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医疗中心内呼吸护理中心开放式吸痰过程中的气溶胶分布及空气质量长期监测

Aerosol distribution during open suctioning and long-term surveillance of air quality in a respiratory care center within a medical center.

作者信息

Chung Fen-Fang, Lin Hui-Ling, Liu Hsueh-Erh, Lien Angela Shin-Yu, Hsiao Hsiu-Feng, Chou Lan-Ti, Wan Gwo-Hwa

机构信息

Department of Nursing, Chang Gung University of Science and Technology.

Department of Respiratory Therapy, College of Medicine, Chang Gung University.

出版信息

Respir Care. 2015 Jan;60(1):30-7. doi: 10.4187/respcare.03310. Epub 2014 Oct 14.

Abstract

BACKGROUND

The investigation of hospital air quality has been conducted in wards, ICUs, operating theaters, and public areas. Few studies have assessed air quality in respiratory care centers (RCCs), especially in mechanically ventilated patients with open suctioning.

METHODS

The RCC air quality indices (temperature, relative humidity, levels of CO2, total volatile organic compounds, particulate matter [PM], bacteria, and fungi) were monitored over 1 y. The air around the patient's head was sampled during open suctioning to examine the probability of bioaerosol exposure affecting health-care workers.

RESULTS

This investigation found that the levels of indoor air pollutants (CO2, PM, bacteria, and fungi) were below the indoor air quality standard set by the Taiwan Environmental Protection Agency. Meanwhile, the levels of total volatile organic compounds sometimes exceeded the indoor air quality standard, particularly in August. The identified bacterial genera included Micrococcus species, Corynebacterium species, and Staphylococcus species, and the predominant fungal genera included yeast, Aspergillus species, Scopulariopsis species, and Trichoderma species. Additionally, airborne PM2.5, PM1, and bacteria were clearly raised during open suctioning in mechanically ventilated patients. This phenomenon demonstrated that open suctioning may increase the bacterial exposure risk of health-care workers.

CONCLUSIONS

RCC air quality deserves long-term monitoring and evaluation. Health-care workers must implement self-protection strategies during open suctioning to ensure their occupational health and safety in health-care settings.

摘要

背景

医院空气质量调查已在病房、重症监护室、手术室和公共区域开展。很少有研究评估呼吸护理中心(RCC)的空气质量,尤其是在接受机械通气且进行开放式吸痰的患者中。

方法

对RCC的空气质量指标(温度、相对湿度、二氧化碳水平、总挥发性有机化合物、颗粒物[PM]、细菌和真菌)进行了为期1年的监测。在开放式吸痰期间对患者头部周围的空气进行采样,以检查生物气溶胶暴露影响医护人员健康的可能性。

结果

本调查发现,室内空气污染物(二氧化碳、PM、细菌和真菌)水平低于台湾环境保护局设定的室内空气质量标准。同时,总挥发性有机化合物水平有时超过室内空气质量标准,尤其是在8月。鉴定出的细菌属包括微球菌属、棒状杆菌属和葡萄球菌属,主要的真菌属包括酵母、曲霉属、帚霉属和木霉属。此外,在对机械通气患者进行开放式吸痰期间,空气中的PM2.5、PM1和细菌明显增加。这一现象表明,开放式吸痰可能会增加医护人员的细菌暴露风险。

结论

RCC空气质量值得长期监测和评估。医护人员在开放式吸痰期间必须实施自我保护策略,以确保其在医疗环境中的职业健康和安全。

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