisted Tuberculosis Control Project in China

In March 2002,the government of China launched the World Bank Loan/ Department for International Development-supported Tuberculosis （TB） Control Project to reduce the prevalence and mortality of TB. The project generated promising results in policy development, strengthening of TB control systems, patient treatment success,funds management, and the introduction of legislation. In light of the global TB epidemic and control environment, it is useful to review the TB control priorities of the project, summarize the achievements and experiences around its implementation.

世界卫生组织人类健康中抗微生物药物耐药性的全球优先研究议题

人类健康中的抗微生物药物耐药性全球研究议程确定了40个优先研究主题,旨在为2030年前的政策提供依据。抗微生物药物耐药性对人类健康构成了巨大威胁,据估计,2019年约有495万人的死亡与细菌耐药相关。2021年全球新增耐利福平和耐多药结核病约45万例。此外,全球范围内侵袭性真菌感染正在增加,存在抗真菌药物耐药和诊断困难的挑战。

甘肃省高校学生肺结核防治信息知晓及宣传资料需求情况分析

目的 了解甘肃省3所高校学生肺结核防治重点信息知晓及宣传资料需求情况,为后续开展肺结核防治健康教育工作提供参考。方法 随机抽取甘肃省3所高校845名在校大学生,通过微信平台和问卷星进行问卷调查,采用Excel进行数据收集和整理,使用SPSS 21.0软件进行数据分析。结果 学生肺结核防治重点信息总知晓率为71.70%,3所高校学生肺结核防治重点信息总知晓率比较差异有统计学意义(P<0.01),家庭常居住地为城镇的学生总知晓率显著高于农村学生(均P<0.001)。结论 甘肃省高校学生对肺结核防治重点信息知晓率不高,高校要利用微信等网络平台,借助视频等宣传材料,开展多维度的结核病知识宣传工作。

江苏省2012—2022年结核病防治进展及展望

结核病是严重威胁人类健康的重大公共卫生问题,江苏省自2012年以来全面强化规划指引,不断完善结核病防治服务体系,各级政府加大经费投入,不断完善患者保障政策,优化实验室能力建设,狠抓学校结核病防控工作,全省结核病发病率逐年下降,各项的指标均达到规划的目标要求,多项工作指标居全国前列。本文回顾江苏省2012—2022年结核病防控工作策略措施和取得进展、成绩,总结工作存在的问题和面临的挑战,为实现健康江苏战略目标提供技术支撑。