吉林省72所医疗机构软式内镜终末漂洗用水管理现状调查

Management status of final rinsing water for flexible endoscopes in 72 medical institutions in Jilin Province

目的调查吉林省各级医疗机构软式内镜终末漂洗用水制备、设备维护、水质监测等管理现状,为软式内镜终末漂洗用水规范管理提供科学依据。方法2020年1—5月基于吉林省研究型医院学会内镜护理与感染控制专业委员会平台选取吉林省9个地级市开展软式内镜诊疗项目的医疗机构,采用自制软式内镜调查问卷对医疗机构负责内镜中心(科)终末漂洗用水管理且自愿参与项目的负责人进行调查。结果共发放问卷75份,有效回收72份,有效回收率96.0%。72所医疗机构中,64所(88.9%)内镜中心(科)由科室独立供水。漂洗用水生产设备配置方面,22所(45.8%)医疗机构安装原水预处理装置,19所(26.4%)医疗机构配置反渗透系统。终末漂洗用水生产设备维护方面,19所(26.4%)医疗机构制定了设备相关质检、维护及保养制度,34所(47.2%)医疗机构对设备维护、耗材更换等情况进行记录;在安装原水预处理及滤膜等设备的医疗机构中,18所(54.5%)医疗机构会定期更换预处理耗材,50所(75.8%)医疗机构会定期更换滤膜;35所(48.6%)医疗机构会定期对终末漂洗用水管路及储水罐进行消毒。终末漂洗用水质量监测方面,26所(36.1%)医疗机构具备终末漂洗用水质量相关监测制度及相应记录,59所(81.9%)医疗机构定期对终末漂洗用水进行微生物检测。结论各级医疗机构对软式内镜终末漂洗用水质量管理科学认知不足,重视程度不够,导致制水设备、相关制度配置率低,设备维护、用水质量监测、记录等工作执行率低。应提高对内镜终末漂洗用水质量控制的重视,加大科研力度,制定并完善相关规范,统一行业标准及行为,从而确保终末漂洗用水质量,保证医疗安全。

Objective To investigate the management status of water preparation,equipment maintenance and water quality monitoring for the final rinsing for flexible endoscopes in all levels of medical institutions(MIs)in Jilin Province,provide a scientific basis for the standardized management of water for the final rinsing of flexible endoscopes.Methods From January to May 2020,based on the platform of endoscopic nursing and infection control professional committee of Jilin Research Hospital Association,MIs in 9 cities in Jilin Province carrying out flexible endoscopy diagnosis and treatment projects were selected,and self-made questionnaire for flexible endoscope was adopted to investigate persons in charge of the management of final rinsing water in endoscopy centers(departments)and voluntarily participated in the project.Results A total of 75 questionnaires were distributed,and 72(96.0%)were available,among 72 MIs,64(88.9%)endoscopy centers(departments)were independently supplied water by departments.In terms installation of final rinsing water production equipment,22(45.8%)MIs were equipped with water pre-treatment devices for raw water,and 19(26.4%)MIs were equipped with reverse osmosis systems.In terms of maintenance of production equipment for final rinsing water,19(26.4%)MIs have formulated equipment-related quality inspection,repair and maintenance systems,and 34(47.2%)MIs recorded equipment maintenance,consumables replacement and so on;among the MIs that installed equipment such as raw water pre-treatment and filter membrane,18(54.5%)MIs replaced pre-treatment consumables regularly,and 50(75.8%)MIs replaced filter membranes regularly;35(48.6%)MIs regularly disinfected the final rinsing water pipeline and water storage tank.In terms of quality monitoring of final rinsing water,26(36.1%)MIs had relevant monitoring systems and corresponding records for the quality of final rinsing water,59(81.9%)MIs regularly performed microbiological testing of final rinsing water.Conclusion MIs at all levels have insufficient scientific understanding and attention to the management of final rinsing water for flexible endoscopes,resulting in low allocation rate of water producing equipment,corresponding systems,and low implementation rate of equipment maintenance,water quality monitoring and water use records.Quality control of endoscopic final rinsing water should be paid more attention,strengthen scientific research,formulate relevant specifications,and unify industry standards and behaviors,so as to ensure the quality of final rinsing water and medical safety.