Professional Documents
Culture Documents
(Healthcare associated-infections,HAIs)
(World
Health Organization, WHO)
5%-10% 20
2002
99,000
(WHO) 2005
2009
(The First Global Patient Safety
Challenge) (Save LivesClean Your
Hands
2010 5 5
(WHO)
1
98 10 2
WHO
3
(WHO)2009
Hand Hygiene GuidelineGuide to Implementation
WHO 2010
3
WHO
3
WHO 20
5
2004
2004 2007
8.9%
WHO 2005
WHO
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13
15
15
5 16
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5 ..33
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WHO .....77
9
(System change)
SARS
WHO
WHO
(patient zone)
(alcohol-based handrubs at the point of care)
()
10
(user-centered)
Q&A
11
12
()
(WHO)
Facility preparedness 2
Baseline evaluation 3
Implementation 3
Follow-up evaluation 2
(Facility preparedness)
()
(Baseline evaluation)
13
(Implementation)
(Follow-up evaluation)
14
(Patient zone)
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2.Alarm
(health-care area)
15
(point of care)
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16
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24
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() /
() (spore-forming
pathogens)(Clostridium difficile)
()
()
()
()
( 7.5% Povidone iodine
4% Chlorhexidine ) (
Chlorhexidine Gluconate 1% solution ethyl alcohol 61%)
()
() (
25
)
()
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()
( 0.5 )
()
1.
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(
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27
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29
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31
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32
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( 4 3+4 )
35
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36
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37
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()
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38
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39
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40
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41
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43
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44
( 1)
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1
()
45
CVP
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Xylocaine
2% Xylocaine
Tegaderm
( 3)
( 3+4)
46
47
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()
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( 3+4)
49
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52
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( 1)
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53
( 1)
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54
(Electroconvul-sive Therapy ECT)
( 1+2) ( 1)
( 2)
( 3+4)
( 3+4)
CPR
( 3 4)
55
2009 WHO
(WHO multimodal hand hygiene improvement strategy) :
1.WHO
2.
56
1 4
3.
1.
2.
3.
observation
biasobserver bias
selection
bias
1.
2.
3. 12~15
)
57
IndicatorMeasurementIndicate
?
??
99-100
()
58
99-100
1.
4 (1)
15
(2)
15
2.
(1)
(2)
(3)
(4)
(5)
%
100%
3.
(1) /
(2)
(3)
(4)
%
100%
59
4.
(1)
(2) 2
(3) /
(4)
(5)
(6)
A %
(+)
100%
+
B %
2
100%
C %
100%
60
1.
2 (1) Indication
/
Opportunities
(2)
Opportunities
Performed actions
(3)
(4)
%
Performed actions
100%
Opportunities
2.
(1)
(
)
(2)
(3)
%
100%
1.
1 (1)
(2)
100
(3)
%
100 100%
61
1.
(1) TNIS
4
(2) 12
(3) %
100%
2.
(1)
12 1 4
4
(2)
(3)
%
100%
(4 )
3.
(1)
Staphylococcus aureusAcinetobacter baumannii
Enterococci( Enterococcus spp.Enterococcus faecium
Enterococcus faecalis)
OxacillinImipenem Vancomycin (S
Non-S) 12 1 3
3
Enterococci
Enterococcus spp.
Enterococcus faecium
Enterococcus faecalis
(2) (S Non-S)
(3)
%
100%
(3 )
62
4. ( MSSA MRSA)
(1) 48
(Staphylococcus aureus)
14
(2)
( MSSA MRSA)
(3) 12
(4)
( MSSA MRSA)%
100%
12
1.
5 (1)
15
(2)
15
2.
(1)
(2)
(3)
(4)
(5)
%
100%
63
3.
(1) /
(2)
(3)
(4)
%
100%
4.
(1)
(2)
(3)
(4)
%
()
100%
5.
(1)
(2)
(3)
(4)
%
100%
64
1.
2 (1) Indication
/
Opportunities
(2)
OpportunitiesPerformed
actions
(3)
(4)
%
Performed actions
100%
Opportunities
2.
(1)
(2)
(3)
%
100%
1.
1 (1)
(2)
100
(3)
%
100 100%
65
1.
(1)
(1)
(2) 15
IOMInstitute of Medicine
To err is human
WHO
//
// ~
(%)
// ~
(%)
// ~
(%)
// ~
(%)
// ~
(%)
// / // ~
/
(%)
66
/ //
5
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/
(%)
// / //
/
(%)
X 2
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67
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68
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()
National Patient Safety Foundation( NPSF) 2002
(Patient Safety Awareness Week PSAW)2009
71
One Partnership,One Team()
Learn how to become more involved in
care
Communicate and partner with
your providers
Reach out to the community
2007 (WHO)Clean Care is
Safer Care
ASK MESPEAK UP
ASK ME
PDCA
72
(WHO)
FOCUS-PDCA(
Finding Plan
Organize Do
Clarity Check
Understanding Action
Selection
FOCUS-PDCA
Finding
6W1H
1.What?
2.Where
3.When
4.Whom
73
5.Which
6.Who
7.How
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74
1. 90%
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75
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76
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Do
77
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baseline rate
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WHO
WHO
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Pseudomonas aeruginosaE. coli
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92
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93
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,_________________________________
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___________________________________________________________________________
94
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Q & A
107
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1 2 3 4 5 6 7 8 9 10 11 12
108
()
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Q&A
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109
()
1 2 3 4 5 6 7 8 9 10 11 12
110
()
1 2 3 4 5 6 7 8 9 10 11 12
111
()
1 2 3 4 5 6 7 8 9 10 11 12
112
() 70v/v (ethanol, ethyl alchol) 62.39% w/w
() 70v/v (isopropanol, isopropyl alcohol, 2-propyl)
( ) 70v/v (1-propanol, 1-propyl alcohol, n-propyl alcohol,
n-propanol, propanol)
() 70v/v
() (Dermal tolerance)
(
)
(dispenser)(
113
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3.4
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10
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31-40 % 5
41-50 % 10
3.4b WHO
51-60 % 15
61-70 % 20
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81 % 30
3.5
116
3.5a 0
3.5b
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118
5
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5
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5
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5
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4
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WHO 5
*3
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119
WHO
80%
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WHO
/20
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120