黑龙江省医疗机构压力蒸汽灭菌质量监测评价

Quality monitoring and evaluation of pressure steam sterilizer in medical institutions of Heilongjiang

目的对黑龙江省医疗机构压力蒸汽灭菌器灭菌效果进行监测,为压力蒸汽灭菌质量监测和管理工作提供依据。方法按照全国医院消毒与感染控制监测方案的要求,2012-2016年对黑龙江省监测点医院压力蒸汽灭菌质量进行监测,对不同监测项目合格率进行统计分析。结果 2012-2016年共监测129台次压力蒸汽灭菌器,总体监测合格率为75.19%,物理、生物和化学监测合格率分别为76.74%、98.45%和100.00%。2012-2014年,灭菌温度、灭菌时间、生物监测和化学监测合格率之间差异有统计学意义(P<0.05)。消毒供应中心、手术室、口腔科监测合格率分别为83.51%、25.00%和75.00%。分别监测下排气式、预排气式和正压脉动排气式灭菌器15台次、95台次和19台次,正压脉动排气式灭菌器物理监测合格率最低(42.11%),与下排气式和预排气式灭菌器监测合格率差异有统计学意义(χ~2=13.021,P<0.05),下排气式灭菌器生物监测合格率最低(93.33%);预排气式和正压脉动排气式灭菌器物理监测、生物监测和化学监测合格率之间差异有统计学意义(P<0.05),正压脉动排气式灭菌器灭菌温度和灭菌时间监测合格率最低,分别为63.16%和47.37%。结论手术室灭菌器监测合格率较低,正压脉动排气式灭菌器物理监测合格率较低。医院应加强压力蒸汽灭菌效果监测,医院感染管理部门应定期根据国家相关标准要求,对消毒供应中心和其他配备灭菌器的部门专业人员进行相应培训,保证压力蒸汽灭菌质量。

Objective To monitor the sterilization effect of pressure steam sterilizer in medical institutions of Heilongjiang and provided a basis for quality monitoring and management of pressure steam sterilization. Methods The pressure steam sterilization quality of monitoring hospitals in Heilongjiang province were monitored according to the nationwide hospital disinfection and infection control monitoring programme. Statistical analysis was made on the qualified rate of different monitoring items. Results From 2012 to 2016,a total of 129 pressure steam sterilizers were monitored with an overall qualified rate of 75. 19%. The overall qualified rates of physical,biological and chemical monitoring were 76. 74%,98. 45% and 100.00% respectively. From 2012 to 2014,there were statistically significant differences in qualified rates of sterilizing temperature,time,biological and chemical monitoring（ P〈0. 05）. The qualified rates of monitoring in central sterile supply department,operating room and stomatology department were 83. 51%,25. 00% and 75. 00% respectively. The sterilizers of exhaust,pre-exhaust and positive pressure pulsating exhaust were monitored for 15,95 and 19 times respectively. The qualified rate of positive pressure pulsating exhaust sterilizer was the lowest（ 42. 11%） with statistically significant difference in the qualified rate between the lower exhaust and pre-exhaust sterilizer（ χ^2= 13. 021,P〈0. 05）. The lower exhaust sterilizer has the lowest qualified rate of biological monitoring（ 93. 33%）. There was a statistically significant differences in the qualified rates of physical,biological and chemical monitoring of pre-exhaust and positive pressure pulsating exhaust sterilizers（ P〈0. 05）. The qualified rate of sterilizing temperature and time were the lowest（ 63. 16%,47. 37%）. Conclusion The qualified rate of sterilizer monitoring in stomatology department is relatively low,and that of positive pressure pulsating exhaust sterilizer is relatively low. Hospitals should strengthen pressure steam sterilization effect monitoring. The infection management department of hospitals should train the professionals in central sterile supply department and other departments equipped with sterilizers regularly according to relevant national standards to ensure the quality of pressure steam sterilization.