医院感染管理科在胃肠镜清洗消毒室改造中的作用和效果

The role and effect of hospital infection management department in improving gastroenteroscope cleaning and disinfection room

目的为了胃肠镜清洗消毒室改造工作顺利进行并达到胃肠镜高水平消毒或灭菌的要求。方法医院感染管理科从建筑布局、装修材质应用、通风和竣工后的空气、纯水及消毒效果监测全过程介入。结果改造后的胃肠镜清洗消毒室布局合理、新风系统做到上送下排、墙地面材料光滑耐腐易清洁,清洗消毒设施符合工作量的需要。工程交付使用前委托有资质室内空气质量检测公司进行检测,检测项目全部合格,纯水供给管道消毒前后内镜终末漂洗用纯水检测合格率分别0%(0/10)、100%(10/10),染菌量中位数(四分位数)分别为500.0(486,513)、1.5(0,6)CFU/100 ml,差异有统计学意义(P<0.01)。全自动内镜清洗消毒机酶洗过程中未启动加热功能前胃肠镜监测结果合格率为80%(8/10),启动加热功能合格率为90%(9/10)。全自动内镜清洗消毒机(AER)终末漂洗水管路自身消毒前后,自动清洗消毒机空载运行后水样本检测合格率分别为50%、100%,染菌量中位数(四分位数)分别为103.5(7,179)CFU/100 ml、5.0(1.75,6.00)CFU/100 ml,差异有统计学意义(P<0.01)。对疑似有生物膜形成的肠镜管腔用2000 mg/L过氧乙酸消毒后,合格率达100%(10/10)。结论医院感染管理科全过程介入胃肠镜清洗消毒室改造工作,减少施工中改动导致的时间延长和成本增加,同时及时地解决验收过程中存在的问题,保障清洗消毒质量。

Objective To revamp the gastroenteroscopy cleaning disinfection room and make sure the disinfection of gastroscopes and enteroscopes meet the requirements of high level disinfection or sterilization.Methods The hospital infection management department intervened in the whole process,including building layout,decoration material application,ventilation system,the test of air and pure water,and disinfection effect monitor after completion.Results After revamping,thegastroenteroscopy cleaning and disinfection room's layout is reasonable;the fresh air system achieves up-feed and down-drain;the wall and floor materials are smooth,corrosion-resistant,and easy to clean;and the cleaning and disinfection facilities meet workload requirements.The pre-completion acceptance was checked by the third party,with qualified results.The indoor air quality is qualified.The air colony number meets the national standard.Before and after the disinfection of the pure water supply pipeline,the qualified rates of end-stage rinsing with pure water were 0%(0/10)and 100%(10/10),and the medians(quartile)of the bacteria number were 500.0(486,513)and 1.5(0,6)CFU/100 ml,respectively,with a statistical difference(P<0.01).Before starting the heating function of the automatic endoscope cleaning and disinfection machine,the qualilfied rate of the gastrointestinal mirror monitoring results was 80%(8/10),and was 90%(9/10)after.Before and after the self-cleaning and disinfection of the automatic endoscope cleaning and disinfecting machine(AER),the qualified rates of water specimens after the no-load operation of the machine were 50%and 100%,respectively,and the medians(quartile)of the bacteria number were 103.5(7,179)and 5.0(1.75,6.00)CFU/100 ml,respectively,with a statistical difference(P<0.01).After the endoscope with suspected biofilm formation in the lumen was disinfected with 2000 mg/L peracetic acid,the qualified rate was 100%(10/10).Conclusion That hospital infection management department intervenes in the whole process of the reconstruction of gastrointestinal endoscope cleaning and disinfection room can effectively reduce the construction time and cost.At the same time,the problems existing in the process of acceptance are solved in time to ensure the quality of cleaning and disinfection.