腹腔镜专用清洗剂对消毒供应室人员的不良反应及护理策略

Adverse reaction and nursing strategy of special cleaning agent for disinfection and supply room

目的研究对于消毒供应室腹腔镜灭菌过程中使用专用清洗剂的应用效果。方法该院2014年7月‐2015年7月消毒供应科室采用常规流动水及清洗剂处理污染器械,作为对照组,同时选取供应科医护人员39例;于2015年9月‐2016年9月提供腹腔镜专用清洗剂进行清洁灭菌处理,选取此时间段科室工作者39例,作为研究组。总结两年度科室物品灭菌合格率,观察两组医护人员不良反应情况。结果第一年度,科室接收的腹腔镜器械经清洗及处理后,灭菌合格率为94.25%,第二年度器械处理合格率为97.22%,比较差异无统计学意义(P>0.05)。第一年度期间科室工作者无发生清洗剂不良反应表现;第二年度在供应科室内全面应用腹腔镜专用清洗剂进行器械清洁处理,18例(46.15%)医护人员主诉存在头痛头晕;8例(20.51%)主诉有恶心呕吐等消化道不适症状;4例(10.26%)成员出现手足皮肤红斑表现。结论消毒供应科室在清洗腹腔镜过程中采用专用清洗剂,护士在长期工作期间发生不良反应可能性较大,主要表现为消化道不良反应、头痛和皮肤损伤等。一旦发生不良反应,护士应及时上报科室护士长,妥善处理;科室应及时制定护理策略,应用腹腔镜专用清洗剂,同时按照科室标准清洗流程操作,可提高器械灭菌质量,保证器械灭菌合格率。使用专用清洗剂清洁效果较好、对器械造成损伤较小、可节省水资源及方便经济。在器械清洗过程中,医护人员应做好机体安全防护工作,可减小不良反应发生。

【Objective】To study the application effect of special cleaning agent in the process of disinfection of laparoscope in the sterilization and supply room of our hospital.【Methods】In disinfection and supply department of our hospital from July 2014 to July 2015, conventional flow water and cleaning agent were used to deal with polluted equipments, and 39 medical personnels in the supply department were selected as the control group; from September 2015 to September 2016, special cleaning agent was provided for cleaning and sterilization of laparoscopic treatment, and 39 medical personnels working in the department during this period were selected as the study group. Sterilization rate in the department of the two years was summed up, and the adverse reactions in the medical staff of the two groups were observed.【Results】In the first year, after receiving the cleaning and processing, the qualification rate of laparoscopic instruments in the department was 94.25%, second annual equipment processing qualification rate was 97.22%, second annual equipment processing qualification rate was higher, but the difference between the first year was not statistically significant（P〈0.05）. During the first year, no adverse reactions of cleaning agent was found in the department workers; during the second year we comprehensively applied special cleaning agent in cleaning equipment of laparoscopic treatment in the supply department, 18 medical staff（46.15%） complained of headache and dizziness, 8 patients（20.51%） complained of nausea and vomiting and other gastrointestinal symptoms, and 4 cases（10.26%） showed signs of hand, foot and skin erythema.【Conclusion】When special cleaning agent was used for cleaning in the laparoscopic process in disinfection and supply department, the probability of the occurrence of adverse reactions for nurses during long-term work was great, which were mainly gastrointestinal adverse reactions, headache, skin damage. Once the adverse reactions occurred, nurses should timely report it to the department head nurse, and handle it properly; the department should timely formulate nursing strategy, apply special cleaning agent for laparoscope in accordance with the standard cleaning process, which can improve the instrument sterilization quality and assure instrument sterilization qualification rate. When using special cleaning agent, the cleaning effect is good, the damage for equipments is small, water resources can be saved, and it is convenient and economic. It must be noted that, in the process of equipment cleaning, the staff should do the security work, which can reduce the occurrence of adverse reactions.