الصحة هي حالة من الكمال الجسمي والعقلي والاجتماعي
وليست خلو الجسم من الأمراض أو الضعف
Health is state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity
رقم المشاركة : ( 1 )
Hospital hygiene and
Management of health-care waste is an integral part of hospital hygiene
and infection control. Health-care waste should be considered as a reservoir
of pathogenic microorganisms, which can cause contamination and
give rise to infection. If waste is inadequately managed, these microorganisms
can be transmitted by direct contact, in the air, or by a variety
of vectors. Infectious waste contributes in this way to the risk of
nosocomial infections, putting the health of hospital personnel, and patients,
at risk. The practices described in Chapters 6 to 10 of this handbook
for the proper management of health-care waste should therefore be
strictly followed as part of a comprehensive and systematic approach to
hospital hygiene and infection control.
This chapter outlines the basic principles of prevention and control of the
infections that may be acquired in health-care facilities (but does not
address other aspects of hospital hygiene and safety such as pressure
sores and the risk of falls). It should be stressed here that other environmental
health considerations, such as adequate water-supply and sanitation
facilities for patients, visitors, and health-care staff, are of prime
14.2 Epidemiology of nosocomial infections
Nosocomial infectionsÑknown also as hospital-acquired infections,
hospital-associated infections, and hospital infectionsÑare infections
that are not present in the patient at the time of admission to hospital
but develop during the course of the stay in hospital. There are two
¥ Endogenous infection, self-infection, or auto-infection. The causative
agent of the infection is present in the patient at the time of admission
to hospital but there are no signs of infection. The infection develops
during the stay in hospital as a result of the patientÕs altered
¥ Cross-contamination followed by cross-infection. During the stay in
hospital the patient comes into contact with new infective agents,
becomes contaminated, and subsequently develops an infection.
While there is no clinically signiÞcant difference between the endogenous
self-infection and the exogenous cross-infection, the distinction is important
from the standpoint of epidemiology and prevention.
Healthy people are naturally contaminated. Faeces contain about 1013
bacteria per gram, and the number of microorganisms on skin varies
between 100 and 10000 per cm2. Many species of microorganisms live
Hospital hygiene and infection control
on mucous membranes where they form a normal ßora. None of these
tissues, however, is infected. Microorganisms that penetrate the skin or
the mucous membrane barrier reach subcutaneous tissue, muscles,
bones, and body cavities (e.g. peritoneal cavity, pleural cavity, bladder),
which are normally sterile (i.e. contain no detectable organisms). If a
general or local reaction to this contamination develops, with clinical
symptoms, there is an infection.
14.2.1 The transition from contamination to infection
Whether or not a tissue will develop an infection after contamination
depends upon the interaction between the contaminating organisms and
Healthy individuals have a normal general resistance to infection.
Patients with underlying disease, newborn babies, and the elderly have
less resistance and will probably develop an infection after contamination.
Health-care workers are thus less likely to become infected than
Local resistance of the tissue to infection also plays an important role: the
skin and the mucous membranes act as barriers in contact with the
environment. Infection may follow when these barriers are breached.
Local resistance may also be overcome by the long-term presence of an
irritant, such as a cannula or catheter; the likelihood of infection increases
daily in a patient with an indwelling catheter.
The most important determinants of infection, however, are the nature
and number of the contaminating organisms. Microorganisms range
from the completely innocuous to the extremely pathogenic: the former
will never cause an infection, even in immunocompromised individuals,
while the latter will cause an infection in any case of contamination. A
classiÞcation of conventional, conditional, and opportunistic pathogens is
given in Box 14.1.
When only a few organisms are present on or in a tissue, an infection will
not necessarily develop. However, when a critical number is exceeded,
it is very likely that the tissue will become infected. For every type of
microorganism, the minimal infective dose can be determined; this is the
lowest number of bacteria, viruses, or fungi that cause the Þrst clinical
signs of infection in a healthy individual. For most causative agents of
nosocomial infections, the minimal infective dose is relatively high. For
Klebsiella and Serratia spp. and other Enterobacteriaceae, for example,
it is more than 100 000, but for hepatitis B virus it is less than 10.
14.2.2 The sources of infection
In a health-care facility, the sources of infection, and of the preceding
contamination, may be the personnel, the patients, or the inanimate
The hospital environment can be contaminated with pathogens. Salmonella
or Shigella spp., Escherichia coli O157:H7, or other pathogens may
be present in the food and cause an outbreak of disease just as they can
in a community outside the hospital. If the water distribution system
breaks down, waterborne infections may develop. In more sophisticated
premises the water cooling system of air conditioning equipment may
|12-10-2009, 10:28 PM||رقم المشاركة : ( 2 )|
الاخ مصطفي شكري وتقديري لهذا الموضوع الثر واتمني يتم نشره في اوسع نطاق ويتم تسويقه في المستشفيات لانها تغمل في وادي وصحتها في وادي اخر (وضابط الصحة )في وادي اخر لك التحية
|12-10-2009, 10:42 PM||رقم المشاركة : ( 3 )|
If hospital waste is not managed properly it proves to be harmful to the environment. It not only poses a threat to the employees working in the hospital, but also to the people surrounding that area.
Infectious waste can cause diseases like Hepatitis A & B, AIDS, Typhoid, Boils, etc.
A common practice in some cmmunities is the reuse of disposable syringes. People pick up used syringes from the hospital waste and sell them. Many drug addicts also reuse the syringes that can cause AIDS and other dangerous and contagious diseases. If a syringe, previously used by an AIDS patient, is reused, it can affect the person using it. So, the hospital staff should dispose off the syringes properly, by cutting the needles of the syringes with the help of a cutter, so that the needle ca, not be reused.
When waste containing plastics are burnt, Dioxin is produced, which can cause Cancer, birth defects, decreased psychomotor ability, hearing defects, cognitive defects and behavioral alternations in infants.
Flies also sit on the uncovered piles of rotting garbage. This promotes mechanical transmissions of fatal diseases like Diarrhea, Dysentery, Typhoid, Hepatitis and Cholera. Under moist conditions, mosquitoes transmit many types of infections, like Malaria and Yellow fever. Similarly, dogs, cats and rats also transmit a variety of diseases, including Plague and Flea born fever, as they mostly live in and around the refuse. A high tendency of contracting intestinal, parasitic and skin diseases is found in workers engaged in collecting refuse
|12-26-2009, 06:26 PM||رقم المشاركة : ( 4 )|
شكرا يامصطفى على الموضوع وصراحة موضوع العدوى فى المستشفيات من الاهمية بمكان وهو علم يختلف الى حد ما عن مكافحة الامراض المعدية حيث لكل منهما الياته . الا ان مكافحة العدوى عندنا فى المستشفيات تحتاج الى وفقة سواء كانت ممارسة (وطبعا اشك انو توجد اقسام بالمتشفيات لهذا الغرض واذا وجدت تحتاج لوقفة عندها) او معرفة لان الممارس لهذه المهنة لابد له من معرفة وتاهيل ومعينات داخل المستشفى المعنى. فمزيد من تسليط الضو على هذا الموضوع الهام
وكميات من المودة
|01-17-2010, 09:39 PM||رقم المشاركة : ( 5 )|
تانى يا مصطفى رفعنا الموضوع لكى تلقى المزيد من الضؤ عليه نسبة لاهميته البالغة وارجو ان تلخص لينا هذا الكتاب فى نقاط وتضع لينا فيه لمساتك الخبراتية والعلمية حتى نستفيد منه ولك من المودة طن
|01-23-2010, 01:20 PM||رقم المشاركة : ( 6 )|
نشكر الاخ مصطفي علي اثارة موضوع عدوي المستشفيات وهو من المواضيع المهمة جداً والتي لم تلقي اي اهتمام عندنا في السودان وانا بحكم تخصصي وعملي فترة ليست بالقصيرة في هذا المجال ان شاء الله احاول ان اكتب لكم مجموعة ملخصات وأطر عمل عنه وانا اعتقد انها سنتكون مفيدة بس اليومين ديل مشغولين شوية امتحانات .
والشئ الثاني آمل ان تدرس هذه المادة في كليات الصحة عندنا لأنها من صميم عملنا
|01-23-2010, 11:01 PM||رقم المشاركة : ( 7 )|
يسرني جدا ان يتبني الزميل حامد البله الحديث في موضوع عدوي المستشفيات خاصة وانه نال ماجستير الصحة العامة في هذا الموضوع وعمل في هذا المجال فترة طويله ،ويبقي لي الشرف بفتح الموضوع
مع تحياتي لكل من علق علي الموضوع واخص بالشكر الزملاء عمر عبد المجيد وعبدالرحيم احمد واستاذنا زين العابدين
|06-07-2011, 04:27 PM||رقم المشاركة : ( 8 )|
infections (HAIs), also known as health-care–associated infections, encompass almost all clinically evident infections that do not originate from a patient's original admitting diagnosis. Within hours after admission, a patient's flora begins to acquire characteristics of the surrounding bacterial pool. Most infections that become clinically evident after 48 hours of hospitalization are considered hospital-acquired. Infections that occur after the patient's discharge from the hospital can be considered to have a nosocomial origin if the organisms were acquired during the hospital stay.
Introduction: nosocomial infections are those which result of treatment in a hospital or a healthcare service unit, but secondary to the patient's original condition. Infections are considered nosocomial if they first appear 48 hours or more after hospital admismeion (νοσοκομείον) meaning hospital (nosos = disease, komeo = to take care of). This type of infection is also known as a hospital-acquired infection (or more generically healthcare-associated infection).
Nosocomial infections are transmitted due to the fact that hospitals house large numbers of people who are sick and whose immune systems are often in a weakened state. Increased use of outpatient treatment means that people who are hospitalized are more ill and have more weakened immune systems than may have been true in the past. Moreover, some medical procedures bypass the body's natural protective barriers. Since medical staff move from patient to patient, the staff themselves serve as a means for spreading pathogen.
Hospitals have sanitation protocol regarding uniforms, equipment sterilization, washing, and other preventative measures. Thorough hand washing and/or use of alcohol rubs by all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infection . More careful use of anti-microbial agents, such as antibiotics, is also considered vital
Despite sanitation protocol, patients cannot be entirely isolated from infectious agents. Furthermore, patients are often prescribed antibiotics and other anti-microbial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant
|06-07-2011, 04:29 PM||رقم المشاركة : ( 9 )|
السلام عليكم الاخوة الزملاء ارجو ان تكونو فى تمام الصحة والعافية ....
هذا الموضوع يشغل بالى منذ كنت طالبا" ولدى بحث تكميلى البكلاريوس عن نفس الموضوع سأمدكم به انشاء الله
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