Isparta il ve ilçe merkezlerindeki aile sağlığı merkezlerinde soğuk zincir, mevcut durum ve uygulamalar
Cold chain, recent status and applications in the family health centers centers Isparta city and districts
- Tez No: 203473
- Danışmanlar: DOÇ.DR. AHMET NESİMİ KİŞİOĞLU
- Tez Türü: Tıpta Uzmanlık
- Konular: Halk Sağlığı, Public Health
- Anahtar Kelimeler: The Family Health Centers, cold chain, recent status, applications
- Yıl: 2007
- Dil: Türkçe
- Üniversite: Süleyman Demirel Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Halk Sağlığı Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 186
Özet
Özet yok.
Özet (Çeviri)
One of the main essentials in supplying the supposed immune response is the storage and transport of the vaccines regarding to the cold chain rules. Cold chain is the system that protects the efficiency of a vaccine beginning from production until application, and includes staff and vehicles that secures the vaccine which is effective enough reach the humans in need. Family doctors (FD) and health staff in in 33 family health centers (FHC) centers Isparta City and its 12 districts participated in the study. 95 FDs and 95 health staff adding up to 190 was questionnaired under supervision. Observation forms were filled out for 32 fridges in FHCs. The ratios of participants were 50.0% for doctors, 31.6% for midwifes16.3% for nurses and 2.1% for health officials, and mean age was 34.5± 5.5, and mean working period was 11.7±5.5. 96.3% knew that there was staff responsible for the cold chain, and 68.9% attended a course concerning the cold chain. None could replied all the seven querries concerning the cold chain. Three of the querries were truly replied in higher frequency by midwifes, also another three by nurses, and one by the doctors. Two querries were truly replied by 75%, one by 11%, and three by less than 5%. 43.7% of the staff in FHCs did not know for how many years the fridge had been working, and 55.3% said it had been used regardless of staff, or co-staff, responsible for the cold chain. 60.0% said the temperature was not controlled at weekends, 66.3% knew that there was an application plan ready for use for the situations in which the temperature is out of normal range, and 15.3% could truly define the cold chain. Staff other than doctors knew better than doctors where to place the Measles, OP, BCG, MMR, Hib, Rabies, DBT and Hepatitis B vaccines and their diluents in the freidge. 75.2% of the participants said that the cold chain only worked or worked perfect. 12 of the 32 fridges in FHCs was found door closed, and only one had a lock. 17 were snow-clad more than 5 mm. All had ice-containers but no thermometers in ice-boxes. arrangement is explained, and 18.8% had temperature follow-up chart hung on the door, whereas none had any sheets showing the input dates of the vaccines. Only one had all the vaccines and diluents placed correct, and OPV was the first in correctness by 84.4%. 31.3% of the fridges had ordinarily placed water bottles in greens division. 12.6% had the vaccines packed by producer, and 25.0% had them placed so as the air to circulate amongst. The vaccines had boxes for first use in shelves of 53.3%. 59.4% of the fridges contained some stuff other than vaccines, but all had working thermometers and the temperatures were all in normal range. Used vaccines had no date inscriptions on the vials in 40.6% but none had any expired date vaccines. All the FHCs had vaccine port cases with hangings, and 18.8% of these were old. None of the FHCs had long-life vaccine port case. According to the cold chain control list including 10 articles for fridges or other cold chain applications, 3 of the articles were thoroughly, and 4 was incompletely carried out in all the FHCs, 3 was applied in nowhere. In conclusion, recent situation and the aplications in cold chain is generally at a good level with the fact that it has some defects. For the improvement, courses concerning the cold chain should be provided for all the staff in FHCs, and these courses should be re-held perodically. Secondly, the doctors in the FHCs should be involved in active management in providing the continuity and controlling the cold chain. The health administrations should periodically control the equipment and applications.
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