感染预防控制最佳实践(双语)

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Chapter Two The World Health Organization Approach to  Health Care-Associated Infection Prevention and Control第二章        世界卫生组织对医院感染预防控制的要求Health care-associated infection represent a major patient-safety issue worldwide. They are the most frequent adverse event during health care delivery and potentially result in prolonged hospital stays, long-term disability, increased antimicrobial resistance, high additional costs for the health care system, financial and human-suffering burdens for patient and their families, and excess deaths.1 Through the Fifty-fifth World Health Assembly Resolution (WHA 55.18), the World Health Organization (WHO) has recognized the need to promote patient safety as a fundamental principle of all health systems and urged Member States to take action, including the prevention of HAIs.2,3 Regional Offices and Committees across all six WHO regions (Africa, the Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific) formally committed to respond to this call through official documents and clear mention of HAIs as being among the most serious threats to patient safety in their health care setting. 2在世界各地医院感染已成为病人安全问题的一个主要话题。医院感染是医疗服务期间经常出现的最不利事件，潜在着延长住院时间、长期残疾、增加抗菌药物的耐药性、给医疗服务体系造成高的额外花费、给病人及其家人带来经济负担和身体痛苦，甚至增加死亡等不良后果1。第55届世界卫生大会通过决议(WHA 55.18)，世界卫生组织认识到促进病人安全作为一项基本原则所有的卫生机构必须做到，敦促成员国开展活动，包括对医院感染的预防2,3。世界卫生组织所有的6个区域(非洲、美洲、东地中海、欧洲、东南亚和西太平洋)的办事处和委员会通过公文正式确认响应这一号召，清晰地认识到医院感染已成为这些医疗机构中对病人安全最为严重的威胁2。The emergence of life-threatening infections, such as severe acute respiratory syndrome (SARS) and viral hemorrhagic fevers (for example, Ebola and Marburg viral infections), highlight the urgent need for efficient infection control practices in health care. Among many important lessons learned from the SARS and viral hemorrhagic fevers epidemics is the fact that health care settings can act as amplifiers of disease. HAI prevention and control can be enforced also by WHO through International Health Regulations,4 an international legal instrument that is binding on 194 United Nations (UN) Member States across the globe and that entered into force in June 2007. An essential element for the implementation of the International Health Regulations is the early detection and contention of events that may constitute public health emergencies of international concern. To enable a timely public health response to infectious threats, hospital-based surveillance and infection prevention and control (IPC) practices must be in place for early reporting and containment purposes. International Health Regulations represent an excellent opportunity for the prevention and control of HAIs internationally.威胁生命感染的出现，如严重急性呼吸综合症(SARS)和病毒性出血热(如埃博拉病毒和马尔堡病毒感染)，强调在医疗机构迫切需要有效的感染预防措施。从SARS和病毒性出血热流行中学到了许多重要的课程，事实上，医疗服务机构充担了疾病放大镜的角色。医院感染的预防和控制被世界卫生组织通过的《国际卫生条例》4作为国际法律文件要求联合国的194个成员国于2007年6月始进行实施。实施《国际卫生条例》的基本要求是早期发现和使突发性公共卫生事件成为国际关注的焦点。对感染威胁的公共卫生对策应及早实施，医院基础监测和感染的预防控制策略必须到位，达到早期报告和遏制事件发生的目的。《国际卫生条例》为国际间预防控制医院感染提供了极好的合作机会。HAIs may represent serious occupational hazards. Health care workers (HCWs) have been heavily affected during epidemics5,6 and are frequently victims of occupational exposure to blood-borne pathogens. Pruss-Ustun et al.7 estimate the global burden of disease attributable to occupational exposure among HCWs to be 40% hepatitis B and C infections and 2.5% human immunodeficiency virus (HIV) infections.医院感染是一严重的职业危害。医务人员在疫情流行期间深受影响5,6，常常是血源性病原体职业暴露的受害者。Pruss-Ustun等7估计归因全球医务人员职业暴露的疾病负担，乙型肝炎病毒和丙型肝炎病毒感染占40%，人体免疫缺陷病毒占2.5%。Antimicrobial resistance is a global threat, which is accelerating with the emergence of new multiresistance mechanisms and is fast outpacing available solutions. It challenges the control of infectious diseases, jeopardizes progress on health outcomes by increasing morbidity and mortality, and imposes huge costs on societies. It is clear that comprehensive global action by all stakeholders is needed. In response to this growing threat, WHO introduced a policy package on World Health Day on 7 April 2011 to combat antimicrobial resistance and reframe critical actions to be taken by governments, including the need to enhance IPC measurees.8细菌耐药性是一全球性威胁，新的多重耐药机制的加速出现，快速超过了有效的解决方案。是对感染性疾病控制的挑战，增加了发病率和死亡率，在社会上加大了巨大的花费，危害了医疗效果的进步。很清楚，这是关系所有利益相关者广泛的全球性行动。面对这一威胁的出现，世界卫生组织在2011年4月7日世界卫生日出台了一揽子政策，抗击细菌耐药性，重新评价政府有关活动，包括进一步加强感染预防控制措施8。HAI prevention and control is now an important area of work for WHO, particularly over the last decade, with several World Health Assembly and Regional Committee resolutions2,9-15 emphasizing the need to enhance its capacity worldwide, and WHO has committed to focusing on this aspect by providing leadership, technical expertise, and coordination. Beyond its key role in reaction and support to emergency situations, WHO develops and promotes standards and essential infection control recommendations (for example, hand-hygiene best practices) and supports countries to build and to strengthen long-term capacities—to be better prepared to prevent and to respond to potential outbreaks and to reduce the burden of endemic HAIs.医院感染预防控制现在是世界卫生组织工作的一个重要方面，特别是过去十年中，几次世界卫生大会和区域委员会2,9-15决定强调在世界各地强化医院感染预防控制能力，世界卫生组织在这方面一直致力于加强提供领导、技术专家和协调工作。世界卫生组织在应对紧急情况时发挥了关键性的作用和支持，制定提升标准和基本的感染控制建议(例如手卫生最佳实践)，支持地方建立强化长效机制—好的应对医院感染潜在性的暴发和减轻流行负担的预防准备措施。Given its leading role in international health among UN Member States, WHO is in a unique position to encourage and to strengthen HAI prevention and control through its Regional and Country Offices and WHO Collaborating Centres, to coordinate efforts with ministries of health and other key players, and to create partnerships at local and international levels. Regional and Country Offices have multiple critical roles, including ensuring that the specific needs of Member States in their regions are known and addressed; adapting global standards, directions, plan, and tools appropriate for the region; and coordinating regional initiatives. Country offices have the lead role in coordinating communications and other critical activities with national authorities and WHO efforts to provide local assistance. WHO headquarters collaborates closely with Regional Offices and plays a key role in the coordination of global initiatives and the development of global standards.鉴于在联合国成员国之间发挥领导国际卫生的主导地位，世界卫生组织在一个独特的位置，通过它的区域、国家办事处及世界卫生组织合作中心，对卫生部门和其它核心成员进行有效地协调沟通，创建地方和国际层面的合作伙伴关系，进行鼓励和强化医院感染预防控制。区域和国家办事处有多重关键角色，包括确保这些区域的成员国特别需要知道和解决的问题；为这些区域调节适合全球的标准、指南、计划、工具；协调区域的积极性。国家办事处在国家当局与世界卫生组织积极给当地提供援助的协调交流和其他重要活动中担任领导角色。世界卫生组织总部与区域办事处紧密合作，在协调全球主动性和全球标准化的发展中扮担重要角色。

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As a result of this commitment, the following examples can be cited to illustrate the global scope and reach of some WHO headquarters’ initiatives in the field of HAI prevention and control. By developing and testing the Guideline on Hand Hygiene in Health Care16 and the Multimodal Hand Hygiene Improvement Strategy and Toolkit17 over the past five year, WHO has emphasized the importance of hand hygiene as the most effective measure to prevent the transmission of health care-associated pathogens. However, evidence has shown that for many reasons, this basic procedure is often neglected by HCWs, and average compliance is estimated at less than 40% worldwide.18 Although overcoming this reality (and behavioral issue) initially appeared to be a massive challenge in 2005, WHO has now succeeded in establishing a global campaign, with 124 governments formally committed to reducing HAIs through hand-hygiene best practices and other measures. Among these, 43 have initiated national/subnational hand-hygiene campaigns.19 Since its launch in 2009, the WHO SAVE LIVES: Clean Your Hands global initiative has snowballed, with the participation of almost 14,000 hospitals from 153 countries in 2011.20 One of the key success factors of this global campaign has been the strong and continuous support of all key players in the field of infection control worldwide as well as of WHO Collaborating Centres and Regional and Country Offices.作为这个承诺的结果，下列例子能引用说明在医院感染预防控制领域，全球范围和世界卫生组织总部的一些举措。在过去5年中，制定和检测《医疗服务手卫生指南》16和《手卫生多模式促进策略和工具包》17，世界卫生组织强调手卫生的重要性作为最有效的预防医疗服务相关病原体传播措施。然而，许多原因的证据显示，这一基本步骤常常被医务人员所忽视，世界范围内平均依从率估计低于40%18，虽然在2005年开始克服这一现实(行为问题)仿佛是一巨大挑战，现在世界卫生组织已经成功地建立了一个全球性运动，124个政府正式承诺通过手卫生最佳实践和其他措施降低医院感染。这当中有43个开展国家或地区性手卫生运动19。自2009年起，世界卫生组织发起的：拯救生命：清洁你的手运动在全球象滚雪球般铺开，到2011年有153个国家大约14000家医院参与了这项运动20。这次全球性运动取得成功的关键因素是得到了地方感染控制核心成员同世界卫生组织合作中心及区域和国家办事处的强力和不断的支持。Another example of global spread is the Safe Injection Global Network (SIGN) launched by WHO in 1999.21 SIGN is a network of stakeholders aiming to ensure the safe and rational use of injections worldwide and includes prominent international organizations, government bodies, scientific societies, universities, and industry representatives. A greater awareness of the need for safe injections has been achieved in almost every country since the SIGN launch, and by 2008, two thirds of the 96 low- and middle-income countries for which information is available had implemented safe injection programs under its guidance. More than 90 countries have built the capacity to identify infection control breaches in injection practices and to implement the needed strategies to address the gaps by using SIGN tools to assess injection practices and to support the development of evidence-based injection-safety strategies.另一个例子是1999年由世界卫生组织发起的安全注射全球网(SIGN)在全球展开21。SIGN是由利益相关者，特别包括国际组织、政府机构、科学团体、大学和企业代表针对在世界范围确保注射的安全合理使用而建立的一个网络组织。自SIGN建立以来，大部分国家都对安全注射的必要性有了清晰的认识，到2008年，在96个低、中收入国家中有三分之二的国家能依据安全注射指南，获得其有用的信息，实施安全注射项目。有90多个国家具有鉴别在注射过程中是否违反感染控制措施的能力，利用SIGN工具去评价注射过程中缺陷处理的必要策略非常重要，支持对注射安全循证战略的发展。A very important development is the fact that WHO has recently taken up the task of coordinating efforts for HAI prevention and control around the global by launching the Global Infection Prevention and Control (GIPC) Network in June 2011.22 The overall aim is to enhance IPC practices as tools for promoting safer care, containing infectious-disease outbreaks, and fighting antimicrobial resistance. Of note, the Regional and Country Offices are crucial to its functioning. The GIPC Network is expected to assist WHO in providing technical support to Member States through a broad dissemination of IPC policies and guidance documents. In addition, it will contribute to WHO efforts to build IPC Capacity, particularly in low- and middle-income countries. The network will take advantage of already-established Collaborations with institutions, organizations, agencies, and professional societies with demonstrated influence and experience in international infection control capacity building. Other WHO programs focused on HAI prevention and control will also contribute to its activities.一个非常重要的发展是2011年6月建立全球感染预防控制网(GIPC)，世界卫生组织开始对全球医院感染预防控制措施进行有效的评估工作22。提高感染预防控制策略实践的目的是作为工具为促进安全护理，控制感染性疾病暴发，抗击细菌耐药性服务。必须注意到，区域和国家办事处对它的实施起了重要的作用。全球感染预防控制网期待帮助世界卫生组织为其成员国对感染预防控制策略和指南文件进行广泛宣传提供技术支持。在另一方面，它为世界卫生组织建立有效的感染预防控制功能，特别是在低、中收入国家作出了贡献。全球感染预防控制网将利用体系、组织、机构和专业团队已经建立的协作去展示国际间感染控制功能建设的影响和经验。其他的WHO项目对医院感染预防控制的关注也将有助于它的活动开展。Since WHO has actively demonstrated its high commitment to HAI prevention and control, the topic of patient safety has finally attracted attention in the developing world. This represents a major change, as the scientific evidence and tradition of IPC have grown in Industrialized nations where the vast majority studies are conducted and key recommendations are issued. With its global perspective, WHO works to raise awareness of the fact that no country or health care setting worldwide can claim to be exempt or to have resolved the problem of HAIs. This not only means that recommendation and standards must be rigorously based on high-quality evidence and valid guidelines developed for use in any country but also implies significant efforts to facilitate implementation and adaptation according to available resources and the local culture and conditions. The work of WHO and others has demonstrated that the burden of HAIs in low- and middle-income countries is much higher and has some implication that differ from those of high-income countries, although other health problems are usually prioritized in settings with limited resources.1-3 Another aspect indicating the global perspective of WHO’s approach is the commitment to translate and to disseminate tools and documents as widely as possible to achieve the best audience reach and adoption.由于WHO积极展示它对医院感染预防控制的高调承诺，患者安全这一主题最终吸引了发展中国家的关注。这象征着一个大的改变，有关感染预防控制的科学证据和传播，大部分研究的进行和关键建议的发布是来自于工业化国家。从全球角度来看，WHO的工作对世界范围内没有任何国家和医疗服务机构敢自称摆脱或解决了医院感染的问题提高了认识。这不仅意味着其建议和标准必须建立在高质量证据的严谨基础上，所制定的有效指南能被任何国家使用，而且也意味着根据现有的资源和当地的文化及条件，能通过大的努力去促进实施和适应这些建议、标准和指南。WHO的这一工作和其他工作显示了医院感染的负担在低、中收入国家非常之高，暗示了与高收入国家的不同，尽管其他的健康问题通常也先出现在资源有限的地区1-3。另一方面表明WHO的全球视角方法是承诺尽可能广泛地调动传播工具和文件，达到最佳的影响和采纳效果。

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Within WHO headquarters, two programs are focused only on HAI prevention and control (Clean Care Is Safer Care and Infection Prevention and Control in Health Care) and tackle different aspects of the problem. Other programs are related to specific topics of infection prevention or environmental health that are relevant for the community and health care settings or include some specific areas of work that have related implications. All collaborate and interact in a complementary manner. Most of these programs are reflected at the regional level with coordinated, but also partially independent, activities. In Table 2-1 these programs are listed in alphabetical order together with the main topics tackled, the main objectives, and the key documents produced to date. Refer to the specific website pages for more details. This list may not be exhaustive, as HAI prevention and control as well as patient-safety aspects might also be included within additional WHO programs. In general, all programs aim to raise awareness among governments, HCWs, and other key players to develop guidelines, standards, policies, and implementation and monitoring tools to support systems and resource strengthening for infection control, to engage with stakeholders and experts, to support training activities, and to facilitate field implementation, monitoring, research, and sharing of results and local experiences.在世界卫生组织总部，医院感染预防控制的两个项目(清洁护理是安全护理和医疗服务机构的感染预防控制)被关注, 处理这一问题的不同方面。其他项目是涉及到感染预防或环境卫生相关的社区和医疗服务机构包括一些有相关影响的具体工作领域的特殊主题。所有的合作和互补的方式交互进行。这些项目的大多数体现在区域范围的协调中，但也有部分地独立活动。表2-1按字母顺序一起列出迄今为止要解决的主要议题、主要目标和关键文件。更多细节参考特别的网页。这表可能不详细，医院感染预防控制象患者安全情况一样可能包括在其他WHO项目中。一般地，所有项目的目的是提高政府、医务人员、其他核心成员对制定指南、标准、策略、执行、检测工具的意识，为控制感染支持系统和强化资源，吸引利益相关者和志愿者去支持训练活动，促进专业项目的实施，对取得的成果和地方经验进行检测、研究和分享。

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Table 2-1. Main WHO Programs Focused on Health Care-Associated Infection (HAI) Prevention and Control表2-1. WHO项目中主要的医院感染预防控制要点Blood Transfusion Safety (http://www.who.int/bloodsafety/en/)输血安全Prevention of transfusion-transmissible infections (including HIV, hepatitis B, hepatitis C, and syphilis, and bacterial contamination of blood and blood products)输血感染的预防(包括HIV、HBV、HCV、梅毒和含在血液或血液制品中的细菌)Relation to HAI Prevention and control相关的医院感染预防控制Main guidelines and documents*主要的指南和文件*●To develop norms, standards, best-practice guidelines, tools, and materials relating to the entire blood-transfusion process from donor to patient to ensure blood safer●建立规范、标准、最佳实践、工具和与输血有关的捐献者到病人的相关数据，确保血液安全●To support the establishment of sustainable national blood programs, ensuring the provision of safe, high-quality blood and blood products to all patients requiring transfusion and their safe and appropriate use●支持建立可持续的国家血液规范，确保为需要输血的病人提供安全、高质量的血液和血液制品，保证他们安全恰当地使用●To build capacity in countries through structured training activities, voluntary unpaid blood donation, donor selection, donation testing, risk assessment and management, data and quality management, external quality assessment, blood cold chain, hemovigilance, and the clinical use of blood●组织培训构建国家能力：志愿无偿献血，供者选择，捐献测试，风险评估管理，数据和质量管理，外观质量评估，血液冷冻链、血液预警，临床的血液使用●To support the implementation of a quality system in all aspects of blood collection, processing, testing ,and clinical use, including setting up the system for surveillance, vigilance, and monitoring●支持对血液收集、加工，检验、临床应用质量体系的实施，包括建立监测、警示、检测体系To support the development of education and training programs and to incorporate transfusion medicine into medical and nursing school curricula●支持发展教育培训项目，包括在医生和护士的课程体系中设立输血医学●To establish a global monitoring mechanism on safe blood and blood products and to collect, to analyze, and to disseminate reliable information on blood safety and availability●在血液和血液制品安全、收集、分析、和对血液安全、实用性信息宣传等方面建立全球性的监督机制。●To promote harmonization and collaboration of international efforts to ensure sufficient quantities of safe blood and blood products●促进国际间有效的协调和合作，确保足量的安全血液和血液制品●To promote research and development in the provision and appropriate use of safe blood and blood products●促进安全血液和血液制品供应和合适使用的研究与发展●Information sheet●信息表●Prevention of health care-associated HIV infection: Flyer●预防医疗相关HIV感染：传单●Aide-memoire for good policy process for blood safety and availability●好的血液安全和实用性策略方案备记录●Aide-memoire for national health authorities: Developing a national blood system●国家卫生部门备忘录：发展国家血液体系●Universal access to safe blood transfusion●安全输血的一般方法●Guidelines: Maintaining a safe and adequate blood supply during pandemic influenza●指南：在流感大流行期间维持足量安全的血液供应●WHO resource materials on blood safety: CD-ROM●血液安全WHO资源材料：CD-ROM●The Melbourne declaration on 100% voluntary nonremunerated donation of blood and blood components●墨尔本宣布100%的志愿者无偿捐献血液和血液成份●Toward 100% voluntary blood donation: A global framework for action●面对所有志愿献血者：献血活动全球框架●Developing a voluntary blood donor program (DONOR): Facilitator’s toolkit (6 modules): CD-ROM●开发自愿献血项目(DONOR)：辅助工具包(6个模块)：CD-ROM●Blood-donor selection: Recommendation on assessing suitability for blood donation●献血选择：合适的献血评估建议●Screening donated blood for transfusion-transmissible infections: Recommendation for blood transfusion services●对献血传播感染的献血筛查：输血服务建议●Aide-memoire: The blood cold chain●备忘录：血液冷冻链●The blood cold chain: Guide to the selection and procurement of equipment and accessories●血液冷冻链：设备和附件的选择与采购指南●Manual on the management, maintenance, and use of blood cold chain equipment●血液冷冻链的管理、维护和使用手册●Aide-memoire: The clinical use of blood●备忘录：临床用血●Aide-memoire: Clinical transfusion process and patient safety●备忘录：临床输血方案和病人安全●Developing a national policy and guidelines on the clinical use of blood recommendations●制定临床用血国家策略和指南的建议●The clinical use of blood: Information sheet of clinicians●临床用血：临床医生信息表●The clinical use of blood: Handbook●临床用血：手册●The clinical use of blood in general medicine, obstetrics, pediatrics, surgery and anesthesia, trauma, and burns: Module●普通内科、产科、儿科、外科和麻醉、创伤、烧伤临床用血：模块●The clinical use of blood: CD-ROM●临床用血：CD-ROM●Aide-memoire: Quality systems for blood safety●备忘录：血液安全质量体系●Quality management training for blood transfusion services: Facilitator’s toolkit (5 books, 15 modules, CD-ROM)●输血服务质量管理训练：辅助工具包(5本书，15个模块，CD-ROM)●Distance learning in blood safety: Flyer●血液安全远程教育：传单●Establishing a distance-learning program in blood safety: A guide for program coordinator●建立输血安全远程教育项目：项目协调指导●Safe blood and blood products: Distance-learning materials (five modules)●血液和血液制品安全：远程教育模块(5个模块)  - Safe blood and blood products: Trainer’s guide  -血液和血液制品安全：教员手册  - Introductory module: Guidelines and principles for safe blood-transfusion practice  -引导模块：安全输血实践指南和规则  -Module 1: Safe blood donation  -模块1：安全献血  -Module 2: Screening for HIV and other infectious agent  -模块2：HIV和其他感染病原体筛查  -Module 3: Blood-group serology  -模块3：血型血清学Clean Care is Safer Care (http://www.who.int/gpsc/en/)清洁护理是安全护理HAI prevention control, and in particular, surveillance and prevention of the endemic burden of HAIs, with special focus on hand医院感染预防控制，特别是对医院感染的监测与预防的地方负担及手的特别关注●To raise awareness of the burden of HAIs worldwide and the importance of hand hygiene in health care●提高对世界范围的医院感染负担和医疗服务中手卫生重要性的认识●To catalyze political and stakeholders’ commitment to reducing HAIs●为减少医院感染，敦促政府和利益相关者的承诺●To develop technical guidance and recommendations on hand hygiene and infection control measures and to support their implementation in Member States●制定手卫生和感染控制措施的技术规范和建议，支持它们在成员国中实施●To promote and to sustain hand-hygiene improvement at the point of care, through the SAVE LIVES: Clean Your Hands initiative and through a network of hand-hygiene campaigning countries—the CleanHandsNet●促进和维护在护理要点上的手卫生改进，主动参与拯救生命：清洁你的手活动，登录国家手卫生运动网—CleanHandsNet●To undertake reviews and to report updates related to the endemic burden of HAIs and to promote HAI surveillance and data reporting●对医院感染的地区负担进行相关评价和更新报告，促进医院感染监测和数据报告●To evaluate the impact of infection control interventions to reducing the HAI burden, with particular focus on settings with limited resources●评估感染控制干预对降低医院感染负担的影响，特别关注资源有限的机构●To coordinate the development of new approaches for the prevention of surgical site infections●为预防手术部位感染协调发展新方法●To integrate infection control and hand hygiene in the approach to preventing bloodstream infection●将控制感染和手卫生方法结合起来预防血流感染●To support development and strengthening of infection control capacity and knowledge, skills, and behaviors at regional, subregional, and country levels through the provision of tools and materials●通过给区域、次区域、国家层次提供工具和材料，支持发展和强化感染控制的能力、知识、技巧和行为●To develop and to coordinate educational, training, and research activities●发展和协调教育、培训、研究活动●To advise WHO on infection control measures and priorities and integration with patient-safety strategies●建议WHO将感染控制措施、重点与病人安全策略紧密联系在一起●Guidelines on hand hygiene in health care●医疗服务中的手卫生指南●Guide to implementation of the WHO multimodal hand- hygiene improvement strategy●WHO手卫生多模式促进策略实践指南●Hand Hygiene Implementation toolkit (32 tools)●手卫生实践工具包(32套工具)  - Tools for system change   -系统改进工具  - Tools for training and education  -培训教育工具  - Tools for evaluation and feedback  -估计和反馈工具  - Tools as reminders in the workplace  -工作场所提醒工具  - Tools for institutional safety climate  -安全意识制度工具●Hand-hygiene self-assessment framework●手卫生自我评价框架●“Hand Hygiene Moment 1—Global Observation Survey”Summary report●“手卫生重要时刻1—全球观察调查”小结报告●SAVE LIVES：Clean Your Hands Promotional video●拯救生命：清洁你的手推广视频录像●Outline action plan and top 10 tips for country/area campaigns●活动计划和国家/地区活动的10个重要技巧●Using hand-hygiene improvement tools to implement country/area campaigns●在国家/地区活动中实施手卫生改进工具●Report on the endemic burden of HAIs worldwide●报告世界各地的医院感染负担●HAIs fact sheet●医院感染情况说明书●Scientific publications in peer-reviewed journals●期刊科学论文的同行评议 Infection Prevention and Control in Health Care(http://www.who.int/csr/bioriskreduction/infection_control/en/index.html)医疗服务中的感染预防控制HAI prevention and control; in particular, prevention, preparedness, and response to epidemics that can be associated with or amplified by health care医院感染预防控制，特别是预防和准备对应医疗服务相关(或演练)的感染流行●To support IPC capacity building in Member States through technical assistance and development of guidance on core elements for national and local IPC programs●支持成员国感染预防控制的能力建设，对国家和地区的感染预防控制项目通过技术援助和指导基本要点来发展●To provide support to help prevent spread of infectious diseases through development and dissemination of evidence-based infection control measures in health care settings●对在医疗服务机构开展和宣传循证感控措施预防感染性疾病传播的提供支持●To provide IPC tools for health care facility preparedness to respond to pandemics and epidemics●为医疗服务机构应对感染大流行和流行提供感染预防控制工具●To coordinate the Global Infection Prevention and Control (GIPC) Network to foster alignment of policies and to enhance IPC practices worldwide●协调全球感染预防控制网培养智囊团队，提高世界各地感染预防控制能力●To support Member States in responding to outbreak through the WHO Global Outbreak Alert and Response Network(GOARN)●支持成员国应用全球疫情警报与反应系统应对感染暴发●To develop evidenced-based norms and standards for antimicrobial-resistance containment strategies in health care setting●在医疗服务机构制定遏制耐药性细菌战略循证规程和标准●To support infection control preparedness to cope with public health emergencies●支持对突发公共卫生事件的感染控制应对●Prevention of hospital-acquired infection●医院获得性感染的预防●Practical guidelines for infection control in health care facilities●医疗服务机构感染控制实践指南●Infection prevention and control of epidemic- and pandemic- prone acute respiratory diseases in health care WHO interim guidelines and an accompanying set of implementation tools for community and hospital health care facilities●WHO医疗服务中急性呼吸疾病流行暴发感染预防控制临时指南和相应的社区、医院医疗设备实施工具●Interim infection control recommendations for care of patients with suspected or confirmed filovirus (Ebola, Marburg) or hemorrhagic fever●对丝状病毒(埃博拉病毒、马尔堡病毒)或出热血的疑似或确诊病人护理的感染控制临时建议●Core components for IPC programs and an accompanying set of implementation tools for national and local programs●国家和地区的感染预防控制项目的主要内容和相应的实施工具●WHO policy on tuberculosis (TB) infection control in health care facilities, congregate setting, and household●医疗服务机构、娱乐场所和家庭控制结核感染的WHO策略●Natural ventilation for infection control in health care setting●医疗服务机构控制感染的自然通风●Advice on the use of masks in the community setting in Influenza A (H1N1) outbreaks●甲型H1N1流感暴发期间社区使用口罩的建议●IPC during health care for confirmed, probable, or suspected cases of pandemic (H1N1) 2009 virus infection and influenza-like illnesses●2009年H1N1流感病毒感染和流感样疾病期间，对确诊和可疑患者医疗护理的感染预防控制策略Injection safety (http://www.who.int/injection_safety/en/)注射安全Prevention of blood-borne pathogens transmission through unsafe injection practices不安全注射传播血源性病原体的预防●To promote the rational use of injections and safe practices for injections and related procedures, including phlebotomy intravenous, and fingerpick procedures●提倡合理注射和安全及相关规程，包括静脉回血和拨针规程●To produce policies on the prevention of needlestick injuries in HCWs and the use of personal protective equipment (PPE) following accidental stick injuries●制定医务人员预防针刺伤伤害策略，使用个人防护装备防止意外刺伤伤害●To support the implementation of the recommendation for providing hepatitis B vaccine for all HCWs●支持实施为所有医务人员接种乙肝疫苗的建议●To improve access to safety-engineered injection devices and sharps containers●通过安全工程改善注射设备和锐器装置●To promote safe sharps waste management●促进安全锐器废物管理●To provide the secretariat for the “Safe Injection Global Network” (SIGN), which aims to achieve safe and appropriate use of injections throughout the world●设置“安全注射全球网”秘书处，达到在全球安全合理使用注射的目的●First, do no harm: Introducing auto-disable syringes and ensuring injection safety in immunization systems of developing countries●基本的无伤害：在发展中国家推介自限式注射器，建立注射安全保护制度。●WHO best practices for injections and related procedures toolkit●WHO注射最佳实践和相关规程工具包●WHO guidelines on drawing blood: Best practices in phlebotomy●WHO采血指南：静脉穿刺最佳实践●Revised injection-safety assessment tool●改进安全注射评估工具●Communication strategy for the safe and appropriate use of injection●安全和合理使用注射传播策略●The injection-safety policy planner●注射安全策略规划者●Guiding principles to ensure injection-device security●确保注射器械安全指导原则●Guide to supervising injection providers●监测注射提供者指南●SIGN 2010 meeting report●SIGN 2010年会议报告Occupational Health (http://www.who. Int/occupantional_health/topics/hcworkers/en/index.html)职业卫生Prevention of HAIs among HCWs医务人员的医院感染预防●To promote the protection of occupational health of HCWs and the greening of the health sector (for example, less toxic disinfectants, natural ventilation)●提倡对医务人员的卫生职业保护和卫生部门的绿化工作(例如：低毒性折消毒剂、自然通风)●To support the hepatitis B immunization campaign for HCWs (linked in regions to vaccination week and other vaccine-preventable diseases)●支持对医务人员进行乙肝免疫活动(与地区免疫周和其他接种预防疾病相联系)●To reduce the exposure to HIV and other sharps-related infection (hepatitis B and C) associated with injections in HCWs●降低医务人员与注射相关的HIV和其他锐器相关感染(HBV、HCV)的暴露●To review and to report data on global burden of disease from sharps injuries to HCWs●评价和报告医务人员因锐器伤引起的全球疾病负担的数据●Joint WHO-ILO-UNAIDS policy guidelines for improving HCW access to HIV and TB prevention, treatment, care, and support services●提高医务人员对HIV的预防、治疗、护理和后勤保障的WHO-ILO-UNAIDS联合策略指南●Occupational health: A manual for primary HCWs●职业卫生：医务人员基本手册●Role of occupational health nurse in the workplace●工作场所职业保健护士的角色●Protecting HCWs—preventing needlestick injuries tool kit●保护医务人员—预防针刺伤伤害工具包●Joint WHO/ILO guidelines on postexposure prophylaxis (PEP) to prevent HIV infection●HIV暴露后感染预防WHO/ILO联合指南Safe Surgery Saves Lives(http://www.who.int/patientsafety/safesurgery/en/index.html)手术安全，拯救生命Reduction of complications due to surgery, including surgical site infections (SSI)减少手术期并发症，包括手术部位感染(SSI)●To improve the safety of surgical care around the world by ensuring adherence to proven standards of care in countries●在所有国家确保遵守明确的护理标准，在世界范围提高手术护理安全质量●To contribute to the prevention of SSIs through the use of the WHO surgical-safety checklist●使用WHO手术安全一览表，促进对SSIs的预防●WHO surgical-safety checklist●WHO手术安全一览表●Checklist implementation manual●一览表实施手册Water Supply, Sanitation, and Hygiene Development (http://www.who.int/water_sanitation_health/hygiene/en/)水供应，环境和卫生发展Promotion of environmental health in health care settings; in particular, safe health care waste management做好医疗服务机构的环境卫生，特别是医疗废物的安全管理●To support the development and implementation of national policies, guidelines on safe practices, and training and promotion of effective messages in a context of healthy settings●支持发展和实施国家关于安全工作的政策和指南，为建立健康的环境，营造和推广有效措施●To develop technical guidance on environmental health standard in health care●建立医疗服务环境卫生标准技术指南●To develop technical guidance materials for assessing the quantities and types of waste produced in different facilities●建立不同机构产生废物的数量和类型评估材料技术指南●To develop national health care waste-management guidelines●建立国家医疗服务废物管理指南●To build capacity at national level to enhance the way health care waste management it dealt with in low-income countries●在低收入国家建立提高医疗废物管理处理能力的国家机制●Safe health care waste management: Policy paper●医疗废物安全管理：政策文件●WHO core principles for achieving safe and sustainable management of health care waste●WHO关于实施医疗废物安全及可承受管理的基本原则Management of solid health care waste at primary health care centers: A decision-making guide●基层医疗机构固体医疗废物管理：一个决策指南●Essential environmental health standards in health care●医疗服务中基本的环境卫生标准●Natural ventilation for infection control in health care setting●医疗机构为控制感染的自然通风●Mercury in health care: policy paper●医疗服务中的汞：政策文件* These documents are all available in PDF format on the cited website pages related to the corresponding WHO program*这些文件的PDF格式文档全部引用于WHO相关项目的网站上






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References参考文献1. World Health Organization. Report on the Burden of Endemic Health Care-Associated Infection Worldwide. 2011. Accessed 26 Sep 2011. http://whqlibdoc.int/publications/2011/9789241501507_eng.pdf.2. World Health Organization. Quality of Care: Patient Safety (Resolution WHA55.18). 18 May 2002. Accessed 26 Sep 2011. http://apps.who.int/gb/archive/pdf_files/WHA55/ewha5518.pdf.3. World Health Organization. Quality of Care: Patient Safety. 23 Mar 2002. Accessed 26 Sep 2011. http://apps.who.int/gb/archive/pdf_files/WHA55/ea5513.pdf4. World Health Organization. International Health Regulations. 2008. Accessed 26 Sep 2011. http://apps.who.int/ihr/9789241596664/en/index.html.5. Feldmann H, Geisbert T, Kawaoka Y. Filoviruses: Recent advances and future challenges. J Infect Dis. 2007 Nov 15; 196 Suppl 2:S129-1306. Jeffs B, et al. The Medecins Sans Froutieres intervention in the Marburg hemorrhagic fever epidemic, Uige, Angola, 2005. I. Lessons learned in the hospital. J Infect Dis. 2007 Nov 15; 196 Suppl. 2:S154-161.7. Pruss-Ustun A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med. 2005 Dec; 48(6):482-490.8. World Health Organization. World Health Day 2011: Policy Briefs. Accessed 26 Sep 2011. http://www.who.int/world-health-day/2011/policybriefs/en/index.html.9. World Health Organization. Emerging and Other Communicable Disease Antimicrobial Resistance (Resolution WHA51.17). 11-16 May 1998. Accessed 26 Sep 2011. http://apps.who.int/medicinedocs/index/assoc/s16334e/s16334e.pdf.10. World Health Organization. Ameliorer l’endiguement de la resistance aux autimicrobiens (Resolution WHA58.27). 25 May 2005. Accessed 26 Sep 2011. http://apps.who.int/gb/ebwha/pdf_files/WHA58/WHA58_27-fr.pdf.11. World Health Organization. Prevention and Control of Influenza Pandemics and Annual Epidermics (Resolution WHA56.19). 28 May 2003. Accessed 26 Sep 2011. http://www.who.int/immunization/sage/1_WHA56_19_Prevention_and _control_of_influenza_pandemics.pdf.12. World Health Organization. Strengthening Pandemic-Influenza Preparedness and Response (WHA58.5). 23 May 2005. Accessed 26 Sep 2011. http://apps.who.int/gb/ebwba/pdf_files/WHA58/WHA58_5-en.pdf.13. World Health Organization. Prevention and Control of Multidrug-Resistant Tuberculosis and Extensively Drug-Resistant Tuberculosis (WHA62.15). 22 May 2009. Accessed 26 Sep 2011. http://apps.who.int/gb/ebwha/pdf_files/A62/A62_R15-en.pdf.14. World Health Organization. Viral Hepatitis (WHA63.18). 21 May 2010. Accessed 26 Sep 2011. http://www.worldhepatitisalliance.org/Libraries/Documents/2010_WHO_Viral_Hepatitis_Resolution.sflb.ashx.15. World Health Organization. Infection Prevention and Control in Health Care: Time for Collaborative Action (Em/RC57/6). Oct 2010. Accessed 26 Sep 2011. http://www.emro.who.int/rc57/resolutions.htm.16. World Health Organization. WHO Guidelines on Hand Hygiene Health Care. 2009. Accessed 26 Sep 2011. http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf.17. World Health Organization. Save Lives: Clean Your Hands: Guide to Implementation. Aug 2009. Accessed 26 Sep 2011. http://whqlibdoc.who.int/hq/2009/WHO_IER_PSP_2009.02_eng.pdf.18. Allegranzi B, et al. Burden of endemic health-care-associated infection in developing countries: Systematic review and meta-analysis. Lancet. 2011 Jan 15; 377(9761):228-241.19. World Health Organization. WHO CleanHandsNet—A Network of Campaigning Countries. Accessed 26 Sep 2011. http://www.who.int/gpsc/national_campaigns/en/.20. World Health Organization. Save Lives: Clean Your Hands-WHO’s Global Annual Campaign. May 2011. Accessed 26 Sep 2011. http://www.who.int/gpsc/5may/en/.21. World Health Organization. The SIGN Alliance. Accessed 26 Sep 2011. http://www.who.int/injection_safety/sign/en/.22. World Health Organization. GIPC Network Launch Meeting and Next Steps. 29 Jul 2011. Accessed 26 Sep 2011. http://www.who.int/csr/bioriskreduction/laboratorynetwork/gipc_next_steps/en/index.html.23. Jha AK, et al. patient safety research: An overview of global evidence. Qual Saf Health Care. 2010 Feb; 19(1):42-47

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Chapter three   Joint Commission International’s Infection Prevention and  Control Standards and Requirements第三章        JCI的感染预防控制标准与要求A Detailed Study详细研究The prevention and control of infection represent one of the most significant safety initiatives for a health care organization. Infections can be acquired in any health care setting, transferred between organizations, or brought in from the community. Because infections are a significant safety risk for patients, other care recipients, and health care workers (HCWs), infection prevention and control (IPC) must be high on every organization’s list of priorities.感染的预防控制代表着一个医疗服务组织最为有效的安全措施。感染能从任何医疗服务机构中获得，能在机构之间传播的，或来自社区。由于感染是对病人、其他需要护理的人员和医务人员最大的安全危害，感染的预防控制必须列为任何医疗机构最为重要的事项。To help organizations focus on IPC issues and address related challenges, Joint Commission International (JCI) has developed IPC and related standards in all of its accreditation and certification programs as follows:为帮助医疗机构关注感染预防控制问题及应对相关挑战，国际医疗卫生机构认证联合委员会(JCI)已制定了感染预防控制策略和相关标准，所有评审和认证计划如下：●Ambulatory Care: Infection Control and Facility Safety (IFS; partial chapter)●非住院医疗：感染控制和机构安全 (IFS；部分章节)●Clinical Laboratories: Resource Management and Laboratory Environment (RSM; 1 standard)●临床检验室：资源管理和实验室环境(RSM；1个标准)●Home Care: Infection Prevention and Control (IPC; entire chapter)*●家庭治疗：感染预防控制(IPC；全部章节)*●Hospitals: prevention and Control of Infections (IPC; entire chapter)●医院：感染的预防与控制(IPC；全部章节)●Long Term Care: Infection Prevention and Control (IPC; entire chapter)*●长期护理机构：感染预防控制(IPC；全部章节)*●Medical Transport: Exposure to and transmission of Biologic and Chemical Agent (BCA; entire chapter)●医疗运转：生物或化学因子的暴露与传播(BCA；全部章节)●Primary Care: Organization and Delivery of Services (ODS; chapter portion on IPC)●初级治疗：服务的机构与运转(ODS；IPC部分章节)●International Patient Safety Goal 5(IPSG.5)—Reduce the Risk of Health Care-Associated Infections (goal applicable for all accreditation and certification programs except Medical Transport)●国际病人安全目标(IPSG.5)—降低医疗相关感染的危险(目标适用于除医疗运转外的全部评审和认证计划)The purpose of this chapter is to provide an in-depth look at JCI IPC requirements. A complete list of all JCI IPC requirements at the time of this publication is provided in Appendix 1. For the current IPC requirements regarding any JCI accreditation or certification programs, please consult the applicable JCI comprehensive accreditation or certification manual or access JCI accreditation and certification Web page at http://www.jointcommissionintern ... ification-Process/.这一章的目的是提供一个JCI对感染预防控制要求的详细说明。本书出版时JCI对感染预防控制要求一览表见附录1。有关JCI评审与认证计划对于感染预防控制的最新要求，请查阅可实施的JIC综合评审与认证手册或登录JCI评审和认证网页：http://www.jointcommissioninternational.org/Accreditation-and-Certification-Process/.Please note: the majority of organizations surveyed by JCI are hospitals—three out of four organizations, as of the publication of this book—and as a result, the JCI hospital standards are used as the foundation of much of this chapter and Chapter 4. However, it is important to note that JCI accreditation standards are similar in theme, tone, and detail across accreditation and certification programs, and therefore, JCI requirements are similar no matter the accreditation and certification programs.请注意：JCI机构检查的主要是医院，4个机构中的3个，出版这本书，作为一个结果，JCI医院标准作为一个基础更多的应用在这一章和第4章。然而，重要的是要注意JCI评审标准都是相似的主题、语气，详细地贯穿于评审和认证计划中，因此，JCI的要求都是相似，不管什么评审和认证计划。It is also important to note that for the sake of the following discussion, only JCI requirements with direct application to IPC are noted. Many JCI standard could and do apply indirectly to the concepts discussed below, but only those requirements specific to prevention and control of infection are noted,同样重要的是要注意，为了下面的讨论，JCI要求仅直接到感染预防控制应用中指出。许多JCI标准可以或间接适用于以下概念的讨论中，但要指出的是那些具体要求仅是用于感染预防控制。* At the time of publication, the first edition of the JCI Home Care and Long Term Care manual were being developed for publication in January 2012. Standards for both programs were derived from JCI’s Care Continuum standards and will be in effect starting 1 July 2012. For the current status of these initiatives, visit the JCI Accreditation website (http://www.jointcommissioninternational.org/Accreditation-and-Certification-Process/) or e-mail JCI Accreditation at JCIAccreditation@jcrinc.com.*本书出版时，JCI家庭护理和长期护理手册第一版编写出版于2012年1月。这两个计划的标准来自于JCI护理连续标准并将于2012年6月1日开始生效。对这些举措的当前现状，请访问JCI评审网站(http://www.jointcommissioninternational.org/Accreditation-and-Certification-Process)或JCI评审电子邮箱JCIAccreditation@jcrinc.com。

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JCI RequirementsJCI要求Most JCI Requirements are in the form of standards, which were created to respond to requests from the international community for external, objective, standard-based ways to evaluate health care practices and organizations. The goal of the accreditation program is to stimulate demonstration of continuous, sustained improvement in health care organizations by applying international consensus standards and indicators. JCI standards require a focused look at IPC across an organization and have an underlying philosophy of quality management, continuous quality improvement, and patient safety. These standards guide the organizations leadership to establish and to maintain a comprehensive, integrated IPC program that is adequately supported and well managed.许多JCI要求以标准为形式，为回应来自国际社会适合于国际的、客观的、基于标准的方式来评估医疗服务实践和机构的要求而创建标准。评审计划的目标是促进连续论证医疗服务机构对应用国际共识的标准和指标的持续改进。JCI标准要求集中关注贯穿一个机构的感染预防控制策略及其质量管理、持续质量改进、病人安全的基本理念。这些标准指导机构的领导去建立和维护一个全面的、互相协调的，充分支持和管理有序的感染预防控制策略。JCI standards discuss the components of a comprehensive IPC program and the resources and support systems necessary to successfully implement such a program. There are three parts to the JCI standard: the standards, intent statements, and measurable elements.JCI标准讨论一个完整的感染预防控制策略计划和保证这一计划成功实施的资源和支持系统。JCI标准有三个部分：标准、含义说明和衡量要素。Standards标准JCI standard define the performance expectation, structures, or functions that must be in place for IPC. These standards were developed using a consensus process with a task force of international experts. The standards are based on accreditation experiences during recent years in more than 40 countries. The standards are validated through accreditation surveys and designed to incorporate local or national laws and regulations. JCI has determined that organizations being surveyed must satisfactorily meet the requirements of all standards for the prevention and control of infection to achieve accreditation. These standard are designed to create a culture of patient safety and to lead organizational to best-practice levels to protect fundamental patient and family rights, to reduce risks during patient care processes, and to enhance a safe environment where care is provided.JCI标准为感染预防控制策略定义必要的业绩期望、结构或功能。这些标准是由一个国际专家特别小组形成共识制定的。标准建立在近年来经40多个国家体验认可的基础上。标准是通过评审调查设计，包括地区和国家的法律法规确定的。JCI确认的机构被认为是令人满意的，符合全部感染预防控制标准，已达到评审要求。这些标准设计为创建病人安全文化及保护病人和家属的基本权利、降低病人治疗期间的危险和提供一个安全治疗环境，引导机构达到最佳实践的层次。A 12-member International Standard Subcommittee composed of experienced physicians, nurses, administrators, and public-policy experts, guides the development and revision process of the JCI standards. The subcommittee consists of members from six major world regions: Lain America and the Caribbean, Asia and the Pacific Rim, the Middle East, Central and Eastern Europe, Western Europe, and Africa. The work of the subcommittee is refined based on an international field review of the standards and the input from experts and others with unique content knowledge.国际标准小组委员会由12位具有丰富经验的医师、护士、管理人员和公共政策专家组成，指导JCI标准的制定和修改工作。小组委员会组成成员来自6个主要的世界区域：拉丁美洲和加勒比海地区、亚洲和泛太平洋地区、中东、中欧和东欧、西欧、非洲。小组委员会的工作是对基于标准的国际现场调查评价与专家及其他人一些独特的知识内容融合到炉火纯青的地步。Intent Statements含义说明A standard’s intend statement helps explain the full meaning of the standard. The intent describes the purpose and rationale of the standard, providing an explanation of how the standard fits into the overall program, sets parameters for the requirement(s), and otherwise “paints a picture” of the requirements and goals.一个标准的含义说明是对标准的完整意思作说明。含义描述了标准的用途和基本原理，提供一个标准如何适应总体计划的解释，为要求设置参数，在其他方面为要求和目标“画一幅图”。Measurable Elements衡量要素Measurable elements of a standard indicate what is reviewed and assigned a score during the survey process. The measurable element(s) for each standard identify the requirements for full compliance with the standard. The measurable elements are intended to bring clarity to the standards and to help the organization fully understand the requirements, to help educate leaders and HCWs about the standards, and to guide the organization in accreditation preparation.标准中的衡量要素是指在检查过程中对所检查要素的评价，并给予一个评分。每个标准中的衡量要素是指满足标准的全部要求。衡量要素是对标准清楚的说明，帮助机构完整理解要求，用标准去帮助培训领导和医务人员，在准备评审过程中对机构进行指导。Examples of the standards, intent statements, and measurable elements are found throughout this book (see, for example, Box 3-1). The standard are update approximately every three years based on the ongoing assessment of science, contemporary health care practice, available technology, quality and patient-safety practices, and other information.标准、含义说明、衡量要素的例子贯穿本书(例子见插入框3-1)。标准基于对科学、当时的医疗服务实践、有效的技术、质量、病人安全实践和其他信息不断地评估，大约每三年进行更新。

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Box 3-1.  Example of JCI Standard, Intent, and Measurable Element插入框3-1.  JCI标准、含义、衡量要素的例子Standard PCI.1PCI标准. 1One or more individuals oversee all infection prevention and control activities. This individual(s) is qualified in infection prevention and control practices through education, training, experience, or certification.一名或多名在监管整个的感染预防控制活动。这些人员通过教育、培训、实践或认证获得感染预防控制资格。Intent of PCI. 1PCI含义. 1The infection prevention and control program has oversight appropriate to the organization’s size, level of risk, complexity of activities, and the program’s scope. One or more individuals, acting on a full-time or part-time basis, provide that oversight as part of their assigned responsibilities or job descriptions. Their qualification depends on the activities they will carry out and may be met through感染控制与预防项目的监管要与医疗机构的规模、风险水平、医疗工作的复杂性及该项目工作范围相适应。监管由一名或多名全职或兼职人员负责，并将这项工作作为其部分责任或岗位描述。他们的资质取决于所需要完成的工作，并通过以下几方面达到●education;●教育；●training;●培训；●experience;●实践；●certification or licensure.●认证或核发执照。Measurable Elements of PCI. 1PCI衡量要素. 1 □1. One or more individuals oversee the infection prevention and control program.□1.一名或多名人员监管感染控制项目□2. The individual(s) is qualified for the organization’s size, level of risks, and program scope and complexity□2.人员资质符合医疗机构规模、风险水平、项目范围及复杂性□3. The individual(s) fulfills program oversight responsibilities as assigned or description□3.人员能胜任所分配的岗位描述的项目监管责任

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Components of a Comprehensive IPC Program一个完整IPC项目的组成The goal of an organization’s infection surveillance, prevention, and control program is to identify and to reduce the risk of acquiring and transmitting infections among patients, HCWs, contract workers, volunteers, students, and visitors.一个机构的感染监测、预防和控制项目的目标是监管和降低病人、医务人员、雇员、志愿者、学生和来访人员中获得和传播感染的风险。IPC programs differ from one organization to another, depending on the organization’s geographic location, community, socioeconomic and physical environment，patient volume, populations served, types of clinical activities, and number and education of employees. Effective programs include identified leaders, appropriate policies and procedures, HCW education, coordination throughout the organization, and systems to identify risks and to intervene to minimize or to eliminate infections.感染预防控制项目一个机构与另一个机构的不同，取决于机构的地理位置、社区、社会经济和自然环境，病人量，总体服务，临床工作的种类及员工的数量与教育。影响项目的因素包括领导认识，评审办法和规程，医务人员的教育，整个机构的协调，确定风险和使感染最小化或消除的干预体系。The JCI hospital IPC standard are organized into the following six major sections:JCI医院感染预防控制项目由下列六个主要部分组成：1. Program Leadership and Coordination1.项目的领导和协调2. Focus of the Program2.项目的要点3. Isolation Procedures3.隔离规程4. Barrier Techniques and Hand Hygiene4.屏障技术和手卫生5. Integration of the Program with Quality Improvement and Patient Safety5.项目对质量改进与病人安全的整合6. Education of Staff About the Program6.针对项目的工作人员教育As mentioned earlier in this chapter, other JCI accreditation programs also have IPC requirements listed. Where those requirement overlap with JCI hospital standard is note below.正如本章前面提到的，其他的JCI评审项目也有感染预防控制要求事项，那些要求与下面的JCI医院标准有部分重叠。Program Leadership and Coordination项目的领导和协调Applicable JCI Standard可实施的JCI标准The following JCI standard are directly applicable this section of text. For complete standard and further compliance information, see Appendix 1下列JCI标准可直接应用于本段。全部的标准和进一步可遵循的信息，见附录1。Ambulatory case非住院医疗IFS.1 through IFS.4Clinical Care Program (Certification)临床医疗项目(认证) Clinical Laboratories临床检验室 Home Care家庭治疗IPC.1 through IPC.3Hospitals医院IPC.1 through IPC.4Long Term Care长期护理机构IPC.1 through IPC.3Medical Transport医疗转运BCA.1 through BCA.3Primary Care初级医疗ODS.27through ODS.29