| 英文摘要 |
The practice of nosocomial infection control is one of the targets for maintaining patients’safety. Due to the average annual infection rate of urological wards dramatically increasing recently (0.38% in 2006 vs. 1.81% in 2007,respectively), this plan was established and carried out. With the epidemiological investigation, we found all patients with nosocomial infection had undergone an endoscopic ureterolithotrispy and placement of double J ureteral catheter. The endoscope in the operation room was suspected to be the infection source. With the checklist of causative analysis, we found the disinfection of endoscope was incomplete. The potential causes might be: 1. the disinfection time is not enough; 2.the disinfection solution has not been properly checked; 3. the tube and cavity of the instruments have not been thoroughly cleaned; 4. the time for immersion disinfection is insufficient due to the shortage of instruments. According to the causative analysis, the improvement measures might be: 1. strictly comply with the time of immersion and disinfection for high-level disinfectant; 2. revise the checkup for the effective concentration of the disinfection solution; 3. fully adhere to the correct procedure for cleaning the instruments; 4.increase the number of available instruments. For the patients who underwent endoscopic ureterolithotrispy and placement of double J ureteral catheter, the urinary tract infection rate decreased from 1.81% to 0.0% following implementation of the improvement measures. Therefore, the length of hospital stay and unnecessary medical cost could be diminished. |
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