VIETNAM MEDICAL JOURNAL N'2 - OCTOBER • 2017 lam sang chiem den 68,5%, khu vyc Can lam
sang va Hanh ehinh ehi ehiem 13,2% va 18,3%.
Cd eau sap xep bo tri nhan lyc nay tai BVOK tinh Bae Giang chya phii hpp theo quy djnh dinh miTc nhan lyc tai Thdng t y 08 cua BYT. Tuy nhien, cac nha lanh dao, quan ly cung tuy vao tinh hinh thyc tien, mue tieu yu tien eiia ed quan de ed quyet djnh ty le nhan lye lam viec tai cae khu vdc dat hieu qua, dac biet la trong tinh hinh dang thieu hut nhan li/c.
2. Nhu cau phat trien nguon nhan ly'c cua BVDK ttnh Bac Giang den nam 2 0 2 0 : BVDK tinh Bac Giang la benh vien tuyen cao nhat trong tinh. Theo ke hoach dypc phe duyet, den nam 2020 BVDK tinh Bae Giang ed quy md 800 giydng benh vdi tren 40 khoa phdng, tuyen dung nhan lyc theo dinh mii'c tai TT 08 eiia BYT, vdi ed eau' nhan lye mire 1,4 CBYT/OIGB, d y kien den nam 2020 la 1.120 CBVC[1]. Theo dd ty le phan bo nhan lyc trong cae khu vyc lam viec trong benh vien nhy sau: 19% nhan lye tai khoi quan ly hanh chinh, 18% nhan lye d khoi can lam sang va khoi lam sang chiem ty le 63%, vdi ed eau nhan lye nhy vay eung rat phii hpp vdi quy dinh ve ed eau'nhan lye tai TT 08 ciia BYT-BNV.
LTdc tfnh so lu'dng can bp nghi hyu td 2015 den 2020 la 52 ngu'di, trong dd chu yeu la DDTH 21 ngydi, cac nhan vien khac 19 ngydi. Ty le nghi hyu trung binh hang nam eua benh vien la 2% tong CBVC. Ket qua bang 4 eho thay so nhan lyc cian bd sung eho benh vien den nam 2020 la 512 nhan lyc, trong dd so nhan lyc vdi chirc danh DD, KTV, HS ran bd sung nhieu nhat, tiep theo ta bac sT va cae thanh phan chu'c danh khae. Nhy vay so lypng can bp can bo sung la rat Idn, do do can xay dyng ke hoach tuyen dung hang nam phij hpp vdi Ip trinh phat trien cua benh vien.
V. KET LUAN
1 . Thii'c trang nguon nhan lu'c cua BVDK f- tinh Bac Giang tOr nam 2 0 1 1 den 2015
- So lypng nhan lye cdn thieu: ty so CBYT/GB \ nam 2011 la 1,11; dypc bo sung, ve hiAi va ehuyen cdng tac den nam 2015 giam edn la 0,9-1 ' (cdn thieu 320 can bp).
- Cd eau nhan lye theo bp phan ehuyen mon i chda hdp ly: nhan lye khoi lam sang eao (68,5%\ - nhan liic khoi can lam sang (18,3%) va khoi quan ly hanli chi'nh (13,2%) thap hdn so vdi qui djnh.
- Cd cau nhan lyc theo chirc danh chuyen >
mdn dydc dieu chinh hdp ly dan qua eae nam, ty le chu^ dat la DSDH/ BS (1/19).
2. Nhu cau phat trien nguon nhan lu'c ciia BVDK tinh Bac Giang den 2020
- Nhu cau nhan lyc den nam 2020 la 1.120 CBYT (dat ty le 1,4 CBYT/IGB).
- Sd nhan lye can bo sung tiT nam 2016 - 2020 la 512 CBYT, trong dd nhu cau BS la 32 ngydi, DSDH la 5 ngydi, DSTH la 14 ngydl, DD, KTV va HS la 406 ngydi va 55 chu'c danh khac cho khdi quan ly hanh chinh.
TAI U | U T H A M KHAO ^ 1. Benh vien da khoa tinh Bac Giang (2013), (h
hoach phat trien Benh vien da khoa tinh Bac Giafig den nSm 2020, Van ban so 263/QH-BV. "{
2 BQ Y te- Bp N6i vu (2007)^ Hddng dan dinh m bien che sd nghiep trong cacedsdy tenha ndifc, Thong tu" lien tich 08/2007/TTLT-BYT- BNV. -%
3 Bo Y te (2015), Phe duyet ke hoach phat firg nhan Idc trong he thong kham benh, cfiiia l}m giai doan 2015-2020. Quyet dmh so 2992/(3B-Bft»..
4. Lu'dng Ngoc Khue (2011), "Thyc trang TigiKfi nhan lu'c Benh vien Viet nam giai doan 20IM- 2010", Tap ehi Y hoe thanh phd Ho Oii'Minh m 15). tr 209-213. *
5. WHO (2006), Working together for Haettfi, The World Heaelth Report, Vlforld Health Organization 1211 Geneva 27, Switzerland E-mail: [email protected]
NGHIEN Ciru TI LE NGHE KEM VA PHAN TICH MOT SO YEU TO NGUY CO 6* TRE DE NON TAI KHOA HOI SU'C SO SINH
BENH VIEN NHI TRUNG U'aNG
Nguyen Phirong Dung*, Lg Thanh Hai*, Do^n Thi Hong Hoa**
TAT ^'^^^ ^°^^ v^ ^^ *^'^P ^^^ ^ ^^^ ^^ " ° " va &e sd sinh la rat can thiet giiip tre hda nhSp vao cong^dong.
Muc tieu eiia nghien cdu nay la xac dinh ti le nghe kem d tre de non dieu tri tai khoa hoi sire sd smh va phan tfch nhuhg yeu to ngiiy cd lien quan den nghe kem. Dol tu'dng va phu'dng phap nghien ctfu:
Nghien cinj mo ta cat ngang dydc tien hanh de xac dinh ti le nghe kem d nhiJng tre dieu trj tai khoa hoi sire sd sinh cua vien Nhi trung u'dng tir 1/2013 aen 10/2016. Chire narig thinh giac se dyde chan doan '"Benh vien Nhi trung ddng
**Benh vien tai mui hong trung ddng Chiu traeh nhiem chinh: Nguyen Phydng Dung Email: [email protected] Ngay nhan bai: 3.8.2017 Ngay ohan bien khoa hoe: 29.9.2017 Ngay duyet bai; 4.10.2017
TAP CHi Y HOC VlgT NAM TAP 459 - T i 1 3 - 3 0 2-2017 nhcl sir dung test do am oc tai (OAE) va dien thinh
H giac than nao (ABR). Ket qua: trong so 264 tre de U non trong nhdm nghien culi, 38 tre nghe kemjl4,4%3,.
,;! Co moi liSn quan thong ke dang chu y giii'a yeu to tuoi
; thia dydi 30,9 tuan (P=0,0149, can nang du'di 1000 f gram (P=0^004) va nhiem triing bao thai (P=0,000) 3 vdi nghe kem. Mat khac, Khong cd moi lien quan Q\da
nghe kem va thd may tren 7 ngay, vang da thay mau, -. tien sir gia dinh c6 ngu'di nghe kem va di tat dau m|t.
i" K€t luan: ChiTc nang thinh giae d tre de non dieu trj
* tai Wioa hoi sire sd sinh can phai du'dc danh gia ngay
^1 khi tre con dang nam vien.
Tu'ldtoa: tre de non, nghe kem, Khoa hoi sut sd sinh.
., SUMMARY
PREVALENCE OF HEARING IMPAIRMENT . OF PREMATURE NEWBORN TO NEONATAL
INTENSIVE CARE U N I T I N NATIONAL PEDIATRIC HOSPITAL AND ANALYZE
RISKS FACTORS
j Early diagnosis of hearing loss and inten/ention in ,, neonates and infants isessential for children integrate
"• into the community. The aim of the present study
» was to assess tlie prevalence of heanng ' npairment in
% premature newborns admitted to a neonatal intensive care unit (NICU) and analyze the assodated nsk factors. Material and method : this cross- sectional study was conducted to assess the prevalence of ML in
•; premature newborns who were admitted to the NICU -i at pediatric national hospital, Vietnam between
January 2013 to October 2016. Auditory function was )! examined using otoaeoustic emission (OAE) followed
•I by auditory brainstem response (ABR) test. Results:
: Among the 264 premature newborns included in the .' study, 38 cases (14,4%) showed hearing loss. There - was a significant statistical relationship between
^ gestational age of less than 30,9weeks (P=0,014), ' birth weight of less than 1000 gram (P=0,004) and
^ gestational infection (P=0.000) and hearing loss. On the contrary, there was no significant relationship . between HI and use ventilator, hyperbilirubinemia, y ftimily history of HL and craniofacial abnormality.
J Conclusion: Auditory function in premature newborns who were admitted to the NICU should be assessed during their stay in hospital.
Keyword: Premature newborn, hearing loss.
Neonatal Intensive care unit.
1 1 . 0 J 3 L T V A N O E
Nghe kem la mot trong so nhu'ng benh ly bam sinh hay gap nhat d tre sd sinh chiem khoang 2- 1 4 ca/1006 tre sd sinh trong dan so noi chung
nhu'ng d tre sd sinh nam trong khoa hoi su'c tich cu'c nghe kem co the len den 24-46%. O Viet I Nam, trong nhiJng nam gan day co nhO'ng
! nghien eiru ve tinh trang nghe kem cho tre sd ' sinh CO nguy cd cao, bu'dc dau cho thay cf tre de ' non nguy ed nghe kem cao gap 9,71 lan so vcfi . tre du thang (1). Chi so nay co the tang khi tre
•• de non phai vao dieu trj tai khoa hoi su'c tich cdc do cac benh ly phoi hdp va cac bien phap dieu trj
tich cu'c nhu' khang sinh, thong khi nhan tao va cae thuoc khae. Tinh trang thieu 6 xy phai thong khi ho trd cung nhu' viee sir dung eae thuoc co kha nang dpc vdi tai nhu' nhom amincMlueosides hay ldi tieu, thuoe an than deu co the lam tang nguy cd ton thu'dng oe tai. Phat hien va can thiep sdm nghe kem d tre sd sinh la rat quan trpng gliip cho tre hda nhap vdi epng dong, giam ganh nang eho xa hoi va gia dinh. Cac phu'dng phap sang lpc nghe kem eho tre sd sinh bao gom 2 loai ehinh, dd la phu'dng phap quan sat hanh vi eiia tre va phu'dng phap dien sinh hpc. Phu'dng phap quan sat hanh vi eua tre dang dieu tri tai khoa hoi sire tich cu'c rat khd thy'c hien, dBng thdi ti le am tinh gia eao va khd phat hien du'cfc nghe kem viTa hay nghe kem 1 tai. Viee su'dung phu'dng phap dien sinh hpc nhu' do am oe tai (OAE) va dien than kinh thinh giac (ABR) la test do khach quan, cd dp nhay cao cd the xae djnh mire do nghe kem d tre va bu'dc dau tim hieu nguy cd lien quan den nghe kem ciia tre giiip eae nha lam sang ed each nhin toan dien khi dieu trj tre de non tai khoa hoi sire tieh ci/c. Chinh vi vay, chung tdi nghien cu'u de tai: xac djnh ti le nghe kem bang test ABR va phan tieh mpt sd yeu to nguy cd lien quan den tre de non tai khoa hoi su'c sd sinh ciia benh vien nhi trung u'dng vdi 2 mue tieu: Xac dinti ti le nghe kem ciia tre de non tai khoa hoi sii'c sd sinh ciia Benh vien nhi trung udng; Bdde dau phan tfch mdt sd nguy cd lien quan den nghe kem dtre de non.
II. OOI TU'pNG VA PHLTONG PHAP NGHIEN COU 2 . 1 . Ooi tu'dng nghien cu'u
>Tleu chuan lu'a chon benh nhan
• Tre du'dc chan doan de non du'di 37 tuan, du'dc dieu tri tai khoa Hoi su'c sd sinh cua Benh vien Nhi Trung u'dng tir thang 1/2013 den thang 10/2016.
• Du'dc tien hanh sang Ipe thinh liTc sau sinh tai thdi diem nam vien.
• Cha me hoac ngu'di than dong y tham gia nghien eifu.
> Tieu chui'n ioai triy benh nhan:
• Tre dii thang
• Tre td vong tru'dc khi do chan doan
• Cha me hoac ngu'di than tir choi tham gia nghien eiru.
2.2. Phu'dng phap nghien cii'u Muc beu 1: nghien eiru md ta eat ngang tim ti le nghe kem d tre de non tai khoa hoi sifc tich cdc
Myc tieu 2: nghien ciru benh chirng dy'a tren phan tich eae yeu to nguy ed giu'a 2 nhdm tre cd nghe kem va khdng nghe kem.
VIETNAM MEDICAL JOURNAL N°2 - OCTOBER - 2017
2.3. Cac bu'dc tien hanh
- Cae tre de non dieu trj tai khoa Hoi su'c sd sinh du'dc sang Ipe thinh life bang test AABR. Ket qua thu du'dc gom hai nhdm: Nhdm Pass va nhdm refer. Nhdm Refer la doi tu'dng nghi ngd nghe kem se du'dc do ABR va OAE chan doan, dong thdi phan tieh cac yeu t d nguy ed da du'dc cong bo. • „ ,
- Cae yeu to nguy ed lien quan den nghe kem bao gom:
• Tien sir gia dinh cd nghe kem tiep nhan vTnh vien.
• Nhiem triing trong tir eung nhy cytomegalovirus, rubella, toxoplasma hoac herpes (TORCH).
• Bat thydng so mat bao gom ca nhO'ng bat thu'dng ve hinh thai vanh tai va dng tai.
• Tat ea eac tre du'dc dieu tri d khoa sd sinh tren 7 ngay.
• tre can du'dc thd may ho trd.
• Tre du'dc illeu tri bang thuoc ed ddc tfnh cao (khang sinh nhdm aminoglyeosid) hoac ldi
tieu ong than(Furosemid hoac Lasix).
• Vang da d mire dp can thay mau.
- Thu thap va sir ly so lieu bang phan mem SPSS 20.0
Ml. KET QUA NGHIEN CU'U
3 . 1 . Xac djnh ti le nghe kem d nhom b^
Nhin xet: 264 tre de non nghien eiru co 38 tru'dng hdp nghe kem, chiem ti le 14,4%, trong dd ed ti le nam, nu" ngang nhau.
3.2 Phan tich mot so y§u to nguy cd lien quan den nghe kem.
3.2.1 Mdi lien quan giii'a yeu tdtudi thai va nghe kem Bang 1. Mdi lien quan giu'a phan bdtud'i thai va nghe kem
Nhdm tuoi thai
<28 tuan
28 tuan < tudi thai <32 tuan 32 tuan < tuoi thai <3'1
tuan 34 tuan < tuoi thai <37
tuan
Nhom tuoi thai 28 tuan < tudi thai < 32 tuan 32 tuan < tuoi thai < 34 tuan 34 tuan < tudi thai < 37 tuan
<28 tuan 32 tuan < tuoi thai < 34 tuan 34 tuan < tudi thai < 37 tuan
<28 tuan 28 tuan < tudi thai < 32 tuan 34 tuan < tuoi thai < 37 tuan
<28 tuan 28 tuan < tuoi thai < 32 tuan 32 tuan < tudi thai < 34 tuan
P 0,000 0,000 0,000 0,000 0,202 0,961 0,000 0,202 0,463 0,000 0,961 0,463 Nhan xet: Nhdm tre de non du'di 28 tuan la yeu td nguy ed lien quan den nghe kem , P=0,000 3.2.2 Moi lien quan giCa yeu t d tuoi thai trung binh va nghe kem
Bang 10. Mdi lien quan giii'a tudi thai trung binh vi nghe kem:
Tuoi thai trung binh (tuan)
Nghe kem n =38 I Khong nghe kem n= 226
30,9±3,6 32,25±2,9 P=0,014
Nhan jret/Tuoi thai cang nho thi nguy cd nghe kem cang cao. Sir khac biet nay co y nghla thong kevdi"p= 0,014.
3.2.3 Moi lien quan giu'a yeu to can nang va nghe k e m : Bang 3: MdJ lien quan giita yeu to can ning va nghe kem
Nhom can nang Nhom can nang
<1000 gram 1 Q0Qgr<ca n nang < 1500gr
1500gr<cannang<2500gr 0,003
Can nang > 2500 gr 0,002
lQOOgr<cannang< ISOOgr <1000 gram
lOOOg r<ean nang < 1 SOOgr 0,994 1500gr<cannang<2500gr
TAP CHi Y HOC V | £ T NAM TAP 459 - THAHG 10 • SO 2 - 2017 1500qr<cannanq<2500qr
Can nang > 2500 qr
Can nang > 2500 qr 1000qr<cannanq<1500gr
Can nang > 2500 gr
<1000 gram 1000gr<cannang< ISOOgr 1500qr<cannanq<2500qr
0,003 0,994 0,947 0,002 0,992 0,947
Nhin xet: Nhdm can nang du'di 1000 gram la yeu to lien quan den nghe kem, P= 0,002. Tuy nhien khdng tim du'dc moi lien quan giu'a can nang trung binh va nghe kem, P= 0,102.
3.2.4. Mdi lien quan giii'a yeu to nhiem triing bao thai va nghe kim:
Khong Tong
Nghe kem
23
39,5
%
60,5
khong nghe kem
223 1,3
Tong so
18 264
6,8 P=0,000
Nhin xit: Cd sy" khac biet giu'a ve yeu to nguy cd nhiem triing bao thai giu'a nhom tre nghe kem va khong nghe kem, P= 0,000.
3.2.5 Cac yeu tn nguy cd khac nhu" thd may tren 7 ngay, tien sir gia dinh, di tat dau mat, Vang da thay mau, sir dyng khang sinh nhdm Aminoglyeosid ehu^ thay moi lien quan den nghe kem d nhom tre nghien cirii nay.
IV. BAN LUiOLN
Ngay nay sang Ipc nghe kem d tre sd sinh la rat quan trpng va dac biet la d nhdnq nhdm tre nguy cd cao dieu tri tai khoa Hdi sii'c tieh cu'c.
Binh thu'dng ti le nghe kem d nhdm tre khde manh trong epng ddng la 0,3%. Nghien eiru ciia chiing ^ i tren 264 tre de non dieu tri tai khoa Hoi sire sd sinh ed 38 tre nghe kem chiem ti le 14,4 %.
Ti le nay cao hdn rat nhieu so vdi ti le nghe kem d tre sd sinh khde manh. Ti le nay cung tu'dng irng vdi cae nghien culi khae tren the gidi.
Trong nghien cutJ cua chiing tdi nhan thay rang tuoi thai cang nho thi kha nang mac nghe kem cang ldn vdi tudi thai trung binh la 30 tuan, dac biet la nhdm tre du'di 28 tuan tuoi. Sd khac biet nay cd y nghta thdng ke vdi P= 0,000. Nhom nghe kem cd tudi thai du'di 28 tuan chiem ti le 3,2%. Ket qua nay thap hdn nghien cu'u cua tac gia M.T Robertson tren 1274 tre de non du'di 28 tuan, dieu tri tai khoa Hoi su'c sd sinh tir nam 1974- 2003 vdi t i le nghe kem la 5,01%. Nguyen nhan cd the do cd mau cua chung tdi chu'a dii ldn va ti le song ciia nhdm tre de du'di 28 tuan con thap do nhdm tre nay thu'dng kem theo nhu'ng roi loan dac biet nghiem trpng vi cac cd quan ehu<i lioan thien nhU phdi chu'a tru'dng thanh, tim bam sinh, vang da keo dai, nhilm khuan huyet, nen thdi gian dieu tri can thiep tai cac khoa hoi su'c sd sinh thu'dng keo dai, ti le song cung thap hdn han cac nhdm khac [2].
Cung vdi tudi thai thap kem theo can nang cung la mot yeu to nguy cd, dac biet la d nhdm tre ed can nang du'di 1000 gram (chiem ti le 1,9%). Ket qua nay thap hdn so vdi nghien ciTu
ciia tac gia Kitten W tren 305 tre de non can nang tu' 500- 999 gram dieu tri tai khoa hoi sii'c sd sinh, phat hien cd 3 tre nghe kem, chiem t i le 3,3% [3]. Phai chang d Viet Nam hoi siTc sd sinh cho nhdm tre can nang diTdi 1000 gram edn gap nhieu khd khan, dong thdi tre thu'dng hay phdi hdp da di dang khac nhu' phoi chu'a trydng thanh,bai nao, mii hai mat, cham van dpng, trf tue kem phat trien nen tl le song eiia nhdm tre nay chu'a cao[4],[5].
Cuoi ciing trong nghien ciTu ciia ehiing tdi nhiem trung bao thai la yeu to nguy cd lien quan den nghe kem . Dieu nay cung da du'dc giai thieh trong y van td lau vdi nhuYig ton thydng thinh giac do nhiem virus nhy CMV, Rubella, toxoplasma, herpes... trong thdi kl bao thai. Tuy nhien chiing tdi khong phan tich du'dc tiTng loai viruslien quan den nghe kem, ma chi chan doan thdng qua khai thac tien siTmang thai ciia ngu'di me. Vi vay can ed nhu'ng nghien cii'u sau hdn tren nhu'ng tre cd me mang thai b| nhiem virus de danh gia cu the mdi lien quan nay.
Ngoai ra cae yeu to nguy cd khac nhu' thd may tren 7 ngay, tien sd gia dinh, di tat dau mat, vang da thay mau va sir dyng khang sinh nhdm aminoglycoside chu'a thay moi lien quan vdi nghe kem. Phai chang do thdi gian nghien cdu cua ehimg tdi cdn han hep, cd mau nhd, chu'a theo ddi du'dc lau dai nen khdng phan tich de tim ra du'dc moi lien quan.
V. KET LUJJkN
Tre de non dieu trj tai khoa hoi sii'c sd sinh cd ti le nghe kem tang dang ke so vdi nhdm tre dii thang khoe manh, ti le nay chiem den 14,4%.
245
VIETNAril MEDICAL JOURNAL f^'^2 - OCTOBER • 2017 Cae yeu to nhu' tuoi thai trung binh du'di 30
tuan, dae biet la du'di 28 tuan, can nang du'di 1000 gram va nhilm triing bao thai la nhu'ng yeu td nguy cd lien quan den nghe kem.
TAI Ll|U THAM KHAO
1. Nguyen Thu Thiiy (2005). Nghien CUIJ giam thmh bing tham octai, thiet lap chu'dng trinh can thiep sdm phuc hoi chirc nang cho tre khiem thinh.
LuSn van thac sT Y khoa, Dai hoc Y Ha Npi.
2. Charlene M.T.Robertson(2008). Permanent bilateral sensory and neura hearing loss of children after neonatal intensive care because of extreme prematurity: a Thirty- year study. Pediatries, Volume 123/ISSUE 5
3. Kitchen W (19840). Outcome in infants wlBi birth weighr 500 to 999gm* a region study of 1979 and 1980 births,: Pediatr. 104{6):921-7.
4. LDoyle and D Casaiaz (2001). Outcome at 14 year of extremely lowbirth weight infants: a regional Study ,Arch Dis Child Fetal Neonatal Ed 85 (3): F159-F164,
5. Goldenberg M, Clark U, Koehler €(2006).
"newborn heanng screening; A retrospective analysis of hit and false positive rates in NICU and how they are in fluenced by risk factor for hearing loss in a suburban birthing hospital". Program in Audiology and communication science, Washington University of Medicine. Independence studies and capstones, Page 579.
Sir HAI LONG COA NGirai BENH VE THITC HANH KIEM SOAT NHIEM KHUAN TAI KHOA RANG HAM MAT, BENH VIEN QUAN TAN PHU
Nguyin Duy Tien \ Lu-o-ng Van Sinh^, Nguyin Th[ Kim Anh^
Vo Gia Hiep*, Huynh Thi Ly-\ Nguyin Diic Hu6^ Nguyin Van Tap' of the patients and propotion of patients who satisfied about infection control at dental department at Tan Phu hospital. Ho Chi Minh city. Methods. A cross- sectional study was conducted on 226 outpatients at dental department of Tan Phu district hopital, Ho Chi Minh City. Results. The practice of infection control of dental staff in Tan Phu distnct hospitals is good, as shown by the evaluation of the patient to the denal examination and treatment in the department. The propotion of patient who satisfied on infection control in dental department was 76.5%. There are sonne of solutions to improve the quality and facilitation of facilities to improve service quality and increase patient sabsfaction.
Keywords. Infection control, dental department.
T O M TAT
Muc tieu. Tim hi^u danhjgia ciia ngu'di benJi ve cd sd vat chat va thi/c hanh kiem soat nhiem khuan^va t / ie.ngu'di benh hai long ve cong tae kiem soat nhiem khuan tai khoa Rang Ham Mat, benh vien Quan Tan Phu, thanh pho Ho Chi Minh. Phu'dng pliap. Dieu tra ngang 226 benh nhan ngoai tru tai khoa Rang Ham Mat, benh vien quan Tan Phu, thanh pho Ho Chf Mjnh nam^ 2017. Ket qua. Thu'c hanh kiem soat nhiem khuan cua nhan vien y te tai khoa Rang Ham Mat, Denh vien quan Tan Phil la tot, du'dc the hien qua danh gta ciia ngudi benh den kham va dieu trj tai khoa.JTuy vay, ty^ le hai long ciia ngu'di benh ve cong tac Idem soat nhiem khuan tai khoa rang ham mat dat 76,5%. Can c6 mot so bien phap cai tien chat lu'dng va tao dieu kien thuan ldi ve cd sd vat chat tai khoa rang ham mat, de nang cao chat lu'dng djch vu, tang sir hai long eiia ngudt benh.
rd'iWrda.'Kiem soat nhilm khuan, khoa rang ham mat.
SUMMARY
SATISFACTION OF PATIENT ABOUT INFECTION CONTROL AT DENTAL DEPARTMENT AT TAN
PHU HOSPITAL
Objective. Determining the propotion of right practice about infection control through the evaluabon
^•^•'^•'^•denh vien Quan Tan Phu,
^Benh vien Ring Ham Mat - TP HCM
^Benh vien RSng Ham Mat Trung udng • TP HCM, ''Dai Hgc Y Dddc TP HCM.
Chju trach nhiem chinh: Nguyen Dire Hue Email: [email protected] Ngay nhan bai: 2.8.2017 Ngay phan bien khoa hoe: 29.9.2017 Ngay duyet bai: 3.10.2017
I. OiC^T VAN OE
Trong thu'c hanh nha khoa, nguy cd lay nhiem ed the xay ra trong qua trinh cham soc dieu tri, ngudn lay nhiem cd the tir benh nhan lay truyen cho nhan vien y te va ngu'de lai. Su" lay nhilm eung cd the xuat phat tir benli nhan nay den benh nhan khae qua thao tae ky thuat dieu trj, dung cu y te, thiet bj vay nhiem neu kh6ng_xir ly dung theo quy trinh khir khuan - tiet khuan, do do nhan vien y te va benh nhan thu'dng tiep xiic vdi nhieu benh lay nhiem va nguy ed lay nhiem rat cao [2],[3]. Tai Viet Nam, cdng tae kiem soat nhiem khuan trong eae ed sd y te noi ehung da dat mdt sd thanh tiTu nhat dmh, nhuTig con rat nhieu van de ton tai can glai quyet [1]. Be co ed sd gliJp nang cao chat lu'dng dieu tri va sd hai long ciia ngu'di benh chung toi tien hanh khao sat mot so y kien cua ngu'di benh den kham va dieu trj vdi muc tieu:
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