河南宏力医院消毒供应中心器械污染现状及影响因素分析

Current situation and influential factors of equipment contamination in Sterile Supply Center of Henan Hongli Hospital

目的分析河南宏力医院消毒供应中心器械污染现状,并对影响器械污染的因素进行分析,以期指导未来消毒供应中心器械管理。方法选取2018年3月至2019年7月河南宏力医院消毒供应中心中准备接受消毒灭菌的438件器械,观察全部器械的污染情况,依据器械污染情况分为污染组和无污染组,将全部可能的因素纳入后,分析器械污染的影响因素。结果全部438件器械中,有52件器械存在污染现象,污染发生率为11.9%;经单因素分析结果显示,消毒剂合理应用、清洗质量检查、卸载情况、包装材料均与器械污染无关(P>0.05);工作人员对工作标准掌握情况、清洗方式、无菌器械存放区温度、装载过程、工作区域划分情况、清洁流程均可能是器械污染的影响因素(P<0.05);将单因素分析检出的可能的影响因素纳入,经Logistic回归分析结果显示,清洁流程不合理、工作人员对工作标准掌握不到位、手工清洗、无菌器械存放区温度高、装载过程不合理、工作区域不合理划分均是消毒供应中心器械污染的影响因素(OR>1,P<0.05)。结论清洁流程不合理、工作人员对工作标准掌握不到位、手工清洗、无菌器械存放区温度高、装载过程不合理、工作区域不合理划分均是消毒供应中心器械污染的影响因素,针对这些风险因素应积极给予合理干预,以降低器械污染率,保障广大患者的生命安全。

Objective To investigate the current situation of equipment contamination in our Sterile Supply Center,and to determine the influential factors of the equipment contamination,so as to guide future inventory management of the equipment in our Sterile Supply Center.Methods A total of 438 pieces of equip-ment prepared for disinfection and sterilization in our Sterile Supply Center between March 2018 and July 2019 were investigated for equipment contamination,and accordingly,these equipment were assigned to the contami-nated and non-contaminated groups.By taking into account all potential factors,analyzed the factors affecting equipment contamination.Results Among the 438 pieces of equipment,52 were contaminated,corresponding to a contamination rate of 11.9%.A preliminary univariate analysis showed that rational use of disinfectants,inspection of cleansing quality,unloading,and packaging materials were not associated with equipment contami-nation(P>0.05);however,workers′mastery of the standard operating procedure,cleansing methods,tempera-ture at the sterile equipment storage area,loading,working zone division,and cleansing procedure may be influ-ential factors of equipment contamination(P<0.05).These probable influential factors identified in the prelimi-nary univariate analysis were further fed into the multivariate logistic regression,which showed that improper cleansing procedure,inadequate worker mastery of the standard operating procedure,manual cleansing,high temperature at the sterile equipment storage area,improper loading and suboptimal working zone division were factors affecting the equipment contamination in Sterile Supply Center(OR>1,P<0.05).Conclusion Improper cleansing procedure,inadequate worker mastery of the standard operating procedure,manual cleansing,high temperature at the sterile equipment storage area,improper loading and suboptimal working zone division are factors affecting the equipment contamination in Sterile Supply Center.Proactive interventions should target these risk factors to reduce equipment contamination for sake of the life-safety with a wide range of patients.