A Study on Infection Control System at Home Care

在老年人和病人家中，“妥协的主人”越来越多。本研究首先对MRSA的存在、传播途径和传播途径进行了微生物学调查。其次，对美国的感染控制实践和感染控制体系进行了研究，并与日本进行了比较。结果表明：1)MRSA通过院内（机构获得性）感染在患者家中传播。2) MRSA通过被污染的线、内衣和手传播到浴室的门把手、窗户推拉门和地板上。3)通过洗手和消毒液从污染的指尖去除MRSA。用普通消毒液喷洒或擦拭可有效清除病区周围的病原菌。用常规方法去除患者浴缸内的沐浴网的污染非常困难。4)美国的RANN-MED国际家庭保健公司已经将类似的指导方针与疾病预防控制中心的普遍预防措施适用于家庭护理环境。无论诊断结果如何，他们都采取感染控制措施。他们发展为感染控制准备用品或设备，如消毒棉签包用消毒剂润湿。建立了感染控制手册，感染控制制度与医疗保障制度和劳动安全管理相对应。根据我们的研究结果，日本的感染控制需要系统化的家庭护理。因此，本研究建议《神经肌肉疾病家庭照护手册》加入传染病控制项目。

Compromised hosts are getting increase among elderly people and patients at home. This study was, firstly, conducted micro biological investigation on the existence, means of transmission and dissemination on MRSA.Secondly, the study made researches into the Infection control practices and infection control system in the US and compared it with Japan.The findings were as follows :1) Transmission of MRSA to patients at home occurs via nosocomial (Institutional acquired) infection.2) MRSA was spread to door knobs, the pulls of sliding door of window's and floor in bathroom and bath tubs, by means of contaminated line, underwear and hands.3) MRSA was removed from contaminated fingertips by hand washing and disinfectant. Spray of or wipe with common desinfectant were effective for removing the pathogens from the contaminated area surrounding patients'beds. It was much difficult to remove the contamination from net for bathing which support patients in their bathtubs by ordinal methods.4) RANN-MED International Home Health Care Incorporated in the US has adapted the similar guidelines as the CDC's Universal Precautions to home care settings. They exercise the infection control practices regardless of any diagnoses. They develop to prepare supplies or equipment for infection control such as sterilized kit of cotton swab moistened with disinfectant. They have established the manual for infection control, and their infection control system corresponds with medical security system and the labor security mangement.On the basis of our findings, infection control in Japan needs to be systematized on home care nursing. Thus, the Home care nursing manual for neuro-muscular diseases includes the item of infectious control by the recommendation of this study.