消毒供应中心复用医疗器械清洗质量现状及影响因素分析

Analysis of Status Quo and Influencing Factors of Reusable Medical Device Cleaning Quality in Cen⁃tral Sterile Supply Departments

目的调查消毒供应中心复用医疗器械清洗质量现状,分析其影响因素,以期为医院感染控制部门制订相应的提高消毒供应中心医疗器械清洗质量措施提供参考。方法以2022年1-7月福建省龙岩市第一医院消毒供应中心回收的286件复用医疗器械作为研究对象,采用自制的一般资料调查表评估复用医疗器械清洗质量。结果286件回收的复用医疗器械中,249件(87.06%)清洗质量合格、37件(12.94%)清洗质量不合格。单因素分析显示,预处理规范、严格执行清洗流程、除锈剂残留、器械浸泡清洗剂时间是消毒供应中心复用医疗器械清洗质量是否合格的影响因素(P<0.05)。多因素分析显示,预处理不规范(β=2.388,OR=10.891,95%CI为4.997~23.740)、未严格执行清洗流程(β=1.724,OR=5.606,95%CI为2.600~12.087)、有除锈剂残留(β=2.573,OR=10.811,95%CI为8.220~20.894)、器械浸泡清洗剂时间<20 min(β=2.636,OR=13.956,95%CI为5.523~35.262)及器械浸泡清洗剂时间>30 min(β=2.824,OR=16.846,95%CI为6.346~44.723)是复用医疗器械清洗质量的高危因素(P<0.05)。结论消毒供应中心复用医疗器械整体清洗质量有待提高。临床护理人员应针对预处理规范、严格执行流程、除锈剂残留、器械浸泡清洗剂时间等影响因素加强管理,提高复用医疗器械清洗质量。

Objective To investigate the status quo of reusable medical device cleaning quality in central sterile supply departments(CSSDs)and analyze its influencing factors,so as to provide a reference for nosocomial infection control departments to formulate corresponding measures to improve the medical device cleaning quality in CSSDs.Methods From January to July 2022,286 pieces of reusable medical devices were recycled from the CSSD of Longyan First Hospital and selected to be evaluated for cleaning quality by using a self⁃made general information questionnaire.Results Of the 286 recycled medical devices,249(87.06%)had satisfactory cleaning quality while 37(12.94%)had unsatisfactory cleaning quality.Univariate analysis showed that the standard degree of pretreatment,the strict degree of cleaning process implementation,the presence or absence of rust remover residue and the duration of device soaking in cleaning agents were the influencing factors for the cleaning quality of reusable medical devices in the CSSD(P<0.05).Multivariate analysis showed that non⁃standard pretreatment(β=2.388,OR=10.891,95%CI=4.997~23.740),less strict implementation of the cleaning process(β=1.724,OR=5.606,95%CI=2.600~12.087),presence of rust remover residue(β=2.573,OR=10.811,95%CI=8.220~20.894),<20 min soaking in cleaning agents(β=2.636,OR=13.956,95%CI=5.523~35.262)and>30 min soaking in cleaning agents(β=2.824,OR=16.846,95%CI=6.346~44.723)were high risk factors for the cleaning quality of reusable medical devices(P<0.05).Conclusion The overall cleaning quality of reusable medical devices in the CSSD needs to be improved.Clinical nurses should strengthen management in response to the influencing factors(the standard degree of pretreatment,the strict degree of cleaning process implementation,the presence or absence of rust remover residue and the duration of device soaking in cleaning agents),so as to improve the cleaning quality of reusable medical devices.