HACCP在肠内营养配制室的应用

Application of HACCP in enteral nutrition preparation department

目的建立肠内营养配制室危害分析关键控制点(HACCP)体系,保证肠内营养配制工作的安全与规范。方法应用HACCP原理进行分析、确定关键控制点、措施、关键限值。结果最终确定营养液瓶消毒、食材制熟、巴氏杀菌、冷藏、发放,共5点为关键控制点,并确定关键控制点的限值,其中营养液瓶杀菌条件为100℃、20 min,食材制熟条件为煮沸15 min,巴氏杀菌条件为70℃、10 min,冷却条件为快速冷却至4℃,发放时采用条形码电子扫描核对患者信息及营养液有效期。最终进行了效果验证,采用GB19645-2010中的微生物限量标准进行检测,在配制后以及4℃冷藏24 h后微生物结果均符合标准。结论近年来,随着肠内营养广泛受到临床认可,适用范围不断扩大,临床对于肠内营养的配制水平也越来越重视。应用HACCP原理规范医院肠内营养配制的工作过程,保证了肠内营养液的质量与安全。

Objective To establish the hazard analysis critical control point(HACCP) system in enteral nutrition preparation room, and ensure the safety and standardization of enteral nutrition preparation. Methods The HACCP principle was applied to analyze and determine the key control points, measures and critical limits. Results Total of 5 key control points were determined, including sterilization of nutrient bottles, cooking of food materials, pasteurization, refrigeration and distribution. The limits of key control points were determined. The sterilization conditions of nutrient bottles were 100 ℃, 20 min, cooking conditions of food materials were 15 min, pasteurization conditions were 70 ℃, 10 min, and cooling conditions were fast cooling to 4 ℃. The barcode electronic scanning was used to check the patient information and the expiry date of the nutrition solution. Finally, the effect was verified. The microbial limit standard GB 19645-2010 was used for detection. The microbial results after preparation and refrigeration at 4 ℃for 24 h were in accordance with the standard. Conclusion In recent years, with the wide acceptance of enteral nutrition and the expanding scope of application, more and more attention has been paid to the formulation of enteral nutrition in clinical practice. The quality and safety of enteral nutrition solution are guaranteed by applying HACCP principle to standardize the working process of enteral nutrition preparation in hospital.