Isizathu Esikhulu Sokuthi Kungani Amakhethini Ezibhedlela Alahlwayo Aguqula Kanjani Ukunakekelwa Kwezempilo

Iyalahlwa amakhethini esibhedlela ziguqula ngokuphelele izindawo zokunakekelwa kwempilo. Zinikeza indlela entsha yokulwa nokutheleleka okuhlobene nokunakekelwa kwempilo (ii-HAI). I-HAI ithinta isiguli esisodwa kwezingu-31 zase-US ezibhedlela, okubiza izigidigidi ngonyaka. Lolu shintsho, oluqhutshwa yiabakhiqizi bamakhethini esibhedlela, kuthuthukisa kakhulu ukuphepha kweziguli kanye nokusebenza kahle kwazo. amakhethini egumbi lezokwelapha, kufaka phakathi ikhethini lobumfihlo bezokwelapha imiklamo, manje isici amakhethini alahlwayo.

Izinto Ezibalulekile Okufanele Uzicabangele

• Amakhethini asesibhedlela alahlwayo avimba ukusabalala kwamagciwane. Anezinto ezikhethekile ezibulala amagciwane, okwenza izibhedlela ziphephe kuwo wonke umuntu.
• La makhethini kulula ukuwashintsha. Lokhu konga isikhathi nemali ngoba izibhedlela azidingi ukuwageza. Lokhu kusiza izibhedlela ukuthi zisebenze kangcono.
• Ukusebenzisa Ikhethini elilahlwayos kwenza iziguli nabasebenzi bazizwe bephephile. Bayazi ukuthi isibhedlela sihlanzekile futhi sisebenza kanzima ukuvimbela ukugula.

Isidingo Esiphuthumayo Soshintsho: Kungani Amakhethini Esibhedlela Endabuko Ehluleka

Izindawo zokunakekelwa kwempilo zendabuko zivame ukuthembela emikhubeni, nakuba yake yaba ejwayelekile, manje eletha izinselele ezinkulu ekulawulweni kokutheleleka kwesimanje. Amakhethini ezibhedlela zendabuko, ikakhulukazi, abeka ingozi enkulu. Avame ukuba yizindawo zokuzalela izifo eziyingozi, enze imizamo yokuhlanza ibe nzima, futhi adale imithwalo yokusebenza efihliwe yezikhungo zokunakekelwa kwempilo. Ukuqaphela la maphutha kubalulekile ekuqondeni amandla okuguqula ezinye izindlela ezingasetshenziswa.

Amakhethini Esibhedlela Sendabuko Njengezindawo Zokugcina Izifo Ezingabonakali

Amakhethini endabuko asesibhedlela, aklanyelwe ubumfihlo besiguli, ngokungaqondile aba izindawo zokugcina izinto ezincane eziyingozi. Lezi zithiyo zendwangu, ezivame ukuthintwa abantu abaningi, ziqoqa ngokushesha izinhlobo ezahlukene zezifo ezihlobene nokunakekelwa kwempilo. Izifundo zibonisa njalo ukungcola okusheshayo. Isibonelo, abacwaningi bathole ukuthi amakhethini endabuko asesibhedlela abonise ukungcola ngamagciwane abangela izifo njenge-MRSA ne-VRE phakathi nesonto elilodwa nje lokusetshenziswa.

Izinhlobo zamagciwane atholakala kulezi zindawo ziyakhathaza. Izimbangela ezivame kakhulu zifaka phakathi i-Methicillin-resistant Staphylococcus aureus (MRSA) kanye ne-Vancomycin-resistant enterococcus (VRE). Amanye amagciwane atholakele afaka phakathi I-Staphylococcus aureus, I-Enterococcus spp, kanye nezinduku ze-aerobic gram-negative. Lawa ma-pathogen angaphila ezindaweni zendwangu isikhathi eside. Ucwaningo olulodwa lwembula ukuthi amakhethini asesibhedlela endabuko angama-87% angcoliswa yi-MRSA ngemuva kwezinsuku ezingu-14 kuphela zokusetshenziswa. Olunye ucwaningo oluphelele, oluhlaziya amasampula angu-1,521 avela kumakhethini obumfihlo, luthole ukuthi ama-22% ahlolwe ukuthi ane-multidrug-resistant organisms (MDROs). Ngaphakathi kwala ma-MDRO, i-vancomycin-resistant enterococci (VRE) ivele kuma-culture angu-13.8%, amabhaktheriya e-gram-negative amelana nemithi kuma-6.2%, kanye ne-methicillin-resistant. I-Staphylococcus aureus (MRSA) ngo-4.9%. Lokhu kuba khona okuqhubekayo kwamagciwane ayingozi kugqamisa indima ebalulekile edlalwa amakhethini endabuko ekudlulisweni kwezifo.

Izinqubo Zokuhlanza Ezingasebenzi Kahle Zamakhethini Ezibhedlela

Izindlela zokuhlanza amakhethini ezibhedlela zendabuko zivame ukwehluleka ukuvimbela ukusabalala kwezifo. Ayikho indinganiso evamile yokuthi izikhungo kufanele zihlanze kangaki la makhethini. Izikhungo zokunakekelwa kwempilo ezahlukene zisebenzisa izindlela ezahlukene ngokusekelwe ezidingweni zazo ezithile, indawo, imvamisa yokuxhumana, kanye nengozi yokungcola. Iziqondiso ziphakamisa izinguquko ezisheshayo zamakhethini angcolile ngokusobala kanye nalabo abasesimweni sokuhlukaniswa uma iziguli sezihambile. Ezimweni eziqhubekayo, izinguquko zekota noma izincomo ezivela emaqenjini okulawula ukutheleleka zivame ukwenzeka. Kodwa-ke, lezi ziqondiso azisetshenziswa njalo noma azinele.

Izinselele eziningana zivimbela ukuhlanza okuphumelelayo. Izindwangu zamakhethini ziyinkimbinkimbi; zibamba kalula ukungcola okufana nothuli, ukungcola, namabhaktheriya, okungasuswa ngezindlela zokuhlanza ezijwayelekile. Izikhungo zezempilo zihlanza amakhethini ezibhedlela zendabuko kaningi kunezindawo eziqinile, okwenza kube lula ukuthintana. Ukuxhumana okuphezulu kwabasebenzi, iziguli, kanye nezivakashi kuholela ekungcoleni kabusha okusheshayo, njengoba abantu bevame ukuthinta amakhethini ngaphandle kwamagilavu. Ngaphezu kwalokho, imizamo yokuhlanza endlini ivame ukugxila ezindaweni eziqinile ezithintwa kakhulu, ivame ukunganaki ukuhlanzwa okukhethekile okudingekayo kwamakhethini. Lokhu kuqapha kuvumela amabhaktheriya, njenge-MRSA, ukuthi aphile ezindaweni zendwangu isikhathi eside, okuholela ekutheni amakhethini angcoliswe kabusha ngokushesha ngisho nangemva kokuhlanza.

Umthwalo Ofihliwe Wokusebenza Kwamakhethini Esibhedlela Angasetshenziswa Kabusha

Ngaphandle kwezingozi zokutheleleka, amakhethini asesibhedlela angasetshenziswa kabusha abeka umthwalo omkhulu wokusebenza ezikhungweni zezempilo. Ukugcinwa kwawo kuhilela inqubo eyinkimbinkimbi futhi edinga izinsiza. Isikhathi sokuphila sendwangu elukiwe yekhwalithi enhle cishe iminyaka eyishumi, kodwa lokhu kuphila isikhathi eside kuza nezidingo zokuhlanza eziqhubekayo. Isibonelo, eBrithani, amakhethini angasetshenziswa kabusha adinga ukuhlanzwa kuma-degrees angu-60 okungenani njalo ezinyangeni eziyisithupha, futhi ngokushesha uma engcolile. Iziqondiso zase-Australia ziyahlukahluka ngendawo enobungozi, kusukela ekushintsheni okusheshayo ezindaweni ezinobungozi obukhulu kakhulu kuya ekuhlanzweni kwaminyaka yonke ezindaweni ezinobungozi obuphansi.

Inqubo yokuwasha izingubo ngokwayo idla izinsiza eziningi. Ukuwasha izindwangu zasesibhedlela ezingasetshenziswa kabusha kudinga amanzi amaningi, okukhiqiza inani elilinganayo lamanzi angcolile. Ngisho nokwelashwa nokusetshenziswa kabusha kwamanzi angcolile, umsebenzi wokuwasha izingubo udinga ukusetshenziswa kwamandla amakhulu. Nakuba izindwangu ezisetshenziswa kabusha zinikeza isikhathi eside sokuphila kanye nezinzuzo ezithile zemvelo kunezinto ezilahlwayo ngokwenani lemfucuza, inqubo yokuwasha izingubo idla izinsiza eziningi. Isebenzisa amandla namanzi amaningi futhi yengeza amanzi angcolile amaningi emvelweni uma kuqhathaniswa nezinye izindlela ezilahlwayo. Lo mjikelezo oqhubekayo wokususa, ukuwasha izingubo, nokufaka kabusha unezela ezindlekweni zabasebenzi, ubunzima bezinto zokwakha, kanye nomthelela emvelweni, okudala umthwalo ofihliwe ongabonwa yizikhungo eziningi.

Umphumela Oguqukile Wezindwangu Zezibhedlela Ezilahlwayo

Amakhethini asesibhedlela alahlwayo amelela intuthuko ebalulekile ekuhlanzekeni kwezempilo kanye nokusebenza kahle. Abhekana ngqo nokushiyeka kwamakhethini endabuko ngokunikeza izici ezithuthukisiwe kanye nezinqubo ezilula. Lokhu kusungulwa kushintsha kakhulu indlela izikhungo eziphatha ngayo izingozi zokutheleleka futhi zigcine indawo ihlanzekile.

Izakhiwo Ezithuthukisiwe Zokulwa Namagciwane Ezikhaphethini Zesibhedlela Ezilahlwayo

Inzuzo eyinhloko yamakhethini asesibhedlela alahlwayo ilele ezicini zawo ezithuthukisiwe zokulwa namagciwane. Abakhiqizi baklama la makhethini ngezinto ezivimbela ukukhula nokusabalala kwamagciwane, isikhunta, nezinye izinto ezincane. Le ndlela yokuqapha inciphisa kakhulu umthwalo we-pathogen ezindaweni zeziguli.

Ucwaningo lokuhlola lubonise ukwehla okukhulu kwamayunithi okwakha ikoloni lamagciwane (i-CFU/cm²) kumakhethini okuvikela ubumfihlo be-Fantex alwa namagciwane. Ngemva kwamahora angama-24 okungcoliswa ngamagciwane ahlukahlukene, okuhlanganisa I-Pseudomonas aeruginosa, I-Acinetobacter baumannii, i-MRSA, kanye nezinto eziphilayo ezikhiqiza ama-spectrum amaningi (I-Escherichia coli noma I-Klebsiella pneumoniae), la makhethini abonise ukwehla okukhulu uma kuqhathaniswa namakhethini ajwayelekile obumfihlo. Ngaphezu kwalokho, amazinga okungcoliswa kwemvelo anezinhlobo eziningana zamagciwane ayephansi kakhulu kumakhethini e-Fantex ngemuva kwezinyanga ezimbili zokusetshenziswa emnyangweni wezimo eziphuthumayo.

Idatha ikubonisa ngokucacile lokhu kusebenza kahle:

Lokhu kuncipha okukhulu kokuba khona kwamagciwane kuchaza ngqo indawo ephephile yeziguli nabasebenzi.

Ukuhlanganiswa Okungenamthungo Nokushintshwa Okusheshayo Kwamakhethini Ezibhedlela Alahlwayo

Amakhethini asesibhedlela alahlwayo anikeza ukuhlanganiswa nokufakwa esikhundleni okulula okungenakuqhathaniswa, okuthuthukisa kakhulu ukusebenza komsebenzi. Izikhungo zezempilo zingawashintshanisa la makhethini ngaphansi komzuzu owodwa lapho abasebenzi besebenzisa amathuluzi afana nethuluzi le-Grabber. Lesi sivinini sithuthukisa kakhulu amazinga okushintshana kwegumbi leziguli.

Izinzuzo zokuthutha zalezi zinhlelo zokufaka esikhundleni ngokushesha ziningi:

• Ukufakwa Okusheshayo: Abasebenzi bangashintsha amakhethini alahlwayo ngemizuzu embalwa besebenzisa izinhlelo zokushintsha ngokushesha, okusindisa isikhathi esibalulekile.
• Ukuncipha Kwabasebenzi: Ziqeda ukuphathwa kabanzi, ukuhlanzwa, kanye nokufakwa kabusha okudingekayo kumakhethini endwangu yendabuko.
• Imisebenzi Elula: Abasebenzi bangashintsha amakhethini ngokushesha ngaphandle kokuphazamisa ukusebenza kwansuku zonke, bagweme ukubambezeleka ekunakekelweni kweziguli okubangelwa amashejuli okuhlanza aqinile.
• Ukususwa Kokuhlanza OkuyinkimbinkimbiNgokungafani namakhethini endwangu adinga ukuwashwa njalo emazingeni okushisa aphezulu kanye nezikhathi zokushintsha ngokushesha, amakhethini alahlwayo ashintshwa kalula, okususa izinselele zezokuthutha zokuhlanza izingubo.

Lezi zinhlelo zinikeza nezinzuzo ezengeziwe:

• Ilula futhi kulula ukuyifaka: Lesi sici senza kube lula ukushintshwa okusheshayo.
• Kuqiza kahle: Zinciphisa izindleko zokuhlanza izingubo kanye nezabasebenzi ezihambisana namakhethini endabuko.
• Kuqeda Amashejuli Okuhlanza: Zisusa isidingo sezinhlelo zokuhlanza eziqinile, ezithatha isikhathi, nezibizayo zamakhethini endabuko.

Ukuthuthukisa Ukulawulwa Kokutheleleka Ngamakhethini Ezibhedlela Asetshenziswa Kanye

Amakhethini asesibhedlela asetshenziswa kanye kuphela ayitshe lesisekelo lamasu okulawula ukutheleleka anamuhla. Anikeza isinyathelo sokuzivikela ekulweni nokutheleleka okuhlobene nokunakekelwa kwempilo (HAIs) ngokuqinisekisa indawo ehlanzekile njalo.

Amakhethini asesibhedlela alahlwayo anegalelo ekunciphiseni i-HAI ngezindlela eziningana:

• Ziqeda izingozi zokungcoliswa okuxubile.
• Zinciphisa umthwalo wokuwasha njalo.
• Zithuthukisa ukusebenza kahle kwesibhedlela.
• Ziyindlela yokulawula ukutheleleka ngokushesha.

Izikhungo zokunakekelwa kwempilo kumele zibeke iziqondiso ezicacile zokushintsha la makhethini ukuze zisebenze kahle kakhulu. Kunconywa kakhulu ukuthi amakhethini asesibhedlela angasetshenziswa ashintshwe njalo ezinyangeni eziyisithupha, usuku lokufakwa luphawulwe ngokucacile ekhethinini.

Izilungiselelo ezithile zemitholampilo zivame ukudinga izinguquko ezivame kakhulu:

• Izinga Eliphansi le-CDC: Okungenani kanye ngenyanga.
• Ukushintsha Okusheshayo: Kuyadingeka ekungcoleni okubonakalayo, ukungcola, umonakalo, noma ukuthintana negazi/uketshezi lomzimba.
• Izindawo Ezinengozi Ephakeme (Ama-ICU, Amagumbi Okuzihlukanisa)Lezi zindawo zingadinga izinguquko ezivame kakhulu, ngezinye izikhathi masonto onke, ngenxa yobuthakathaka obukhulu kanye namathuba okungcoliswa.
• Amashejuli Enziwe NgokwezifisoIzibhedlela zivame ukwakha amashejuli afanele ngokusekelwe ezingozini zomnyango kanye nezibalo zabantu abagulayo.

Nasi umhlahlandlela ojwayelekile wemvamisa yokufaka esikhundleni:

Izinzuzo Ezibonakalayo: Indlela Amakhethini Ezibhedlela Alahlwayo Aphakamisa Ngayo Ukunakekelwa Kwempilo

Amakhethini asesibhedlela alahlwayo anikeza izinzuzo ezibalulekile. Athuthukisa ukuphepha kwesiguli, alula ukusebenza, futhi athuthukisa ukuzethemba okuphelele ezindaweni zokunakekelwa kwempilo. Lezi zinzuzo ziwenza abe yingxenye ebalulekile yamasu esimanje okulawula ukutheleleka.

Ukuqeda Izingozi Zokungcoliswa Okuhlobene Namakhethini Ezibhedlela Alahlwayo

Amakhethini asesibhedlela alahlwayo anciphisa kakhulu ingozi yokungcoliswa okuxubile. Izifundo zibonisa ukuthi ukusebenzisa amakhethini eziguli alahlwayo kungaholela ekunciphiseni amazinga okutheleleka ngamaphesenti angama-30. Lokhu kuthuthukisa ngqo ukuphepha kwesibhedlela kanye nokulawulwa kokutheleleka. Amakhethini amaningi alahlwayo esimanje anezakhiwo zokulwa namagciwane. Lawa ma-ejenti avimbela ukwanda kwamagciwane, isikhunta, kanye nezinye izinto eziphilayo ezincane. Lokhu kunikeza isendlalelo esengeziwe sokuzivikela ezifweni ezibangelwa amagciwane. Ucwaningo luvame ukukhombisa ukuthi amakhethini obumfihlo emakamelweni eziguli angaba namagciwane, okuhlanganisa nezinhlobo ezingamelana nemithi. Ochwepheshe basikisela ukuthi ukuklama kabusha la makhethini noma ukusebenzisa ezinye izindlela ezilahlwayo kusiza ukuvimbela ukusabalala kwamagciwane.

Ukunciphisa Ukuphathwa Kwezikhungo Nokunciphisa Izindleko Zabasebenzi

Amakhethini asesibhedlela alahlwayo enza kube lula ukuphathwa kwezikhungo futhi anciphise izindleko zabasebenzi. Aqeda isidingo sezinqubo eziningi zokuwasha. Lokhu kusindisa izinsiza ezibalulekile emanzini, emandleni, kanye nasemsebenzini. Nakuba izindleko zokuqala zamakhethini alahlwayo zifana nalezo ezingagezwa, zisebenza kahle ngokuhamba kwesikhathi. Zisusa ukuhlanza okudinga umsebenzi omkhulu kanye nokubulala amagciwane okudingekayo kumakhethini aphinde asetshenziswe. Amakhethini alahlwayo nawo enza kube lula ukugcina impahla. Avame ukuza ngobukhulu bephaneli elilodwa (66”x 105”). Ama-adaptha aseti yenduku avumela ukuphakama kophahla okuhlukahlukene, okuvumela ukusetshenziswa okufanayo kuyo yonke iminyango. Amalebula ekhethini ngalinye lesibhedlela asiza ukulandelela izinsuku zokufaka. Lokhu kuthuthukisa ukuphathwa kwempahla futhi kuqinisekisa ukuhambisana nezinqubomgomo zokuhlanza.

Ukukhulisa Ukuzethemba Kwesiguli Nabasebenzi Ekuhlanzekeni Kwesibhedlela

Amakhethini asesibhedlela alahlwayo anegalelo endaweni yokusebenza ephephile yabasebenzi bezempilo. Anciphisa kakhulu ingozi yokusabalalisa izifo phakathi kweziguli nabasebenzi. Amakhethini endwangu yendabuko angaba namagciwane ngisho nangemva kokuwasha. Amakhethini alahlwayo, aklanyelwe ukusetshenziswa kanye, avimbela lokhu. Izakhiwo zawo zokulwa namagciwane zivimbela ukukhula kwamagciwane ngenkuthalo. Lokhu kudala indawo ehlanzekile yabasebenzi bezempilo. Indlela yokulahla inkunkuma isusa isidingo sokuba abasebenzi baphathe izingubo ezingase zingcoliswe. Lokhu konga isikhathi nezinsiza ngenkathi kunciphisa izingozi zokuchayeka. Ukusebenzisa amakhethini alahlwayo kusiza izikhungo ukuba zinamathele eziqondisweni eziqinile zokulawula ukutheleleka. Lokhu kubonisa ukuzibophezela ekuphepheni kokubili iziguli nabasebenzi.

Amakhethini asesibhedlela alahlwayo abalulekile ekuhlanzekeni kwezempilo kwesimanje. Amelela ukutshalwa kwezimali okunesu ekuphepheni kweziguli kanye nokusebenza kahle kakhulu. Izikhungo ezisebenzisa lobu buchwepheshe ziqinisekisa ikusasa lezempilo elinempilo neliphephile. Lobu buchwepheshe obuthuthukisiwe bamakhethini asesibhedlela buguqula ukunakekelwa kweziguli kanye nokusebenza kahle kwazo.

Imibuzo Evame Ukubuzwa

Amakhethini asesibhedlela alahlwayo avimbela kanjani izifo?

Amakhethini alahlwayo anezakhiwo zokulwa namagciwane. Lezi zakhiwo zivimbela ukukhula kwezifo. Ukufakwa kabusha njalo kususa izindawo ezingcolisiwe, kunciphisa kakhulu izingozi zokungcoliswa okuhlukahlukene.

Ingabe amakhethini asesibhedlela alahlwayo ashibhile kakhulu kunalawo angasetshenziswa kabusha?

Yebo, kunjalo. Amakhethini alahlwayo aqeda izindleko zokuwasha, umsebenzi wokuhlanza, kanye nokufaka kabusha. Lokhu kwenza kube lula ukuphathwa kwesikhungo futhi kunciphisa izindleko zokusebenza zizonke.

Iyini imiphumela yokusebenzisa amakhethini alahlwayo endaweni ezungezile?

Abakhiqizi bavame ukuklama amakhethini angasetshenziswa kabusha ngezinto ezingasetshenziswa kabusha. Ukusetshenziswa kwawo kunciphisa ukusetshenziswa kwamanzi namandla okuhambisana nokuwasha amakhethini angasetshenziswa kabusha. Lokhu kunciphisa umthelela emvelweni.