2013年四川省直属医疗机构消毒质量监测结果分析

Surveillance on Disinfection Quality in Medical Institutions Directly Subordinated to Sichuan Province,2013

目的通过对医疗机构消毒灭菌效果监测结果的系统分析,评估存在的风险,探寻改善消毒质量的办法。方法2013年对四川省18所直属医疗机构,按《消毒技术规范》采样,按GB15982-2012《医院消毒卫生标准》、GB15980-1995《一次性使用医疗用品卫生标准》、GB15981-1995《消毒与灭菌效果的评价方法与标准》进行评价。结果监测样本1 197份,平均合格率为99.50%,有不合格情况的监测对象为内窥镜、室内空气、物体表面,合格率分别为94.74%、98.11%和99.69%,不合格内窥镜均为人工清洗后2%戊二醛浸泡20 min消毒者、不合格室内空气均为采用紫外线消毒者;私立医疗机构样本不合格率为4.88%,公立者为0.35%,前者高于后者;公立三甲本部、公立三甲分支、公立三甲以下医疗机构样本不合格率分别为0.12%、1.13%和0.68%,与其余两者相比,公立三甲本部最低,公立三甲分支最高。结论内窥镜、室内空气合格率较低,具有一定医院感染风险;采用人工清洗消毒内窥镜的医疗机构应加强管理,确保人工清洗消毒效果;建议逐步淘汰紫外线照射空气消毒法。

Objective By systematically analyzing the disinfection effect in medical institutions to evaluate the risk and to explore appropriate approaches to improve the disinfection quality. Methods Eighteen medical institutions directly subordinated to Sichuan province were samples according to ＂Technical Standard for Disinfection＂and were evaluated according to sanitary standards of GB15982- 2012 ＂Hospital Disinfection Sanitary Standard＂,GB15980-1995 ＂Disposable Medical Supplies Sanitary Standard＂and GB15981-1995 ＂Evaluation Method and Standards of Disinfection and Sterilization＂。Results A total of 1197 samples were monitored,with an average qualified rate of 99.50%. Those unqualified items were endoscope,indoor air and body surface,with qualified rate of 94.74%,98.11% and 99.69%,respectively. The unqualified endoscopes all were conducted immersion disinfection with 2% glutaraldehyde after manual rinsing; unqualified indoor air was disinfected by ultraviolet light. The unqualified rate in private hospitals was 4.88%,which was higher than 0.35% in public hospitals. The unqualified rate of public top three hospital base main body,public top three hospital branches and other hospitals were respectively 0.12%,1.13% and 0.68%. Conclusion The qualified rate of disinfection is low in aspects of endoscope and indoor air,in which infection risk exists. Medical institutions with manual rising endoscope should be strengthened management to insure the disinfection effect.Ultraviolet light disinfection method should be phased-out.