北京市42所三级医院软式内镜清洗消毒状况调查研究

Investigation on cleaning and disinfection of flexible endoscope in 42 tertiary hospitals in Beijing

目的了解北京市医院内镜室清洗消毒现状。方法于2021年3月至8月采用方便抽样的问卷调查方法,对北京市42所三级医院内镜中心(室)的布局设施、制度建设、培训、职业安全防护、清洗消毒(灭菌)流程、监测和记录等全流程进行调查。结果回收调查问卷42份,有效回收率为100%。42所医院中,10所机构没有配备办公用房,12所机构没有设置麻醉恢复室,6所机构应急预案的制订欠缺,培训还存在较大的差距。清洗消毒槽全部配备,动力泵、超声波清洗器的配备分别是76.2%和69.0%,内镜自动清洗机73.8%配置。环氧乙烷、低温甲醛、过氧化氢低温等离子灭菌器分别有30.9%、9.5%和59.5%的医院配备。消毒剂邻苯二甲醛59.5%医院使用,40.5%医院使用复方含氯消毒剂。42所医院都为消毒人员提供了防护用品。15所医院(35.7%)消毒室采用自然通风,27所医院(64.3%)安装了机械通风,安装的位置有5所(18.5%)在天花板,不符合规范的要求。在内镜用后的预处理、测漏等要求上还有一定的差距。结论所有医疗机构能够遵循规范清洗消毒的基本要求。但在设施设备的配置,清洗消毒细节的落实上还存在一定的差距。医疗机构要对照新规范不断改进,降低医院感染发生。

Objective To understand the cleaning and disinfection status of endoscope room in Beijing hospitals.Methods From March to August 2021,questionnaire survey method with convenient sampling was adopted to investigate the layout facilities,system construction,training,occupational safety protection,cleaning and disinfection(sterilization)process,monitoring,and recording of endoscopy centers(rooms)in 42 tertiary hospitals in Beijing.Results A total of 42 questionnaires were collected,with an effective recovery rate of 100%.Among them 10 institutions had no office room,12 institutions had no anesthesia recovery room,and 6 institutions had no emergency plan,and there was still a big gap in training.The cleaning and disinfection tank was fully equipped,power pump and ultrasonic cleaner are 76.2%and 69.0%respectively,and 73.8%of the endoscopic automatic cleaning machines were configured.30.9%of hospitals were equipped with ethylene oxide sterilizers,9.5%with low temperature formaldehyde sterilization,and 59.5%with hydrogen peroxide low-temperature plasma sterilizers.Phthalaldehyde was used in 59.5%of hospitals,and compound chlorine-containing disinfectant was used in 40.5%of hospitals.42 hospitals had provided protective equipment for disinfection workers.Natural ventilation was used in 15 hospitals(35.7%),and mechanical ventilation was installed in 27 hospitals(64.3%),and 5(18.5%)of the installation locations were on the ceiling,which did not meet the requirements.There were still some gaps in the pretreatment,leak detection,flushing water and equipment.Conclusion All medical institutions are able to comply with the basic requirements of standardized cleaning and disinfection. However, there are still some gaps in the configuration of facilities and equipment and the implementation of cleaning and disinfection details. Medical institutions should constantly improve against the new norms to reduce the incidence of nosocomial infections.