腹腔镜手术器械清洗质量管理

Cleaning quality management of laparoscopic surgery instruments

目的通过制定腹腔镜手术器械清洗、保养操作规范及质量标准,不同清洗方法的对比研究,以确保腹腔镜手术器械的清洗质量,延长器械使用寿命,节约开支。方法将术后腔镜器械随机分成A、B两组,每组100件器械进行检测,A组采用传统手工清洗方法,B组采用手工清洗方法联合超声波清洗;通过裸眼目测法、5倍放大镜目测、特殊棉签法、菌落数检测法、ATP生物检测法对两组器械的清洗合格率进行检测,并对2013年1月-2014年12月8 751件器械的清洗合格率进行统计分析。结果传统手工清洗联合超声清洗的清洗质量明显优于传统手工清洗,差异有统计学意义(P<0.05);对医院8 751件腔镜器械进行清洗合格率检测,2013年1-6月合格率为93.0%;2013年7-12月合格率为95.0%;2014年1-6月合格率为97.0%;2014年7-12月合格率为99.0%,医护满意度明显提高。结论采取传统手工清洗联合超声清洗,并加强管理制度的落实和人员培训,使清洗流程不断改进,大大提高了工作效率和清洗质量,也延长了腔镜器械的使用寿命。

OBJECTIVE To formulate the standards and specifications of cleaning and maintenance of laparoscopic surgery instruments and compare the cleaning methods so as to ensure the cleaning quality,prolong the service life,and save costs.METHODS The laparoscopic surgery instruments were randomly divided into the group A and the group B,with 100 pieces in each group.The group A was treated with conventional manual cleaning method,and the group B was given manual cleaning method combined with ultrasound cleaning.The qualified rates of cleaning of the two groups of instruments were detected by using naked eye visual inspection method,5xmagnifier visual inspection,special swab method,bacterial colony counts method,and ATP bioassay.The qualified rates of cleaning of 8 751 instruments that were collected from Jan 2013 to Dec 2014 were statistically analyzed.RESULTS The cleaning quality of the conventional manual cleaning combined with ultrasound cleaning was significantly better than that of the conventional manual cleaning（P〈0.05）.The qualified rate of cleaning was 93.0% among the 8751 laparoscopic surgery instruments from Jan 2013 to Jun 2013,the qualified rate was 95.0% from Jul 2013 to Dec 2013,97.0%from Jan 2014 to Jun 2014,99.0%from Jul 2014 to Dec 2014,and the satisfaction of healthcare was remarkably improved.CONCLUSIONIt is necessary to take the conventional manual cleaning combined with ultrasound cleaning and strengthen execution of management systems and personnel training so as to continuously improve the cleaning procedures,raise the work efficiency and cleaning quality,and prolong the service life of the laparoscopic instruments.