沿海五省市127所医院医疗器械清洗情况的调查研究

Current status of medical instrument cleaning in 127 hospitals in five coastal provinces or cities in China

目的调查127所医院消毒供应中心器械清洗的现状,旨在为提高消毒供应中心器械清洗质量、降低感染风险、进一步规范器械清洗流程提供参考。方法便利选取127所医院消毒供应中心,采用问卷对医院消毒供应中心的设备配置、器械转运情况及清洗剂的选择、器械漂洗情况进行调查。结果超声清洗机和喷淋式清洗机配置率分别为96.6%和78.7%,6.3%使用生理盐水进行预清洗,3.9%使用无菌水进行预清洗;11.0%用自来水进行终末漂洗;78.7%在污染器械转运途中无持续保湿处理;66.9%把多酶清洗剂作为唯一的选择;半数以上的消毒供应中心在手工漂洗和终末漂洗时不记时间。结论 127所医院消毒供应中心医疗器械清洗设备总体配置较好,但仍需重视器械清洗用水的规范,提高器械转运速度并推广持续保湿处理,进一步完善清洗剂的使用标准并建立漂洗和终末漂洗质量的评价标准,确保医疗器械的清洗质量。

Objective To investigate the current situation of medical instrument cleaning in Central Sterile Sup- ply Departments（CSSD）,in order to identify problems and provide references for further improvements of equipment cleaning. Methods Questionnaire survey was adopted,data of 127 CSSDs in five coastal provinces or cities in Chi- na in 2017 were collected,and status of each link of medical instrument cleaning was analyzed. Results The allo- cation rate of ultrasonic cleaner and spray cleaner were 96.6% and 78.7% ,respectively ;62.2% of hospitals used tap water to pre-rinse,and 10.2% used normal saline or sterile water to pre-rinse, 11.0% used tap water for finial rins- ing;78.7% of hospitals did not perform continuous humidification in transit,and 18.1% of hospitals did not perform continuous humidification and their time of transit was more than 2 hours;66.9% of CSSDs only used multi-enzyme detergent. More than half of the hospitals did not record time for manual rinsing/manual final rinsing. Conclusion The configuration of medical instrument cleaning equipment of 127 CSSDs is good. However,it is necessary to pay more attention to cleaning details. Specifications for instrument cleaning water should be established ;continuous hu- midification during transportation of medical instruments should be promoted;cleaning methods and cleaning deter- gents should be selected reasonably;standardized rinsing should be enhanced to ensure quality of medical instru- ment cleaning.