Hands Of Medical Staff Research Articles

Virucidal activity of oral, hand, and surface disinfectants against respiratory syncytial virus

Respiratory syncytial virus (RSV) is known as a major cause of respiratory tract infection in adults and children. Human to human transmission occurs via droplets as well as direct and indirect contact (e.g. contaminated surfaces or hands of medical staff). Therefore, applicable hygiene measures and knowledge about viral inactivation are of utmost importance. Here, we evaluated the virucidal efficacy of oral rinses specifically designed for children, WHO-recommended hand rub formulations and ethanol as well as 2-propanol against RSV in a quantitative suspension test (EN14476). Furthermore, we assessed the stability of RSV on stainless steel discs and investigated its inactivation by different surface disinfectants (EN16777). We observed that all tested oral rinses except one reduced infectious viral titres to the lower limit of quantification. The two WHO-recommended hand rub formulations as well as 30% ethanol and 2-propanol completely abolished the detection of infectious virus. Infectious RSV could still be recovered after several days on stainless steel discs. However, RSV could efficiently be inactivated by all tested surface disinfectants based on alcohol, aldehyde, or hydrogen peroxide. In conclusion, oral rinses, all tested hand rub formulations as well as surface inactivation reagents were sufficient for RSV inactivation in vitro.

How to reduce the exposure risk of medical staff from SARS-CoV-2 by reducing environmental contamination: Experience from designated hospitals in China.

Using daily monitoring of environmental surfaces and personal protective equipment (PPE), we found an increase in environmental contamination since August 18, 2021, in a designated hospital for COVID-19 patients in China, which may lead to an increased risk of exposure to medical staff. To investigate the cause of increased environmental contamination and effect of our intervention, we obtained environmental samples at pre-intervention (August 18-21, 2021) and post-intervention (August 22-28, 2021) from six infection isolation rooms with windows for ventilation and other auxiliary areas at 105 and 129 sites before routine daily cleaning, respectively. In addition, we obtained PPE samples from 98 medical staff exiting the patient rooms/contaminated areas at 482 sites. Between August 22 and 24, 2021, we took measures to reduce environmental contamination based on sampling and inspection results. At pre-intervention, the positivity rates for contamination of environmental surfaces and PPE samples were significantly higher for critical patients (37.21 and 27.86%, respectively) than severely ill patients (25.00 and 12.50%, respectively) and moderately ill patients (0.00 and 0.00%, respectively) (Pearson's Chi-square: χ2 = 15.560, p = 0.000; Fisher's exact test: χ2 = 9.358, p = 0.007). Therefore, we inferred that the source of contamination of environmental surfaces and PPE was mainly the room of critically ill patients, likely through the hands of medical staff to the potentially contaminated areas. A critically ill patient had emergency tracheal intubation and rescue on August 18, 2021, due to worsened patient condition. The ventilator tube used for first aid did not match the ventilator, and the ventilator tube fell off multiple times on August 18-21, 2021, which may explain the increased contamination of environmental surfaces and PPE from critically ill patients, as well as lead to indirect contamination of potentially contaminated areas. The contamination positivity rates of environmental surfaces and PPE were reduced by replacing the appropriate ventilator catheter, limiting the number of people entering the isolation room simultaneously, increasing the frequency of environmental disinfection, standardizing the undressing process, setting up undressing monitoring posts to supervise the undressing process, and preventing the spread of virus infections in the hospital during an epidemic. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was spread on object surfaces in isolation rooms mainly by touch, and the contamination of environmental surfaces and PPE was greater in rooms of patients with greater disease severity and higher surface touch frequency. Therefore, strict protective measures for medical staff, frequent environmental cleaning for isolation rooms, and compliance with mask wearing by patients when conditions permit should be advised to prevent SARS-CoV-2 spread in hospitals.

Analysis of the Application Effect of PDCA Cycle Management Combined With Risk Factor Management Nursing for Reducing Infection Rate in Operating Room.

PurposeTo explore the application effect of plan-do-check-action (PDCA) cycle management combined with risk factor management nursing in an operating room.MethodsA total of 150 surgical patients in our hospital from November 2020 to February 2021 were selected as the conventional group, and 150 surgical patients in our hospital from March 2021 to June 2021 were selected as the research group. The conventional group implemented routine infection management, and the research group implemented PDCA cycle management combined with risk factor management. Detection of pathogenic bacteria, incidence of incision infection, infection control, occurrence of irregular events, and nursing quality in the operating room were observed in the two groups.ResultsThe detection rate of Gram-negative bacillus and Gram-positive cocci, infection rate of incision, and total incidence of irregular events in the research group were lower than those in the conventional group (P < 0.05). The qualified rate of disinfection of object surface, hands of medical staff and air, and nursing quality scores in the research group were higher than those in the conventional group (P < 0.05).ConclusionPlan-do-check-action (PDCA) cycle management combined with risk factor management nursing can reduce the detection rate of pathogenic bacteria and infection rate of incision in the operating room, reduce the incidence of irregular events, improve the qualified rate of disinfection, and greatly improve the quality of nursing, which can be considered to be widely used in clinical practice.

Evaluation of the influence of "Internet+" hand hygiene management model on medical staff's hand hygiene compliance.

Evaluation of the influence of "Internet+" hand hygiene management model on medical staff's hand hygiene compliance.

Design and application of an opening and breaking device of ampoule bottle

Ampoule bottles are common clinical containers forliquid medicine. After use, ampoules occupy a lot of space, which will not only consume a large number of sharp boxes, but also lead to low work efficiency and easy to scratch the hands of medical staff by changing the sharp boxes frequently. In order to overcome the problems mentioned above, the neurosurgery medical staff of Yuechi County People's Hospital designed a new type of ampoule bottle opening and crushing device, and won the national utility model patent. The device includes a bottle-opening structure and a crushing structure, and has both ampoule opening and crushing function, the device is convenient to use, has high safety performance, and is suitable for clinical promotion.

Community health workers in rural Punjab, India: analyzing their role, expectations and challenges

PurposeThis study aimed to analyze the role of community health workers (CHWs) called accredited social health activists (ASHAs) in improving maternal health outcomes in the rural community of Punjab, India. The study also examined the expectations of these workers from the community and identified the problems faced by them in carrying out their roles.Design/methodology/approachUsing multistage sampling, a total of 28 villages were selected from seven districts of Punjab, and from these selected villages, a total of 57 ASHAs working as the interface between the rural community and the public health system and 420 women who had delivered a baby were interviewed.FindingsDesire to earn money was the most prominent reason for joining the community work program, but ASHAs felt overburdened and underpaid compared to their work commitments. Not only was the incentive paid to these workers was insufficient and irregular but they also suffered at the hands of medical staff at public hospitals.Originality/valueWhile exploring the problems experienced by the CHWs, this study recommends opting for a mix of monetary and nonmonetary incentives for acknowledging the work of CHWs. The study is the first of its kind for the state of Punjab battling with a worsening maternal mortality rate (MMR).

The knowledge of nurses about prevention of infections caused by the bacteria Clostridium difficile

&amp;lt;p&amp;gt;Introduction. Clostridium difficile is the leading cause of nosocomial diarrhea, associated with the use of antibiotics. The most common ways of transmitting the infection in hospitals are contaminated surfaces of the premises and the hands of medical staff. Methods. The study involved 68 nurses/technicians employed at the University Hospital Foca in the departments of surgery and internal medicine. As a research instrument, we used a specially designed questionnaire, created by the authors for the purpose of this research. Results. The research showed that 61.8% of respondents knew that hand washing with warm water and soap was considered the most effective prevention of the spread of infections, and 55.88% meant that they used chlorine-based preparations and hydrogen peroxide as the only effective disinfectant. Nurses with a work experience of less than 5 years showed better knowledge than other groups. Conclusion. The knowledge of nurses about the prevention of C. difficile infection is not at a satisfactory level, which indicates the growing need for education of nurses.&amp;lt;/p&amp;gt;

New safety measure for the endoscopic procedures during the COVID-19 pandemic: New STEP.

The novel coronavirus disease (COVID-19) has become prevalent worldwide. As of July 2020, more than 10 million persons were reported to be infected worldwide, and the number of deaths exceeded 500,000. Infection of medical staff continues to be a major problem.1 Endoscopic procedures in particular pose risk of droplet and aerosol infection, and adequate infection control is therefore essential. Many organizations have proposed measures for infection control.2-4 Current infection control protocol consists of the following 3 steps: (1) before the procedure—disinfecting the hands of medical staff before endoscopic examination; (2) during the procedure—wearing appropriate personal protective equipment; and (3) after the procedure—washing the endoscope room and equipment and disinfecting the hands of medical staff.

The application of root cause analysis management in multidrug resistant Acinetobacter baumannii infection in ICU ward

Objective To apply root cause analysis management in multidrug resistant Acinetobacter baumannii infection in ICU ward. Methods Six patients infected with multi-drug resistant Acinetobacter baumannii in ICU ward of our hospital were selected as the study object in February 2018. The instrument and equipment in ICU ward, the surface of bed unit, the diagnosis and treatment instrument, the sanitary ware, hands of medical staff and so on, were sampled. The root cause analysis method was used to find the source of infection and the route of transmission. The root causes of the outbreak of multi-drug resistant Acinetobacter baumannii were summarized and analyzed, and the intervention measures were taken. Results A total of 48 ICU environmental specimens were collected from 6 patients, of which 30 samples were positive showed by etiological examination, and the isolated strains were basically consistent with their drug resistance results (resistance to more than three types of antibiotics). It was inferred that the nosocomial infection of Acinetobacter baumannii in this outbreak was caused by the same pathogen contamination. At the same time, the detection results of Acinetobacter baumannii in ICU environment showed that the contamination of bed units and most of the surface of objects in the ward (the detection rate was 66%-75%), the disinfection and isolation measures not in place, and the non-standard hand hygiene of the staff were the main causes of the outbreak of nosocomial infection. Conclusions The main causes of the spread of multi-drug resistant Acinetobacter baumannii infection of ICU were found by root cause analysis, and the standard manual hygiene and contact isolation standards should be formulated and strictly implemented. It is an effective way to reduce the incidence of nosocomial infection of MDRAB by disinfection and sterilization measures on the surface of objects and the environment in the ward. There were no cases of multidrug resistant Acinetobacter baumannii infection in April 2018. Key words: Root cause analysis; ICU; Multidrug resistance; Acinetobacter baumannii; Nosocomial infection

The role of hospital environment and the hands of medical staff in the transmission of the Clostridioides (Clostridium) difficile infection

This paper attempts to determine the role of the hospital environment in the spread of Clostridioides/Clostridium (C.) difficile infections based on a review of studies published in the medical literature and in the light of the authors' own experiences. Clostridioides/Clostridium difficile has recently attracted more and more attention, not only as an etiological factor of pseudomembranous intestinal inflammation and antibiotic associated diarrhea, but also as an etiologic factor of healthcare-associated infections (HAI) because of the possibility to survive in the hospital environment for a long time. This is caused by the production of spores, whose eradication options are limited. Clostridioides/Clostridium difficile spores are present not only on bedding of infected patients and their other belongings, but also on medical equipment and the hands of medical personnel, constituting a potential source of infection for other patients and some of the staff. The introduction of appropriate procedures for hand hygiene as well as for cleaning and disinfection of hospital surfaces makes it possible to reduce the number of spores and/or eradicate them. These procedures must be strictly followed to reduce the occurrence of spores in the hospital environment and to prevent further spread of C. difficile infections (CDI). Monitoring the presence of the C. difficile spores in a hospital environment using appropriate media (C diff Banana BrothTM) provides additional opportunities for culturing of C. difficile strains and determining ribotypes, especially hyperepidemic ones, which is extremely important from an epidemiological point of view. Med Pr. 2019;70(6):739-45.

Effect of Smart Hand Hygiene Management System on hand hygiene compliance of Intensive Care Unit medical staff

Objective To explore the effect of Smart Hand Hygiene Management System on hand hygiene compliance of Intensive Care Unit (ICU) medical staff. Methods Using convenience sampling method, 106 medical staff in the comprehensive ICU of Tianjin First Central Hospital were selected as the research objects. By deploying Smart Hand Hygiene Management System, medical staff's hand hygiene before and after contacts with patients in the ward were collected automatically, and compliance was calculated. By engineering means, the first month (July, 2018) data collected after removing the system's prompting function was taken as the baseline level, and the month after the system's acousto-optic prompting function was added and working principle training (August, 2018) was taken as the intervening stage. Compare the hand hygiene compliance of selected medical staff before and after intervention. Results The hand hygiene compliance of medical staff was 85.62% after intervention, which was higher than 52.87% before intervention and the difference was statistically significant (P<0.01) . After intervention, the pre-operation compliance increased to 73.90%, and the post-operation compliance increased to 94.94%, which were all statistically different from those before intervention (P<0.01) . Conclusions The application of Smart Hand Hygiene Management System has a significant effect on improving the compliance of hand hygiene performance of medical staff, and the initiatives of performing hand hygiene of medical staff have been greatly improved. Key words: Intensive Care Unit; Hand hygiene; Compliance; Smart Hand Hygiene Management System

Survey and analysis on the general surgery department medical staff hand hygiene compliance in a hospital

Objective To understand the hand hygiene condition and influence factors by researching, evaluating and analyzing the hand hygiene of medical personnel in the general surgery department of hospital. Methods A self-designed hand hygiene knowledge questionnaire was used to investigate 90 medical personnel of general surgery department of our hospital.Among them, there were 32 doctors and 58 nurses. Results 94.44%(85/90) of medical workers knew the seven-step method and 10.00%(9/90) believed wearing gloves can replace hand washing or hand disinfection.There were statistically significant differences in hand-washing rates between doctors and nurses before and after contact with patients and between medical and nursing operations (P<0.05). The average amount of bacteria before and after hand-washing by doctors and nurses was respectively (46.033±4.673)cfu/cm2, (36.281±3.029)cfu/cm2, (8.392±1.065)cfu/cm2 and(5.368±0.573)cfu/cm2. Conclusions By hand washing can effectively remove general surgery medical staff hand most of the bacteria, managers should strengthen the hand hygiene knowledge training and supervision, improve the quality of medical staff hand hygiene consciousness and prevention and control the occurrence of hospital infection. Key words: General surgery; Medical staff; Hand hygiene; Compliance

Dosimetry perspectives in radiation synovectomy

Rheumatoid arthritis (RA) is a chronic inflammatory disease that can potentially damage the synovial joints. One of the effective treatment modality for RA is radiation synovectomy (RSV) where properly selected radionuclide is injected into the joint space, enabling controlled destruction of diseased synovial membrane via radiation exposure. Radiation dosimetry in RSV appears challenging due to the heterogeneous nature of synovial membrane, nonuniform distribution and leakage of radionuclide from the synovial cavity. This article reviews the dosimetric perspective pertaining to RSV. Specifically, characteristics of radionuclide for RSV and radiation dose to target and non-target (i.e., articular cartilage, bone, bloodstream, gonads, etc.) tissues of patient have been discussed. The personal dose Hp(0.07) to the hands of medical staff (i.e., radiochemist, therapist physician, nurse) may be considerably high due to handling of high specific activities (∼500 MBq/ml for Y-90); such doses are typically measured using thermoluminescence dosimeters (TLD) ring dosimeters and ranges from 1 to 21.5, 0.1 to 40 and 0.1 to 5 µSv/MBq for the radiochemist, therapist physician and the nurse, respectively. Methods to minimize radiation doses to the patient, medical staff and public are elaborated. Contamination risks and precautionary measures are also reported.

The efficacy of meticulous process management in control of infections in operating room

Objective To discuss the nursing effect and application value of refinement process of nursing management mode in hospital infection control in the operating room. Methods 620 patients who will carry out surgical treatment were selected as the research subjects.310 cases without detailed process of nursing management were included in the control group, and 310 patients with refinement process of nursing management were selected as observation group.The clinical nursing effects of two groups were recorded. Results Observation group surface 88.94%, medical staff hand 92.54%, disinfectant 95.65%, 100.00% sterile items.The control surface 81.38%, 80.00% of medical personnel hand, disinfectant 75.93%, 90.00% sterile items, the monitoring qualified rate between two groups had statistically significant differences (χ2=5.021, 4.596, 7.581, 6.725, all P<0.05). The sores of nursing safety, operating room management, form filling, ward nursing in the observation group were (95.37±4.66)points, (94.27±5.21)points, (96.13±3.29)points, (95.03±4.87)points.Those in control group were (90.12±2.03)points, (89.13±2.26)points, (90.03±1.88)points, (88.17±2.25)points, the differences between two groups were statistically significant (t=18.185, 15.935, 28.343, 22.514, all P<0.05). The scores of nurses and patients communication, nursing procedures, ward environment, care attitude in the observation group were (24.19±0.87)points, (24.03±0.64)points, (24.51±0.45)points, (24.28±0.36)points.Those in the control group were (21.54±1.65)points, (20.88±1.72)points, (20.95±1.66)points, (21.09±0.89)points, the differences between two groups were statistically significant (t=25.013, 30.220, 36.443, 58.502, all P<0.05). Conclusion Refinement process of nursing management mode application helps to control nosocomial infection in operating room of hospital infection control, improve the quality of clinical nursing services, improve the clinical nursing satisfaction, which is worthy of popularization and application in clinic. Key words: Meticulous process management; Operating room; Infection control

Spread of Staphylococcus aureus between medical staff and high-frequency contact surfaces in a large metropolitan hospital

ObjectiveTo examine whether bacteria are transferred between the hands of medical staff and high-frequency contact surfaces within and between departments of a major metropolitan hospital, and to further analyze the patterns of cross-transmission. MethodsMicrobiological samples were collected from the hands of 112 hospital employees as well as from 120 high-frequency contact surfaces in four hospital departments. Samples were collected on agar plates, analyzed for the presence of Staphylococcus aureus or methicillin-resistant S. aureus (MRSA) by standard microbiology testing, and partially genotyped using pulsed-field gel electrophoresis. ResultsGenetically identical MRSA was identified on the surface of an electrocardiography device in the medical intensive care unit and on the same type of device in the neurosurgical unit. Genetically similar S. aureus was identified on an infusion pump in the medical intensive care unit and on the hands of several doctors in a different department who regularly use that pump. Genetically identical S. aureus was also identified on bedside rail restraint in the medical intensive care unit and on the hands of the nurse in the neurosurgical unit. Finally, genetically similar MRSA was identified both on the surface of an electrocardiography device and on the suction apparatus in the medical intensive care unit. ConclusionCross-contamination of S. aureus or MRSA on medical workers' hands and contact surfaces was demonstrated within and between departments of a large metropolitan hospital. Improvements are needed in medical staff hygiene habits and in the cleaning of high-frequency contact surfaces to help prevent and control nosocomial infections.

The epidemiological investigation of extended-spectrum β-Lactamases-producing Escherichia coli in clinical and environmental samples at the tumor hospital

Objective To analyze the genotypes of extended-spectrum β-Lactamases (ESBL)-producing Escherichia coli (E. coli) and its homology from the clinical and environmental samples at the tumor hospital. Methods The clinical samples (including the patient's blood, urine, sputum, hydrothorax, drainage fluid, stool, etc) and environmental samples (including the air, escort hand, door handles, bed rails, bedside table, medical staff hand) were collected at the Tumor Hospital Affiliated to Zhengzhou University from June 2012 to January 2013. The confirmatory test of ESBL phenotype was performed. β-Lactamase genes (blaTEM, blaSHV, blaOXA, blaCTX and blaFOX) were detected by multiplex polymerase chain reaction (PCR) assays. Pulsed-field gel electrophoresis (PFGE) was used to characterize the homology of all the strains. Results The phenotypic confirmatory test detected a total of 41 ESBL-producing E. coli, among which 36 stains were from clinical specimens (all were from 28 patients) and 5 strains from environmental specimens. Meanwhile, multiplex PCR detection of the genes of ESBL-producing E. coli was performed. TEM-1 or CTX-14 type was predominant in ESBL-producing E. coli carrying one gene. Those carrying two genes were mainly CTX-14 and TEM-1 genes, whereas three genes were CTX-14, TEM-1 and SHV-1. PFGE results showed that the specimens from 28 patients that located in gut or other clinical specimens shared no homology in ESBL-producing E. coli. However, the specimens from 3 patients and 1 patient's bedside table in the first surgical ward shared homology. Conclusions The major epidemic genes of E. coli in our hospital were TEM-1, CTX-14 and CTX-1. The same strain may have many genotypes, mainly with two genes. Exogenous infection may be one major way in ESBL-producing E. coli infection. Key words: Enterotoxigenic Escherichia coli; beta-Lactamases; Pulsed-field gel electrophoresis

Using feedback with adenosine triphosphate (ATP) bioluminescence assay improved the cleanliness of computerized nursing cart

Purpose: The Centers for Disease Control (CDC) recommends hand hygiene as the simplest, most effective method to prevent health care-associated infections. The purpose of this study was to review of literature on effectiveness with hand hygiene strategies in Taiwan medical institution. Methods: A review for relevant published literature in 2004-2014 was undertaken using electronic databases. Databases searched included: Medline, CINAHL, EMBASE, Chinese electronic periodical Service (CEPS), National Digital Library of Theses and Dissertations in Taiwan. Eight studies met the inclusion criteria. Results: Results showed that 8 hand hygiene programs were effective. Hand hygiene strategies such as:Use of alcohol-based hand rubs at the points of patient care. Education program, posters, slogans, revised hand hygiene standard, online self-learning materials, established a monitoring mechanism and enforcement of reward-punishment regulations. To improvement of hand hygiene compliance can effectively transform to the healthcare quality and patient safety in medical centers. Conclusions: These review shows that hand hygiene strategies can increase the medical staff hand hygiene compliance rate and the correction rate of hand hygiene.

Ignaz Philipp Semmelweis: More than antisepsis

Ignaz Philipp Semmelweis, is an actor in one of the most fascinating chapter in the history of preventive medicine discovery of iatrogenic illness. Infection of the genital tract after childbirth and abortion has always been among the leading causes peripartum mortality. This problem reached epidemic proportion in early and mid-nineteenth century, with the development of the maternity ward. Medicine at that time was unknown causal origin (miasma theory) and the causation of disease progression (the theory 'of suppression of lochia' and 'wrongly directed milk'). In 1844., when Semmelweis became an aspirant to the position of assistant of professor Johann Klain at the First Vienna maternity clinic, perinatal mortality was 15,8%, and 1848. increased to 18%. In Second clinic, where they worked only midwives, was only 3%. Semmelweis creates precise statistics, makes number observations on maternity fever, creates and test hypotheses about its causal origin. Challenging the ruling theory, concludes that is the cause of the disease decomposed organic matters (cadaveric particles) who transmitted with hands of medical staff after the autopsy, and that hand disinfection with solution of chlorine lime its incidence can be reduced. Hypothesis is proved in experiments with rabbits. In his time remains unrecognized for refusing to publish their findings, the similarities with the work of English supporters of infection (unrecognized difference between the terms 'infectious' and ' transferable') and high sensitivity of issues. Accepting Semmelweis theory that is every case of puerperal fever caused by absorption of decomposed organic matter, for many would mean a loss of prestige and reputation. A century and half after the death of this great man stands as a lesson 'Semmelweis reflex'- metaphor for tendency that new knowledge and evidence being rejected if they are contrary to the traditional norms, beliefs and paradigms.

Obstetric care providers assessing psychosocial risk factors during pregnancy: validation of a short screening tool - the KINDEX Spanish Version.

BackgroundHigh levels of stress due to diverse psychosocial factors have a direct impact on the mothers’ wellbeing during pregnancy and both direct and indirect effects on the fetus. In most cases, psychosocial risk factors present during pregnancy will not disappear after delivery and might influence the parent-child relationship, affecting the healthy development of the offspring in the long term.We introduce a short innovative prenatal assessment to detect psychosocial risk factors through an easy to use instrument for obstetrical medical staff in the daily clinical practice, the KINDEX Spanish Version.MethodsIn the present study midwives and gynecologists interviewed one hundred nineteen pregnant women in a public health center using the KINDEX Spanish Version. Sixty-seven women were then randomly selected to participate in an extended standardized validation interview conducted by a clinical psychologist using established questionnaires to assesses current stress (ESI, PSS-14), symptoms of psychopathology (HSCL-25, PDS) and traumatic experiences (PDS, CFV). Ethical approval was granted and informed consent was required for participation in this study.ResultsThe KINDEX sum score, as assessed by medical staff, correlated significantly with stress, psychopathology and trauma as measured during the clinical expert interview. The KINDEX shows strong concurrent validity. Its use by medical staff in daily clinical practice is feasible for public health contexts. Certain items in the KINDEX are related to the respective scales assessing the same risks (e.g.PSS-4 as the shorter version of the PSS-14 and items from the ESI) used in the validation interview.ConclusionsThe KINDEX Spanish Version is a valid tool in the hands of medical staff to identify women with multiple psychosocial risk factors in public health settings. The KINDEX Spanish Version could serve as a base-instrument for the referral of at-risk women to appropriate psychosocial intervention. Such early interventions could prove pivotal in preventing undesirable mother-child relationships and adverse child development.

The effect of high-quality nursing management in the control of hospital infects

Objective To explore the clinical effects of high -quality nursing management in the control of hospital infects . Methods High-quality nursing management in the control of hospital infects was implemented in our hospital from April 2012 , before and after implementation monitoring indexes were compared and analyzed including nosocomial infection rate , Hospital environment hygiene rate and medical staff hand hygiene compliance , in order to know about implementation effect .Results After implementing high-quality nurs-ing management, nosocomial infection rate drop 0.67%, hospital environment hygiene rate rose by 0.94%, medical staff hand hygiene compliance rose 8.92%.Conclusions High-quality nursing management can better control hospital infects and improve the quality of medical care . Key words: High-quality nursing; Hospital infects; Effects analysis