河南省170所医院过氧化氢低温等离子体灭菌管理现状调查

Management status of hydrogen peroxide low temperature plasma sterilization in 170 hospitals in Henan Province

目的 调查河南省医院过氧化氢低温等离子体灭菌管理现状,分析存在的薄弱环节并提出有效对策,为提高低温灭菌质量提供参考。方法 2021年7-8月便利选取河南省170所医院,采用自行设计的调查问卷,对过氧化氢低温等离子体灭菌器的基本使用情况、管理制度、灭菌操作、灭菌效果监测、维护保养、操作人员知识与技能培训进行调查。结果 170所接受调查的医院中,147所(86.47%)医院制定了操作人员岗位职责和灭菌器维护保养制度,146所(85.88%)医院建立了灭菌器故障应急预案。152所(89.41%)医院做到了装载物与电极网之间预留至少25 mm的距离,167所(98.24%)医院灭菌器、灭菌剂及监测产品取得了国家卫生健康委员会(原卫生部)消毒产品卫生许可批件。137所(80.59%)医院使用灭菌剂前检查外包装的泄露监测指示条及有效期,126所(74.12%)医院灭菌物品装载时遮挡了紫外线灯。110所(64.71%)医院灭菌后查看及确认过氧化氢浓度,71所(41.76%)医院使用管腔生物灭菌过程验证装置(PCD)对管腔器械进行监测。156所(91.76%)医院操作人员上岗前经相关知识培训考核合格;152所(89.41%)医院操作人员能正确处理灭菌器常见故障。结论 河南省医院消毒供应中心过氧化氢低温等离子体灭菌管理尚存在灭菌操作欠规范、灭菌效果监测执行不到位、操作人员知识与技能培训缺失等问题。应建立过氧化氢低温等离子体灭菌质量管理体系,规范灭菌操作,严格落实灭菌效果监测,细化维护保养内容,强化相关知识与技能培训,保障低温灭菌质量安全。

Objective To investigate the management status of hydrogen peroxide low temperature plasma sterilization in hospitals of Henan Province,analyze existing weakness and provide effective countermeasures and refe-rences for improving the quality of low temperature sterilization.Methods From July to August 2021,170 hospitals in Henan Province were conveniently selected.A self-designed questionnaire was adopted to investigate the use status,management system,sterilization operation,sterilization effect monitoring,maintenance,knowledge and skill training of operators of hydrogen peroxide low temperature plasma sterilizer.Results Of the 170 surveyed hospitals,147(86.47%)have formulated job responsibilities of operators and the maintenance system for sterilizers;146(85.88%)have established emergency scheme for sterilizer failure;152(89.41%)have kept a distance of at least 25 mm between load and electrode grid;167(98.24%)have obtained the sanitary license from National Health Commission(the former Ministry of Health)for the disinfection products for hospital sterilizers,sterilizing agent,and monitored products;137(80.59%)checked the leakage monitoring indicator and the outer packing before using sterilizing agent;126(74.12%)blocked ultraviolet light while loading sterilized items;110(64.71%)checked and confirmed the hydrogen peroxide concentration after sterilization;71(41.76%)used luminal biological process challenge device(PCD)to monitor luminal instruments;operators in 156(91.76%)hospitals received training and passed the assessment of relevant knowledge before working;operators in 152(89.41%)hospitals could correctly handle common sterilizer failures.Conclusion There are still problems in management of hydrogen peroxide low temperature plasma sterilization in hospital central sterile supply departments in Henan Province,such as nonstandard sterilization operation,inadequate implementation of sterilization effect monitoring,as well as lacking of knowledge and skill training of operators.Central sterile supply departments should establish quality management system for hydrogen peroxide low temperature plasma sterilization,standardize sterilization operations,strictly implement sterilization effect monitoring,refine maintenance contents and strengthen relevant knowledge and skill training,so as to ensure the quality and safety of low temperature sterilization.