Ruef Ch
Abteilung Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich.
Ther Umsch. 2004 Mar;61(3):217-22. doi: 10.1024/0040-5930.61.3.217.
Nosocomial infections are usually considered to be a problem of hospitals. However, outpatient care is also not without risks to the patient or to the healthcare workers. Cases of iatrogenic infections following invasive acts such as intramuscular injections in medical offices have occurred repeatedly and have resulted in malpractice charges against the physicians involved. This illustrates a need for physicians in private practice to establish a concept for the prevention of nosocomial infections in their office. This concept should include patients as well as healthcare workers and must be adapted to the particular setting of the practice. After implementation of such a concept, it will be possible to provide care to all patients--the routine patient, the routine patient undergoing an invasive procedure, the patient who is colonized with a resistant microorganism, as well as the patient who presents himself with an infectious disease--under conditions that minimize the risk of nosocomial infection to the patient as well as to the healthcare workers. The essential elements of such a concept include written guidelines for disinfection, sterilization and personnel protection. Depending on the type of practice, additional guidelines, i.e. guidelines for reprocessing of endoscopes in a gastroenterology practice, will be needed.
医院感染通常被认为是医院的一个问题。然而，门诊护理对患者或医护人员也并非没有风险。在医疗机构进行肌肉注射等侵入性操作后发生医源性感染的病例屡见不鲜，并导致对相关医生的医疗事故指控。这表明私人执业医生有必要在其诊所建立预防医院感染的理念。这一理念应涵盖患者和医护人员，并且必须适应诊所的特定环境。实施这样一个理念后，将有可能在将患者以及医护人员发生医院感染的风险降至最低的条件下，为所有患者提供护理——包括常规患者、接受侵入性操作的常规患者、携带耐药微生物的患者以及患有传染病前来就诊的患者。这样一个理念的基本要素包括消毒、灭菌和人员防护的书面指南。根据诊所类型的不同，还将需要其他指南，例如胃肠病学诊所内镜再处理指南。
