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Regulation for prevention and control of healthcare associated infection in outpatient department and emergency department in healthcare facilities
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Basic data
| Standard ID | WS/T 591-2018 (WS/T591-2018) |
| Description (Translated English) | Regulation for prevention and control of healthcare associated infection in outpatient department and emergency department in healthcare facilities |
| Sector / Industry | Health Industry Standard (Recommended) |
| Classification of Chinese Standard | C05 |
| Word Count Estimation | 12,159 |
| Date of Issue | 2018-05-10 |
| Date of Implementation | 2018-11-01 |
| Regulation (derived from) | State-Health-Communication (2018) 10 |
| Issuing agency(ies) | National Health Commission |
WS/T 591-2018: Regulation for prevention and control of healthcare associated infection in outpatient department and emergency department in healthcare facilities
---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Regulation for prevention and control of healthcare associated infection in outpatient department and emergency department in services
ICS 11.020
C 05
WS
People's Republic of China Health Industry Standard
Medical institution emergency department hospital infection management regulations
Regulation for prevention and control of healthcare associated infection in outpatient
Department and emergency department in services
Published on.2018 - 05 - 10
2018 - 11 - 01 implementation
National Health and Wellness Committee of the People's Republic of China
Foreword
This standard is formulated in accordance with the Law of the People's Republic of China on the Prevention and Control of Infectious Diseases and the Measures for the Administration of Hospital Infections.
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
This standard was drafted. West China Hospital of Sichuan University, First Hospital of Peking University, Zhongshan Hospital of Fudan University, Chinese People's Liberation
General Hospital of the General Hospital, Xiangya Hospital of Central South University, Shengjing Hospital affiliated to China Medical University, First Affiliated Hospital of Guangxi Medical University, Jiangsu University
It is an Australian hospital.
The main drafters of this standard. Zong Zhiyong, Yin Weijia, Qiao Wei, Shen Wenwu, He Xiaotong, Li Liuyi, Gao Xiaodong, Liu Yunxi, Wu Anhua,
Zhang Xiuyue, Jin Jinai, Jiang Jiajia.
Medical institution emergency department hospital infection management regulations
1 Scope
This standard stipulates hospital infection management requirements, missions and training for outpatient and emergency departments (departments and departments) of medical institutions (hereinafter referred to as emergency departments).
Training, monitoring and reporting, pre-screening, basic measures to prevent and control infections, precautions based on transmission routes, medical waste disposal, etc.
This standard applies to all types of medical institutions that provide emergency services for the door.
2 Normative references
The following documents are indispensable for the application of this document. For dated references, only the dated version applies to this document.
For undated references, the latest edition (including all amendments) applies to this document.
GB 15982 Hospital Sanitary Hygiene Standard
WS/T 311 hospital isolation technical specification
WS/T 312 Hospital Infection Monitoring Specification
WS/T 313 Medical Staff Hand Hygiene
WS/T 367 Medical Institutional Disinfection Technical Specifications
WS/T 368 Hospital Air Purification Management Code
WS/T 511-2016 Code for prevention and control of hospital infections from airborne diseases
WS/T 512 Medical Organization Environmental Surface Cleaning and Disinfection Management Practices
WS/T 524 Hospital Infection Outbreak Control Guide
Medical Waste Management Regulations, former Ministry of Health,.2003
Medical Waste Management Measures for Health Care Institutions, former Ministry of Health,.2003
Hospital infection outbreak report and disposal management regulations former Ministry of Health.2009
Management measures for pre-examination of infectious diseases in medical institutions, former Ministry of Health,.2005
3 Terms and definitions
The following terms and definitions apply to this document.
3.1
Health care-associated infection
The infection that a patient or patient receives in a health care activity such as diagnosis, treatment, and prevention.
3.2
Respiratory hygiene
Patients with respiratory infections wear medical surgical masks, cover their mouth and nose with a tissue during coughing or sneezing, and contact with respiratory secretions.
Hand hygiene and a set of measures to maintain a distance of more than 1m from others.
[WS/T 511-2016, Definition 3.4]
3.3
Safe injection safe injection
It is harmless to the person receiving the injection, so that the medical personnel who perform the injection operation are not exposed to the avoidable danger, and the waste after the injection is not environmentally friendly.
Harmful to others.
3.4
Safety injection device safety-engineered devices
Needle-free or needle-free device for extracting arteriovenous blood, other body fluids or injecting drugs, through its inherent design, enabling it to be used after use
Shield sharps and reduce the risk of occupational exposure.
4 Management requirements
4.1 Hospital infection management system
4.1.1 The hospital emergency management team should be set up in the emergency department of the medical institution to fully manage the hospital infection management work in the emergency department.
And the duties of their personnel and implementation. The team is headed by the emergency department head, and the staff should include doctors and nurses. The group members are within the region.
Relatively fixed personnel should be equipped with at least one part-time staff of hospital infection management.
4.1.2 The emergency hospital infection management team should develop an emergency medical treatment based on the characteristics of medical care-related infections and the actual medical work in the emergency department.
Hospital infection management related systems (see Appendix A for requirements), plans, measures and procedures to carry out hospital infection management.
4.1.3 The emergency department hospital infection management team is responsible for organizing the staff to carry out training on hospital infection management knowledge and skills, which should be appropriate for patients and
Accompanying personnel carry out corresponding publicity and education.
4.1.4 The emergency hospital infection management team shall accept the supervision, inspection and guidance of the medical institution on the management of hospital infections, and implement the hospital.
Improve the infection management related measures, evaluate the improvement effect, and make corresponding records.
4.2 Staff
4.2.1 Should participate in the training of hospital infection management related knowledge and skills.
4.2.2 The relevant systems and procedures for hospital infection management should be mastered and followed, especially the specific measures for implementing standard prevention.
In accordance with the requirements of WS/T 313, the isolation work shall comply with the requirements of WS/T 311, and the disinfection and sterilization work shall comply with the requirements of WS/T 367.
4.2.3 Sterile technical procedures should be followed when injecting, puncture, treatment, dressing, surgery, debridement and other aseptic diagnosis and treatment operations.
4.3 Equipment and facilities
The emergency department of a medical institution shall be equipped with qualified and adequate facilities and articles related to infection prevention and control, including thermometers (guns),
Hand hygiene facilities and supplies, personal protective equipment, sanitary ware, cleaning and sanitizing products and facilities.
5 Mission and training
5.1 Training for emergency staff
5.1.1 The emergency hospital infection management team should develop a training plan every year and carry out targeted training based on the characteristics of the staff.
5.1.2 Training should include the following.
a) Characteristics of prevention and control of infection-related health care in emergency department;
b) hospital infection management related systems;
c) basic infection prevention and control measures such as hand hygiene, occupational protection of bloodborne pathogens, correct selection of personal protective equipment and
Use standard precautions, methods and frequency of cleaning and disinfection, medical waste management, etc.; and issue according to national and local
The laws, regulations, standards, norms, etc. are updated in a timely manner;
d) When an outbreak occurs, the training content should include the corresponding prevention and control knowledge and skills;
e) Training for part-time staff should also include hand hygiene compliance observation, health care-related infection case monitoring, and multi-drug resistant bacteria management.
5.1.3 Training should meet the following requirements.
a) New arrivals to the emergency department should participate in pre-job training;
b) On-the-job personnel should receive regular training at least once a year and keep a record;
c) According to the occurrence of infectious diseases, on-the-job personnel should receive targeted training in a timely manner.
5.1.4 The training effect assessment should meet the following requirements.
a) It is advisable to conduct an assessment or examination after each training;
b) Forms include on-site questioning, filling out exam papers, on-site operations, etc.
5.2 Missions of patients and their families and accompanying personnel
5.2.1 Various forms of education can be carried out using folding, posters, posters, promotional videos, etc.
5.2.2 The content of the mission should include hand hygiene, respiratory hygiene/cough etiquette and the scope of medical waste.
5.2.3 For patients diagnosed or suspected to have transmitted diseases through air or droplets, proper use of mask training should be carried out; for diagnosis or suspected connection
Patients with tactile disease should be taught the appropriate isolation measures.
5.2.4 It is advisable for patients and their families to indulge in dialysis catheters, peripheral venous catheters, catheters, catheters and other invasive devices.
Infection prevention and control measures.
6 Monitoring and reporting
6.1 Monitoring content and frequency
6.1.1 According to the requirements of WS/T 312, combined with the actual situation of the institution, design and carry out comprehensive monitoring of cases related to health care-related infections
And target monitoring, such as catheter-related bloodstream infections, surgical site infections, etc.
6.1.2 It is advisable to carry out regular monitoring of hand hygiene compliance, at least once a quarter. Hand hygiene compliance monitoring method should refer to world health
Organize the implementation of the Hand Hygiene Technical Reference Manual.
6.1.3 Environmental hygiene monitoring shall be carried out in accordance with GB 15982, WS/T 367, WS/T 368 and WS/T 512.
6.2 Epidemiological investigation of outbreaks or suspected outbreaks related to health care
When there are more than 3 cases of similar health care-related infections in a short period of time in a medical institution, refer to WS/T 524.
The request for timely epidemiological investigation of health care-related infection cases and targeted control measures.
6.3 Health Care Related Infection Case Report
6.3.1 The discovery of health care-related infections should be reported in accordance with the agency's emergency medical care-related infection case reporting system.
6.3.2 If symptoms of infection occur during the work of the staff, they should follow the reporting system of the emergency medical care related infection cases of the institution.
Report.
6.3.3 Health care-related infections should be reported in a timely manner in accordance with the Code for Reporting and Disposal of Hospital Infection Outbreaks and WS/T 524
Hair and suspected cases of violence.
7 Pre-test triage
7.1 Medical institutions shall strictly implement the provisions of the “Administrative Measures for the Pre-examination of Infectious Diseases in Medical Institutions” and establish them according to the service characteristics of the institution.
The corresponding pre-screening triage system.
7.2 Medical institutions should be based on the epidemic season, cycle, epidemic trends of infectious diseases and specific infectious disease warning information issued by the health administrative department.
Or in accordance with the requirements of the local health administrative department, strengthen the pre-examination and triage of specific infectious diseases.
7.3 Infectious diseases departments should be established in general hospitals above the second level, and medical institutions without infectious disease departments should establish separate cases of infectious diseases.
point.
7.4 In the emergency department of the medical institution, the patient can be infected by means of registration, consultation at the consultation desk, and inquiry at the time of the doctor's consultation.
Pre-examination of the disease; if necessary, a temporary pre-examination point (location) can be established for pre-inspection.
7.5 Pre-tests, triages (where) should be equipped with thermometers (guns), hand hygiene facilities and supplies, personal protective equipment and disinfection products, etc.
It is available at any time.
7.6 Physicians in all departments of the medical institution should pay attention to the patient's epidemiological history and occupational history during the consultation process, combined with the patient's
Pre-examination of infectious diseases for patients who come to the hospital for complaints, medical history, symptoms and signs.
7.7 If the pre-examination is an infectious disease patient or a suspected patient who needs to be isolated, the patient should be referred to the Infectious Diseases Department or the triage site for treatment.
At the same time, take the necessary disinfection measures for the clinic.
7.8 Medical institutions should set up eye-catching signs, notices, guidelines, etc., to guide patients with confirmed or suspected infectious diseases to infectious diseases
Visit a clinic or a triage. When a medical institution does not have the ability to treat infectious diseases, it should promptly refer patients to medical treatment capable of treatment.
Institutional treatment.
7.9 Standard precautions should be taken when attending pre-examination and triage staff. If you suspect that you have an infectious disease, you should follow
Choose and use appropriate protective equipment according to its route of transmission and properly guide patients to use appropriate protective equipment. Protective equipment should comply with the country
Relevant standard requirements.
8 Basic measures to prevent and control infection
8.1 Hand hygiene
8.1.1 Hand hygiene facilities should meet the following requirements.
a) Every emergency room in the emergency department should be equipped with hand sanitation facilities, including mobile water hand washing facilities, hand sanitizer, dry hand facilities or quick dry hand disinfection
Agent
b) Clinics that may be exposed to blood, body fluids, and secretions at high frequency, such as dressing rooms, dermatology, burns, otolaryngology, gynecology,
Mobile water hand washing facilities and dry hand facilities should be installed in the Department of Stomatology and Infectious Diseases. Newly built, rebuilt, emergency room, each clinic
Mobile water hand washing facilities and dry hand facilities should be provided.
8.1.2 Hand hygiene indications, methods and precautions should be in accordance with WS/T 313.
8.2 Selection of personal protective equipment
8.2.1 Use personal protective equipment (gloves, surgical masks, medical respirators, goggles or face shields) according to the principles of standard prevention.
For gowns and protective clothing, see Appendix B and in accordance with WS/T 311.
8.2.2 The precautions for using personal protective equipment are as follows.
a) Staff should master the use of personal protective equipment and precautions, and the specific method of wearing and removing is carried out in accordance with WS/T 311;
b) Before performing any treatment or care operation, the staff should assess the body's blood, body fluids, secretions, excretions or
The risk of exposure to infectious substances, select appropriate personal protective equipment according to the evaluation results, pay attention to the use of individual models
Human protective equipment;
c) Avoid contaminating overalls and skin when removing personal protective equipment;
d) If gloves and gowns are required, gloves and gowns should be replaced between different patient treatment operations;
e) Adhesion testing should be performed before using medical respirators.
8.3 safe injection
8.3.1 Medical staff should have indications for treatment and medication.
8.3.2 A single-use sterile injection device should be used for the injection.
8.3.3 A safe injection device should be used when injecting a patient with a blood-borne disease.
8.3.4 Use a single dose of the drug as much as possible. When multi-dose medication cannot be avoided, it should be guaranteed that "one person, one needle, one tube, one tube" should not be used.
The drug solution is again with a used needle and syringe.
8.3.5 After use, the sharps such as the injection needle should be placed in the sharp box of the specification in time.
8.4 Management of medical supplies
8.4.1 Medical equipment, instruments and articles that enter the human body aseptic tissues, organs, cavities, or contact with damaged mucous membranes and tissues of the human body shall be carried out.
Sterilization; diagnostic equipment, utensils and articles that contact intact skin and intact mucosa should be sterilized.
8.4.2 Disposable medical supplies should be disposed of in accordance with medical waste in a timely manner.
8.4.3 Diagnostic devices, utensils and articles that can be reused according to regulations shall be selected according to product specifications, technical specifications, etc. after use.
Choose the appropriate method for cleaning, disinfection or sterilization and meet the requirements of WS/T 367.
8.5 Environment and surface cleaning and disinfection
8.5.1 WS/T 512 shall be followed to clean and disinfect the regional environment and surface of different levels of pollution. Emergency department environment
The degree can be divided into the following three areas.
a) Areas with mild environmental pollution risks, including areas such as emergency offices, emergency pharmacies, and interiors;
b) Moderate environmental pollution risk areas, including emergency room, registration and payment window, waiting area, general consultation room, electrocardiogram room,
Areas such as ultrasound and other functional examination rooms;
c) High environmental pollution risk areas, including blood collection room, dressing room, puncture room, injection room, otolaryngology clinic, gynecological clinic,
Infectious disease clinic, bowel clinic, hot (emergency), emergency room, stomatology, hemodialysis room, endoscopy room, etc.
area.
8.5.2 Cleaning and disinfection of the bathroom environment and the surface of the object, the staff should wear the necessary personal defense before starting cleaning and disinfection.
Protective products. Keep the bathroom sanitation, at least clean or disinfect once a day, and clean and disinfect at any time when it is contaminated.
8.5.3 The compliance of environmental cleaning and disinfection can be assessed using the method described in WS/T 512. Environmental microbial assessment method according to GB
15982 execution.
8.6 Air purification
8.6.1 Air purification measures shall comply with the requirements of WS/T 368.
8.6.2 Natural ventilation is preferred in general clinics. Mechanical ventilation, centralized air conditioning ventilation system, circulating air UV ventilation can be used for natural ventilation.
Gas sterilizer or other qualified air sterilizer. A suitable sterilizer should be configured according to the characteristics of the product and the size of the area used.
8.6.3 When treating patients with airborne or droplet-borne diseases, the clinic should use a centralized air conditioning and ventilation system with an air purification and disinfection device.
Or use air purification and disinfection equipment. Conditional medical institutions can use negative pressure isolation clinics.
8.7 Respiratory health
8.7.1 It is advisable to post a respiratory health poster in the area of the visit and waiting for treatment, and to distribute or broadcast promotional materials.
8.7.2 For patients with respiratory symptoms, they should be instructed to wear masks when they can tolerate them.
8.7.3 Unnecessary close (< 1m) contact with patients with respiratory symptoms should be avoided.
8.7.4 Workers with respiratory symptoms are required to wear surgical masks during work.
9 Precautionary measures based on transmission routes
9.1 Patients with active infections such as respiratory symptoms, diarrhea, rash, drainage wounds or skin lesions should be identified early.
9.2 On the basis of standard prevention, follow the provisions of WS/T 311, and take the following corresponding isolation and prevention according to the route of transmission of the disease.
Protective measures.
a) Isolation and prevention of contact transmission. for contact-borne diseases such as intestinal infections, multi-drug resistant infections, skin infections, and presence
Incontinence, wound drainage, secretions, pressure sores, placement of drainage tubes or drainage bags, and patients with rash should be contacted
Isolation and preventive measures of communication.
b) Isolation and prevention of droplet transmission. within the first 24 hours of treatment specified in WS/T 311 and group A streptococcal infection
Take isolation and preventive measures for droplet spread. Patients should be placed in a clinic where the door can be closed, especially for severe coughing and phlegm.
The patient should wear a surgical mask and perform a respiratory hygiene/cough etiquette when the patient is allowed and tolerated.
c) Isolation and prevention of airborne transmission. for patients with WS/T 311 and for diseases such as disseminated herpes zoster or immunodeficiency
Patients with localized herpes zoster should be provided with airborne isolation and preventive measures. Visiting the clinic of such patients should be
The general office is separated and the patient is placed in a single room where the door can be closed. Conditional medical institutions should place patients in as soon as possible
Negative pressure isolation clinic. Surgical masks should be worn when the patient's condition is tolerated and tolerated, and respiratory hygiene/cough etiquette should be performed.
10 Medical waste disposal
10.1 Medical waste should be classified in accordance with the requirements of the Regulations on the Management of Medical Wastes and the Measures for the Management of Medical Wastes in Health Care Institutions.
Class, closed shipment, related registration for 3 years.
10.2 In the emergency area of the emergency department, a domestic garbage bin should be placed with black garbage bags inside. But special departments such as blood collection rooms, injection rooms, etc. may
The area where medical waste is discarded should be placed in a medical waste bin containing a yellow medical waste bag.
10.3 emergency room change room, blood collection room, injection room, otolaryngology clinic, gynecological clinic, infectious disease clinic, anorectal clinic,
A room for medical treatment, such as a urology clinic, should be placed in a medical waste bin with a yellow medical waste bag.
10.4 The general office should be placed in a domestic trash can.
10.5 The area where the domestic trash can or medical waste bin is placed should have a conspicuous and clear indication.
AA
Appendix A
(normative appendix)
Emergency hospital infection management system
The hospital emergency infection hospital infection management system includes the following.
a) the emergency hospital infection management team and its responsibilities;
b) emergency management system for emergency hospitals;
c) the reporting system for emergency medical care-related infections;
d) the training system for emergency medical staff;
e) medical staff hand hygiene system;
f) emergency door cleaning and disinfection system;
g) the pre-examination and triage system for emergency department;
h) the emergency isolation system;
i) personal emergency protection system for emergency services;
j) emergency medical waste management system;
k) Emergency treatment report system for emergency department.
BB
Appendix B
(normative appendix)
Choice of personal protective equipment for medical staff when exposed to different routes of transmission
See Table B.1 for the selection of personal protective equipment for medical personnel in contact with different routes of transmission.
Table B.1 Requirements for selection of personal protective equipment for medical personnel when exposed to different routes of transmission
way for spreading
Personal ...
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