气管插管麻醉器具使用的两级管理

Two-level Management of Endotracheal Intubation Anesthesia Appliances Usage

目的 加强气管插管麻醉器具医院感染规范化管理,避免因气管插管麻醉器具清洗消毒缺陷引起医源性感染,保证患者及医务人员安全.方法 医院感染管理办公室和科室医院感染监控小组两级管理组织,采用现场查看及抽样检测相结合的方法,分别对全院使用中的各种气管插管麻醉器具管理制度、消毒设施的配备、消毒流程的规范、消毒剂的使用方法及消毒效果进行检查;回顾性分析2012年1～12月使用气管插管麻醉器具各项检查记录.结果 院、科两级检查使用中气管插管麻醉器具灭菌合格率存在差异,院级检测麻醉手术科的气管插管、麻醉机外部管路、麻醉机内部管路、临床科室的气管插管、ICU的气管插管灭菌合格率分别为97.8％、88.0％、75.4％、85.9％、91.7％,均比科级灭菌合格率低1.9％、4.3％、11.1％、12.0％、7.2％.结论 医院感染管理办公室只有建立健全使用中气管插管麻醉器具的医院感染规章制度,定期对消毒效果进行监测及督导,才能杜绝因气管插管麻醉器具消毒灭菌不严引发医源性感染的发生.

Objective To strengthen standardized management of intubation anesthesia utensils hospital infection, to avoid endotracheal intubation anesthesia apparatus cleaning disinfection caused by iatrogenic infection, and to ensure the safety of patients and medical staff. Methods By two - level management of hospital infection management office and departments of the hospital infection control team, using the live view and a combination of sampling and testing method, checking the intubation anesthesia appliances in the use of hospital management system, with disinfection facilities, the specification of the disinfection process, the use of disinfectants and disinfection effects ; retrospectively analyzing intubation anesthesia apparatus from January to December, 2012. Results There were difference in acceptabilihy rate of the hospital and office check when using intubation anesthesia utensils sterilization. Tracheal intubation, external piping of intubation, anesthesia branch, anesthesia machines, anesthesia machines internal piping, clinical departments intubation, endotracheal intubation in the ICU sterilization passing rates were 97.8%, 88.0%, 75.4%, 85.9%, 91.7% in hospital check. These were all lower than the rate of 1.9%, 4.3%, 11.1%, 12.0% and 7.2% respectively in the office. Conclusion Only hospital infection management office establishes and improves the use of hospital endotracheal intubation, regulates and supervises anesthesia apparatus can put an end to lax sterilization in- tubation anesthesia appliances leading to iatrogenic infection.