持续提升医疗服务能力背景下的急救车消毒管理研究

Study on disinfection management of emergency ambulance under the context of continuous improvement of medical service capabilities

目的:分析医院急救车实施急救任务后不同消毒方法的效果,探讨提升医疗服务能力背景下的急救车消毒管理。方法:选取2018年5-6月医院6台急救车的运行数据为研究资料,将其2个月期间96台次的抽样检查结果分配编码,按随机数表法分为清水冲洗组、紫外线消毒组和二氧化氯消毒组,每组32台次。三组分别采用3种不同的消毒方法进行车内清洗消毒,并对比分析急救任务后车内空气及器械污染情况,以及采用不同的消毒方法后车内空气及器械菌落数和杀菌率。结果:急救任务后车内空气及器械污染情况三组对比无差异。消毒后清水冲洗组空气平均菌落数和空气杀菌率分别为(1535±386)cfu/m^2和(69±7)%,紫外线消毒组为(389±57)cfu/m^2和(92±8)%,二氧化氯消毒组为(375±38)cfu/m^2和(93±7)%,清水冲洗组菌落数高于其他两组,杀菌率低于其他两组,其差异有统计学意义(F=276.836,F=109.235;P<0.05)。消毒后清水冲洗组器械平均菌落数和器械杀菌率分别为(23±5)cfu/m^2和(81±6)%,紫外线消毒组为(5±2)cfu/m^2和(95±7)%,二氧化氯消毒组为(5±2)cfu/m^2和(95±6)%,清水冲洗组器械平均菌落数高于其他两组,杀菌率低于其他两组,其差异有统计学意义(F=280.241,F=116.157;P<0.05)。紫外线消毒组和二氧化氯消毒组均能达到国家标准规定数值。结论:三组消毒方法中,紫外线消毒组和二氧化氯消毒组的消毒效果符合国家相关质量要求和标准,均能达到良好的细菌杀灭水平。

Objective:To analyze the effects of various disinfection methods after emergency ambulance implemented emergency task and explore the disinfection management of emergency ambulance under context of continuous improvement of medical service capabilities.Methods:Selected operation data of 6 emergency ambulance of hospital from May to June 2018 as research information.And the results of sampling inspection of 96(set or time)in 2 months were allocated different codes,and these results were divided into cleaning water group,disinfection group with ultraviolet and disinfection group with chlorine dioxide as random number table,with 32 set or time in each group.The three groups adopted three various methods to implement disinfection in vehicle,and the contaminated situations of air and instruments in vehicle after emergency task was implemented among three groups were compared and analyzed.And after different disinfection methods were implemented,the colony count and sterilization rate of air and instruments also were compared and analyzed.Results:Thedifferences of contamination situation of air and instruments in vehicle after emergency tasks were implemented among different groups were no significant.After disinfection was implemented,the average colony count and sterilizing rate of air of cleaning water group were(1535±386)cfu/m^2 and(69±7)%.And those ofdisinfection group with ultraviolet were(389±57)cfu/m^2 and(92±8)%.And those of disinfection group with chlorine dioxidewere(375±38)cfu/m^2 and(93±7)%.Compared with other two groups,the colony count of cleaning water group was significantly higher than that of them,while sterilizing rate of cleaning water group was significantly lower than that of them(F=276.836,F=109.235,P<0.05).After disinfection was implemented,the average colony count and sterilizing rate of instruments of cleaning water group were(23±5)cfu/m^2 and(81±6)%,and those of disinfection group with ultraviolet were(5±2)cfu/m^2 and(95±7)%,and those of disinfection group with chlorine dioxide were(5±2)cfu/m^2 and(95±6)%.Compared with other two groups,the average colony count of cleaning water group was significantly higher than that of other two groups,while the sterilizing rate of cleaning water group was significantly lower than that of other two groups(F=280.241,F=116.157,P<0.05).Both the disinfection group with ultraviolet and the disinfection group with chlorine dioxide can achieve the value of national standard.Conclusion:In the three kinds of disinfections,the effects of disinfection group with ultraviolet and disinfection with chlorine dioxide can accord withrelevant quality requirement and standard of state,and they can achieve favorable disinfection level.