Maitiro Ekudzivirira Kutapukirwa neNosocomial muUkoti
Utachiona hweNosocomial, kana kuti hwava kunzi Healthcare-Associated Infections (HAIs), hutachiona hunowanikwa nevarwere pavanenge vachirapwa munzvimbo dzehutano, dzakadai sezvipatara, nzvimbo dzehutano dziri muchipatara, kana makiriniki. Utachiona uhwu hunowanzoonekwa mukati memaawa makumi mana nemasere mushure mekubvumidzwa, kana mukati menguva yakatarwa mushure mekunge nzira dzekurapa dzaitwa. Mukurapa, kudzivirira hutachiona hweNosocomial chiratidzo chemhando yebasa uye chinhu chakakosha chekuchengetedzwa kwemurwere. Vanamukoti vari pamberi pekurapwa, vachitaurirana nevarwere nguva nenguva, nzvimbo yekutarisira, uye michina yekurapa, zvichiita kuti basa ravo rive rinokosha mukuputsa ketani yekutapurirana.
Kunzwisisa cheni yekutapurirana sehwaro hwekudzivirira
Nzira dzekudzivirira hutachiona dzinofanira kutanga nekunzwisisa cheni yekutapurirana. Kutapurirana kunoitika kana paine chinhu chinotapurirana (bhakitiriya, hutachiona, fungus), nzvimbo inochengeterwa utachiona (munhu, mudziyo, pamusoro), nzvimbo yekubuda nayo, nzira yekutapurirana (kubata, madonhwe, mhepo), nzvimbo yekupinda, uye munhu anowanzobatwa nechirwere (murwere ane immune system isina kugadzikana). Kupindira kwakanaka kwevanamukoti kunowanzo tarisa pakupwanya chisungo chimwe chete kana kupfuura mucheni iyi nguva dzose. Zvikanganiso zvidiki zvakaita sekushambidza maoko zvisina kunaka, kushandisa magirovhosi zvisirizvo, kana kuvhiyiwa kwemidziyo zvisina kunaka zvinogona kukonzera kupararira kwehutachiona muimba yekurapwa.
Kutevedzera hutsanana hwemaoko senzira huru
Kuchenesa maoko ndiyo nzira inoshanda uye iri nyore yekudzivirira HAIs. Vanamukoti vanofanira kushandisa 5 Moments for Hand Hygiene (WHO): vasati vabata murwere, vasati vabata mishonga yekudzivirira utachiona, mushure mekusangana nemvura yemuviri, mushure mekusangana nemurwere, uye mushure mekusangana nenzvimbo yemurwere. Kushandisa hand rub ine doro kunoshanda kana maoko asina kusviba zvinoonekwa, nepo kugeza maoko nesipo nemvura inoyerera kuchidikanwa kana maoko akasviba zvinoonekwa kana mushure mekusangana nemamwe ma spores.
Kutevedza mitemo yehutsanana hwemaoko hakusi nyaya yeruzivo chete, asiwo yetsika dzebasa uye kuwanikwa kwenzvimbo. Nokudaro, manejimendi evakoti anofanira kuona kuti kune mishonga inouraya utachiona munzvimbo dzakakodzera, kuongororwa kwemitemo nguva dzose, uye mhinduro dzinovaka. Dzidzo nemuenzaniso kubva kuvakoti vakuru zvinoitawo basa guru mukuvaka tsika dzakanaka muchikwata.
Kushandiswa kwematanho ekudzivirira akajairwa uye matanho ekudzivirira akavakirwa pakutapurirana
Nzira dzekudzivirira dzinofanira kushandiswa kuvarwere vese pasinei nekuonekwa kwavo, sezvo njodzi yekutapurirana inogona kuitika kunyangwe murwere asati aonekwa kuti ane chirwere chakati. Zvimwe zvedziviriro dzakajairika zvinosanganisira kuchena kwemaoko, kushandisa michina yekudzivirira (PPE), tsika dzekukosora, majekiseni akachengeteka, kubata marara nejira, uye kubvisa tsvina mumidziyo.
Pamusoro pezvo, vanamukoti vanofanirwa kushandisa matanho ekudzivirira kutapurirana kwechirwere zvichienderana nenzira yekutapurirana kwechirwere, zvakaita se:
– Nzira dzekudzivirira kubata munhu: dzezvirwere zvinotapuriranwa zviri nyore kuburikidza nekubata munhu zvakananga/zvisina kunanga, semuenzaniso mamwe manyoka anotapukira kana hutachiona hweganda hunotapukira.
– Dziviriro dzekudzivirira madonhwe: dzezvirwere zvinotapuriranwa kuburikidza nemadonhwe, zvakaita sefuruwenza.
– Nzira dzekudzivirira dzinofambiswa nemhepo: dzekutapurirana kwechirwere mumhepo/mumhepo, senge TB, pamwe nekushandisa makamuri ekuparadzanisa vanhu uye kushandisa michina yekufema yakakodzera.
Kusarudzwa kwePPE yakakodzera—magirovhosi, masiki, dziviriro yemaziso, uye magauni—kunofanira kugadziriswa zvichienderana nenjodzi dzekuita izvi. Kushandisa PPE zvisirizvo (semuenzaniso, kupfeka magirovhosi asi usingageze maoko) kunogona kuwedzera njodzi yekutapurirana kwehutachiona.
Nzira yeAseptic mukurapa kwekupinda muropa uye kurapa maronda
Zvirwere zvakawanda zvepa nosocomial zvinokonzerwa nekurapwa kwechirwere chemudumbu zvakaita sekuiswa kwe IV line, ma catheter e urinary, ma ventilator, kana kuvhiyiwa. Mukurapa, nzira ye aseptic inofanira kuva tsika yakajairika kune ese maitiro, kunyanya aya anosanganisira kuwana masisitimu emuviri asina utachiona. Nheyo dzinosanganisira kushandisa zvishandiso zvisina utachiona, kuchengetedza nzvimbo yakachena yekuvhiyiwa, kudzivirira kusvibiswa, uye kuuraya utachiona paganda usati waisa zvishandiso.
Mukurapa maronda, vanamukoti vanofanira kuongorora mamiriro eronda nenzira yakarongeka, kuchinja mabhandeji sezvakaratidzwa, uye kushandisa nzira dzakachena/dzisina utachiona dzakakodzera rudzi rweronda. Zvinyorwa zvakarurama zvinobatsira kuona zviratidzo zvehutachiona nekukurumidza, zvakaita sekutsvuka, kurwadziwa kwakanyanya, kuzvimba, purulent exudate, kana fivha.
Kudzivirira hutachiona hunoenderana nemidziyo: CAUTI, CLABSI, uye VAP
Utachiona hutatu hunowanzo ratidza kunaka kwechipatara ndehwekuti catheter-associated urinary tract infections (CAUTIs), central venous catheter-associated bloodstream infections (CLABSIs), uye ventilator-associated pneumonia (VAP). Vanamukoti vanoita basa rakakosha mukudzivirira hutachiona uhu kuburikidza nekushandisa nzira dzekurapa dzakasanganiswa.
1. Kudzivirira Kuchenjerera
Maitiro anosanganisira kuisa catheter chete kana zvaratidzwa zvakajeka, kuchengetedza nzira yekubuda kwemvura yakavharwa, kuisa weti pasi pedundira, kuita basa rekutarisira perineum, uye kuongorora zuva nezuva kuti catheter inobviswa nekukurumidza.
2. Kudzivirira CLABSI
Tarisa pakuchenesa maoko, kudzivirira ganda kubva muhutachiona, kuchengetedza machira asina utachiona, kuchengetedza catheter yakavharwa, uye kuderedza kushandiswa zvisina kufanira. Kuongorora kutarisirwa kwecatheter uye kudzidziswa kugona kwakakosha.
3. Kudzivirira VAP
Vanamukoti veICU vanofanira kuona kuti vanosimudza murwere kubva pamubhedha, vachenesa muromo nguva nenguva, vanoongorora kubuda kwemvura, vanomunyaradza, uye vanoshanda pamwe chete kuti murwere abviswe mumhepo nekukurumidza. Kutevedzera mitemo yekusvuta isina utachiona kwakakoshawo.
Kuchena kwezvakatipoteredza, maturusi, uye kutarisira machira
Nzvimbo isina kuchena yekutarisira inova nzvimbo inochengeterwa tupukanana. Nekuti vanamukoti vanowanzo bata nzvimbo dzevarwere (mibhedha, matafura, mamonitor), kutevedzera hutsanana hwemaoko kunoramba kwakabatana nekuchena kwezvakatipoteredza. Maitiro anosanganisira kuona kuti pane nguva yekubvisa utachiona, kuchenesa nzvimbo dzinobatwa zvakanyanya, uye kutarisira michina yekurapa inoshandiswa pamwe chete kudzivirira kuti isatapurirwe pakati pevarwere pasina kubvisa utachiona.
Kutarisira machira erineni hakufanirwewo kuregeredzwa. Machira erineni akasviba anofanira kubatwa sezvinhu zvakasvibiswa, kutakurwa nenzira inoderedza kupararira kweutachiona, uye kuchengetwa mumudziyo wakatsaurirwa. Vanamukoti vanofanira kudzidzisa vashandi vanobatsira nemhuri dzevarwere kuti vasasanganise machira akasviba nezvinhu zvavo.
Dzidzo yevarwere nemhuri sevanhu vanobatsirana mukudzivirira
Varwere nemhuri vanowanzova padivi pavo panguva yekutarisirwa uye vanogona kuva chikamu chemhinduro uye chikonzero chenjodzi. Vanamukoti vanofanirwa kupa dzidziso iri nyore asi yakajeka nezvekukosha kwekugeza maoko, tsika dzekukosora, mitemo yekushanyira varwere, kushandisa masiki kana zvichidikanwa, uye kurambidzwa kubata mimwe michina yekurapa. Kupa kunzwisisa kwezvikonzero zviri shure kwemitemo (semuenzaniso, nei macatheter achifanira kuramba akavharwa) kunowanzo vandudza kutevedzera mitemo.
Dzidzo inosanganisirawo kuziva zviratidzo zvehutachiona uye nguva yekuzvitaura nekukurumidza, kuitira kuti kuongororwa nekukurumidza kuitwe uye kurapwa kukurumidze.
Kutarisa, kushuma uye tsika dzekuchengetedza
Kudzivirira hutachiona hakugone kumira vega vasina kutariswa. Vanamukoti vanoita basa rekunyora zviitiko zvehutachiona, kutaura zviratidzo zvinofungidzirwa, uye kutsigira timu yeInfection Prevention and Control (IPC) mukuongororwa kwekutevedzera mitemo. Ruzivo rwakarurama runobatsira zvipatara kuona zvikamu zvine njodzi huru, kuongorora mafambiro, uye kugadzirisa mitemo.
Tsika yekuchengetedza zvinhu inokoshawo: vanamukoti vanofanira kunzwa vakachengeteka kutaura nezvenyaya dzinenge dzakanganiswa kana kutyorwa kwemitemo vasingatyi kurangwa, zvichiita kuti hurongwa hugadziriswe. Hutungamiriri hwewadhi hunoita basa rekuona kuti maSOP anoteverwa, kupa kudzidziswa, uye kusimbisa chirango nenzira yekudzidzisa.
Penutup
Nzira dzekudzivirira hutachiona hwemunocomial mukurapa dzinoda kugara kwenguva refu, hunyanzvi hwehunyanzvi, uye tsika yebasa inotsigira kuchengetedzeka kwemurwere. Hutsanana hwemaoko, matanho ekudzivirira akajairwa uye akavakirwa pakutapurirana, nzira yekusauraya utachiona, kudzivirira hutachiona hune chekuita nemidziyo, hutsanana hwezvakatipoteredza, dzidzo yemhuri nemurwere, uye kutarisa zvinhu zvakakosha zvine chekuita nazvo. Nekushandisa zvine hungwaru uye kushanda pamwe chete muchikwata chehutano, kuwanda kwehutachiona hwemunocomial kunogona kuderedzwa zvakanyanya, mhando yebasa inovandudzwa, uye kuchengetedzeka kwemurwere kuri kuvimbiswa zvakanyanya.
