ObjectiveTo evaluate the high-level disinfection effect of flexible endoscopes in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu, explore the key links of flexible endoscope cleaning and disinfection, and provide theoretical guarantee and technical support for the next step of the endoscope center work.MethodsWe sampled and monitored the lumens, water and air injection ports and biopsy ports of 19 flexible endoscopes after high-level disinfection in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu. A total of 307 specimens were collected from 108 flexible endoscopes. We compared the disinfection effects of different flexible endoscopes and different sampling sites, and compared the microbial detection status of different flexible endoscopes.ResultsThe qualified rates of disinfection of gastroscopes, colonoscope and duodenoscopy were 79.22%, 86.21% and 100.00%, respectively, and the difference was not statistically significant (P=0.721). The qualified rates of disinfection of the endoscopic lumen, water and air injection port and biopsy port were 87.04%, 93.00% and 94.95%, respectively, and the difference was not statistically significant (χ2=4.585, P=0.101). The qualified rates of the lumen, water and air injection port and biopsy port of gastroscope, colonoscope and duodenoscope were 84.42%, 93.10%, 100.00%, 92.96%, 92.59%, 100.00%, 94.29%, 96.30%, 100.00%, respectively. There was no statistically significant difference in the disinfection effect of various parts of different flexible endoscopes (P>0.05). Bacteriological identification showed that of the 28 specimens with excess bacteriological standards, 16 gram-positive bacteria (57.1%), and 12 gram-negative bacteria (42.9%) were found.ConclusionThe cleaning and disinfection effect of flexible endoscopes has certain defect. Endoscope should be treated in strict accordance with the technical specifications for cleaning and disinfection of the flexible endoscope to further improve the disinfection effect of the flexible endoscope.
目的 探討消毒供應中心的管理方法，切實提高其質量。 方法 2008年8月－2010年12月應用PDCA循環管理模式，對消毒供應中心實施標準化、規范化、系統化和科學化的管理。 結果 應用PDCA循環管理模式以來，消毒供應中心的建筑布局及工作流程得以規范；手術器械處置效率、清洗消毒滅菌質量得以提高；手術切口、Ⅰ類手術切口的感染率均得以降低。2009年與2008年、2010年與2008年比較，手術切口感染率均得以降低，差異有統計學意義（χ2=39.95，P＜0.05；χ2=27.80，P＜0.05）；2009年與2010年比較，手術切口感染率差異無統計學意義（χ2=0.02，P＞0.05）。2009年與2008年、2010年與2008年、2010年與2009年比較，Ⅰ類手術切口感染率降低，但差異無統計學意義（χ2=2.83，P＞0.05；χ2=2.21，P＞0.05；χ2=0.05，P＞0.05）。 結論 推行PDCA循環管理模式，促進了消毒供應中心的規范化管理，實現了消毒器械質量控制的前饋控制、過程控制以及反饋控制；拓展了消毒供應專業領域，使醫院的現有資源得到了最為高效的利用；使患者安全得到了切實保障。
ObjectiveTo study the feasibility of using paper hand towels instead of sterilized hand towels in non-rinse surgical hand antisepsis, and make a hygienic and economic evaluation on sterilized hand towels and paper hand towels.MethodsFrom July to September 2016, a cluster sampling method was used to study the hand samples of all health care workers who performed surgical hand sanitization in the operating room on Thursday. According to their work contents, they were asigned into the intervention group (using paper hand towels to dry hands) and the control group (using sterilized hand towels to dry hands); further, according to the odd or even number of the staff identification number, the intervention group was divided into Group A (using Likang hand towels to dry hands) and Group B (using Qingfeng hand towels to dry hands). The packing specifications and costs of hand-drying items in the warehouse were surveyed, as well as the average number of medical workers performing an operation and the number of sheets of sterilized hand towels or paper hand towels used per person, and the cost of different hand dryers for each procedure was calculated. Finally, the hygienic and economic effects of using paper hand towels were evaluated.ResultsThere were 30, 39, and 30 hand hygiene samples collected in the control group, Group A, and Group B, respectively. The total bacterial count of each group was less than 5 cfu/cm2, which met the hygienic requirements of surgical hand disinfection in the manual hygiene standard for medical personnel (WS/T 313－2019), i.e., the passing rate of each group was 100%. According to the calculation that each operation required at least 4 medical workers, each operation consumed 8 sterilized hand towels at a cost of 15.2 yuan; if using paper hand towels, each operation consumed 16 sheets at a cost of 0.8 yuan.ConclusionThe hygienic effect of surgical hand disinfection is not affected by the use of paper hand towels before applying hand sanitizer, while the operating cost of hospital operating room can be significantly reduced by using paper hand towels instead of sterilized hand towels.
Objective To compare germicidal effect of three disinfectants acting on frequently-touched surfaces in Intensive Care Unit (ICU) at different time points after disinfection so as to put forward the reasonable disinfection method and interval before the next disinfection. Methods We wiped the four frequently-touched surfaces in ICU with disinfectant containing acidic electrolyzed oxidizing water (EOW) from the building system of hospital, disinfectant wipes, and 500 mg/L chlorine respectively. The culture samples were collected from the surfaces before wiping, and 10 minutes, 30 minutes, 1 hour, 2 hours and 4 hours after wiping respectively. The bacterial clearance rate and the qualified rate of bacterial colony counts on the surfaces were compared among the three different disinfectants at different time points after disinfection. Results The bacterial killing rate of three methods for disinfection of object surfaces decreased with the passing of time. The bacterial killing rate of EOW from the building system of hospital was lower than that of the other two methods at all five time points after disinfection (P< 0.05). The bacterial killing rate at hour four after disinfection using chlorine-containing disinfectant and disinfectant wipes was higher than 90.0%. The qualified rate of bacterial colony counts on the surfaces at 10 and 30 minutes after disinfection among the three groups was not significantly different (P>0.05). The qualified rate of bacterial colony counts on the surfaces disinfected by EOW from the building system of hospital was lower than that in the other two groups at the other three time points (P<0.05), and it was totally unqualified at hour four after disinfection. Conclusions The germicidal effect of EOW from the building system of hospital is inferior to chlorine disinfectant and disinfectant wipes. Moreover, the surface can be easily recontaminated after disinfection. It is suggested that EOW should be used in ICU every other hour. and the other two disinfection methods should be used every two hours.
目的 分析多功能空氣消毒機在普通內科病房的動態消毒效果，為病房空氣質量的控制提供參考依據。 方法 2010年9月－2011年4月對普通內科病房在動態狀態下進行細菌檢測并使用多功能空氣消毒機消毒，并就消毒前后的空氣細菌菌落總數進行分析比較。 結果 在動態狀態下，病房關門關窗并開啟空調機時，使用多功能空氣消毒機消毒前的空氣細菌菌落總數顯著高于消毒后，差異有統計學意義（P＜0.05）；病房在開門開窗時，使用多功能空氣消毒機消毒前后的空氣細菌菌落總數比較，差異無統計學意義（P＞0.05）。 結論 普通內科病房在關門關窗并開啟空調機動態狀態下，使用多功能空氣消毒機可以降低空氣細菌菌落總數，改善房間空氣質量。
Endoscopic retrograde cholangiopancreatography is one of the main methods for the diagnosis and treatment of biliary tract and pancreatic diseases. Compared with other digestive endoscopes, duodenoscopy has a special structure. Since the outbreaks of nosocomial infections caused by the transmission of multidrug-resistant organism through duodenoscopy in 2010, the reprocessing and design of digestive endoscopes represented by duodenoscopy have faced new challenges. This article reviews the international advances in duodenoscopy reprocessing in the past 10 years including the structural characteristics of duodenoscope, related infection outbreak cases, outbreak control measures, and the use of disposable duodenoscopy, so as to provide guidance and reference for the duodenoscopy reprocessing and related nosocomial infections prevention and control work in China.
The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.