成都市妇幼保健机构新生儿病室配奶间院感管理现状研究

Research on the current conditions of hospital infection management in milk preparation room of neonatal wards of maternal and child health institutions in Chengdu

目的了解成都市各妇幼保健机构新生儿病室配奶间医院感染管理现状及存在的主要问题,为今后规范新生儿病室配奶间管理提供数据支持。方法本研究于2022年10月至12月选取成都市全部妇幼保健机构共21家进行调查,其中三甲4家(19.05%)、三乙14家(66.67%)、二甲3家(14.28%),收集并分析成都市妇幼保健机构新生儿病室配奶间布局流程、建筑布局、操作环境、人物管理、质量控制等。结果21家保健机构均在新生儿病室的独立配奶间内配奶,并制定了配奶室管理制度及配奶相关流程,其中有3家(17.29%)未将相关流程粘贴上墙,1家(4.76%)未对患者开展母乳质量管理的宣教;16家(76.20%)机构用水浴箱或温奶器加热母乳,加热用水多为自来水(62.50%);12家(57.14%)机构配备了专用奶具清洁工具,其中50.00%的机构未每次使用后对专用奶具清洁工具进行清洁消毒;只有15家(71.43%)医疗机构设置了专人对配奶室进行管理;18家(85.71%)机构在配奶间内设置了流动水洗手设施,其中9家洗手设施与配奶操作台面距离≤1m;14家(66.67%)机构取用配方奶的勺子后放入配方奶罐内保存,1家(4.76%)医疗机构将剩余奶液留存待用;2家(9.52%)机构未对消毒后奶具开展卫生学监测,5家(23.80%)机构未针对配奶间建立院感督导标准。结论本调查中成都市各妇幼保健机构新生儿病室配奶间院感管理情况差别较大,且有一部分不够规范,应参照现有指南,加强配奶间院感管理,并完善我国配奶间院感管理相关法律法规及循证指南。

Objective To learn about the current conditions and main problems of hospital infection management in milk preparation room of neonatal wards of maternal and child health institutions in Chengdu and provide data support to standardize the management in milk preparation room of neonatal wards in future.Methods In this study,from October 2022 to December 2022,a total of 21 maternal and child health institutions in Chengdu were selected for survey,including 4 Grade A Class 3 institutions(19.05%),Grade B Class 3 institutions(66.67%),and Grade A Class 2 institutions(14.28%).The layout process,building layout,operation environment,character management,quality control,and others of milk preparation room of neonatal wards of maternal and child health institutions in Chengdu were collected and analyzed.Results All 21 healthcare institutions prepared milk in independent milk preparation room of neonatal wards and developed the management regulations and related process for the milk preparation room.Among them,3 institutions(17.29%)did not post the related procedures on the wall and 1 institution(4.76%)did not conduct education on quality management of breast milk for patients;16 institutions(76.20%)heated breast milk with water bath or milk warmer and most of them used tap water for heating(62.50%);12 institutions(57.14%)had specialized cleaning tools for milk utensils,and 50.00%of these institutions did not clean and disinfect specialized cleaning tools for milk utensils after each use;only 15 medical institutions(71.43%)had specially-assigned personnel for the management of milk preparation room;18 institutions(85.71%)had handwashing facilities of running water in the milk preparation room and the distance between handwashing facilities and the milk preparation operation table in 9 institutions was equal to or less than 1m;spoons used for taking formula milk were stored in formula milk containers in 14 institutions(66.67%),while the remaining milk was kept for future use in 1(4.76%)medical institution;and 2 institutions(9.52%)did not conduct hygiene monitoring on sterilized utensils and 5 institutions(23.80%)did not establish hospital infection supervision standards for milk preparation room.Conclusion In this survey,there were significant differences in the hospital infection management in milk preparation room of neonatal wards in maternal and child health institutions in Chengdu and a portion of them is not sufficiently standardized.It is recommended to refer to existing guidelines,strengthen hospital infection management in milk preparation room,and improve related laws,regulations,and evidence-based guidelines for hospital infection management in milk preparation room in China.