Page 4 of 6
Directions of measures of fight and prevention
1. Specific prevention. Vaccination is a strategic direction in fight against GV, diphtheria and tetanus. All health workers, since the 1st course of medical schools and schools are subject to inoculations against GV. Imparting against GV, we at the same time protect physicians from hepatitis D and primary hepatocellular carcinoma. Unfortunately, in our country needs for a vaccine are provided far not completely. Meanwhile experience of Moscow showed that even at coverage of only 75% of number of those who are subject to inoculations among health workers incidence decreases by 4 times.
Time in 10 years it is necessary to carry out a revaccination of medical personnel against diphtheria and tetanus.
As well as in other countries, it is reasonable to impart not imparted and not having measles, a rubella, parotitis.
2. One of the important directions of prevention of infections of VBI of medical personnel — the prevention of artificial infections.
It is necessary to allocate strict observance by medical personnel of measures of individual protection, especially when carrying out the invasive procedures which are followed by pollution of hands blood and other biological liquids.
Measures of individual protection of medical personnel at tsnvaziviy procedures
• Work in rubber gloves, at the increased danger of infection — in two pairs of gloves.
• Use of masks, points, screens.
• Use of masks when processing of the used clothes and tools.
• Careful handling of acute medical tools.
• Not to remove a needle from the used syringe.
• Storage of the used sharp instruments in containers.
• Collecting the needles which fell to a floor a magnet.
• To close microtraumas on hands an adhesive plaster, lifuzoly or napalechniky.
3. In the emergencies connected with real danger of infection in hospitals the emergency prevention (preventive treatment) is shown by antibiotics or himiopreparata. It is appointed at especially dangerous infections (plague, cholera), HIV infection. Depending on a risk degree of parenteral infection LIE - the infection recommends a combination of 3 drugs or one azidothymidine within 4 weeks.
It is important to begin the emergency prevention in the first 24 hours after infection!
During the outbreak of flu and other ORZ for the purpose of the emergency prevention purpose of immunomodulators (immunostimulators) is shown
• Dibazolum, arbidol, and also the drugs having virulitsidny effect (Remantadinum, etc.).
Immunoproofreaders are shown also out of difficult epidemiological situations to health workers with immunodeficiencies.
At the present stage there is a need for development of the program of prevention of VBI at medical personnel of MPI as parts of the State program on prevention of VBI. On the basis of this program it is necessary to develop specific programs in MPI.
The key provision of the program — implementation of a complex of organizational measures, preventive and anti-epidemic actions.
The main directions of development of the program of prevention of VBI at medical personnel
• Screening of medical personnel on existence of an infection:
- at employment, - in a planned order,
- according to epidemiological indications.
• Development of criteria:
- discharges from work,
- restrictions of professional activity.
• Determination of professional risk factors and risk groups in each hospital.
• Development of standard technology of performance of medical and diagnostic procedures.
• Vaccination of medical personnel.
• Organization of dispensary inspection of medical personnel:
- identification and accounting of diseases on the basis of definition of a standard case of VBI:
- definition of criteria of professional infections of VBI,
• treatment of occupational and nonprofessional infectious diseases,
• creation of the database about incidence of personnel and the held events.
• Definition of duties of hospital administration and necessary resources.
• Training of personnel of different types of MPI
- average link,
- junior staff.
Interaction of administration, clinical physicians, the hospital epidemiologist and Gossanepidnadzor, i.e. accurate system of communication within the program of prevention of VBI at medical personnel is extremely important.