医疗机构医疗器械消毒灭菌监测结果分析

Analysis of monitoring results for disinfection and sterilization of medical instruments in medical institutions

目的了解医疗机构的清洗消毒灭菌工作质量和医院消毒与感染控制措施的效果,控制院内感染和传染病发生。方法采用现场采样和灭菌参数实时监测方法,对哨点医院消毒供应中心可复用医疗器械清洗、消毒和灭菌效果进行监测。结果哨点医院各种类型医疗器械清洗效果肉眼裸视法与放大镜法合格率均为88.28%,ATP含量中位数值为1 937 amol/件;医院压力蒸汽灭菌器生物监测指标均合格,物理参数监测问题突出,灭菌器中温度均匀度≤2℃的仅占33.33%,灭菌温度实测值高于设定值+3℃的占80%以上,灭菌时间实测值符合要求的仅占38.09%;过氧化氢等离子灭菌器生物监测指标均合格。结论医院清洗灭菌控制措施存在薄弱环节与感染风险,应加强清洗消毒过程的质量控制和医护人员相关培训。

Objective To understand the quality of cleaning,disinfection and sterilization in medical institutions and the effects of disinfection and infection control measures of hospital,so as to control the occurrence of nosocomial infection and communicable diseases. Methods Sampling on the spot and the real-time monitoring on the sterilization parameters were used to monitor the effects of cleaning、disinfection and sterilization on the reusable medical instruments of the Disinfection Supply Centre in the targeted hospitals. Results The qualified rates of cleaning effects on all types of medical instruments in targeted hospitals with naked vision method and magnifying glass method were both 88. 28%,and the median number of ATP content was 1 937 amol/item. The biological monitoring indicators of pressure steam sterilizers in hospitals were all qualified,and the monitoring problem of physical parameters was so remarkable. The sterilizers in which even degree of temperature was ≤2 ℃ accounted for 33. 33%,and the sterilizers in which the actual sterilization temperature was ＋ 3 ℃above the set temperature accounted for more than 80%,while the sterilizers for which the actual sterilization time met with the requirements accounted for 38. 09%. The biological monitoring indicators of hydrogen peroxide plasma sterilizers were all qualified. Conclusion The weak links and infection risks exist in the cleaning and sterilization control measures in hospitals. So the quality control of cleaning and disinfection procedures and related trainings for medical staff should be strengthened.