浙江省55所医疗机构新生儿奶瓶清洗消毒现况调查
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摘要
目的 调查浙江省医疗机构新生儿奶瓶清洗消毒现状,为进一步规范新生儿奶具清洗消毒管理提供依据。方法 2019年2月1日-2月28日,通过网络调查方式对浙江省55家有新生儿病房(室)医疗机构的医院感染管理专职人员进行调查。结果 调查的55家医疗机构中,全部使用可复用奶瓶45家(81.82%),全部使用一次性奶瓶8家(14.55%),一次性奶瓶和可复用奶瓶都使用2家(3.64%);专科医院和综合医院奶瓶使用情况差异有统计学意义(P=0.006),综合医院选择复用奶瓶使用率92.11%(35/38)高于专科医院使用率58.82%(10/17)。47家复用奶瓶机构调查显示,46家为手工清洗,玻璃奶瓶以物理消毒方法为主。调查机构在复用奶瓶管理要求方面差别很大,一些医疗机构缺乏专门清洗场地、清洗设施设备及清洗人员培训,个别医疗机构缺乏管理制度和清洗消毒效果评价。结论 浙江省医疗机构新生儿科(室)复用奶瓶清洗消毒管理有待加强,通过细化复用奶瓶清洁消毒管理制度,加强清洗消毒流程监管和效果评价,增加场地和人员设施配置,进一步规范新生儿科(室)复用奶瓶的使用管理。
OBJECTIVE To understand the status of cleaning and disinfection of feeding bottles for neonates in medical institutions in Zhejiang Province, so as to provide basis for improving neonatal feeding bottles management. METHODS From Feb. 1 st to 28 th, 2019, an online survey was conducted among nosocomial infection management staffs in 55 hospitals with neonatal ward(department). RESULTS Fifty-five questionnaires were collected. The results showed that, 45 medical institutions used reusable bottles(81.82%), 8 medical institutions used disposable bottles(14.55%), and 2 medical institutions used both reusable and disposable bottles(3.64%). Feeding bottles usage was significantly different between comprehensive and specialized hospitals(P=0.006). The usage rate of reusable bottles in comprehensive hospitals was 92.11%(35/38), higher than that of specialized hospitals which was 58.82%(10/17). In the 47 medical institutions using reusable bottles, 46 institutions cleaned the bottles manually, and most institutions chose physical disinfection of glass bottles. There were differences in reusable feeding bottles management among these investigated institutions. Some institutions lacked dedicate cleaning space, cleaning equipment, and personnel training, whereas a few institutions had no management and hygiene evaluation regulations. CONCLUSION Cleaning and disinfecting management of feeding bottles in the neonatal ward(department) of medical institutions in Zhejiang Province needs to be strengthened. It is necessary to refine management requirements, enhance process supervision and effectiveness evaluation, increase designated sites, staffing and facilities, and further improve the management of reusable feeding bottles in neonatal wards(departments).
OBJECTIVE To understand the status of cleaning and disinfection of feeding bottles for neonates in medical institutions in Zhejiang Province, so as to provide basis for improving neonatal feeding bottles management. METHODS From Feb. 1 st to 28 th, 2019, an online survey was conducted among nosocomial infection management staffs in 55 hospitals with neonatal ward(department). RESULTS Fifty-five questionnaires were collected. The results showed that, 45 medical institutions used reusable bottles(81.82%), 8 medical institutions used disposable bottles(14.55%), and 2 medical institutions used both reusable and disposable bottles(3.64%). Feeding bottles usage was significantly different between comprehensive and specialized hospitals(P=0.006). The usage rate of reusable bottles in comprehensive hospitals was 92.11%(35/38), higher than that of specialized hospitals which was 58.82%(10/17). In the 47 medical institutions using reusable bottles, 46 institutions cleaned the bottles manually, and most institutions chose physical disinfection of glass bottles. There were differences in reusable feeding bottles management among these investigated institutions. Some institutions lacked dedicate cleaning space, cleaning equipment, and personnel training, whereas a few institutions had no management and hygiene evaluation regulations. CONCLUSION Cleaning and disinfecting management of feeding bottles in the neonatal ward(department) of medical institutions in Zhejiang Province needs to be strengthened. It is necessary to refine management requirements, enhance process supervision and effectiveness evaluation, increase designated sites, staffing and facilities, and further improve the management of reusable feeding bottles in neonatal wards(departments).
引文
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[15] 秦姣红,徐文娟,朱玉叶.探讨PDCA循环在新生儿室医院感染质量管理中的应用[J].中国医学创新,2014,11(15):133-135.
[16] 邵惠明,彭叶,干蓉.综合医院新生儿监护室配奶感染控制与护理[J].内蒙古中医药,2011,30(13):155.
[17] 崔雪华,王玲,黄劲华.循征医学在新生儿重症监护病房感染控制中的应用[J].中华现代护理杂志,2010,16(35):4265-4267.
[18] Ma L,Zhang G,Swaminathan B,et al.Efficacy of protocols for cleaning and disinfecting infant feeding bottles in less developed communities[J].Am J Trop Med Hyg,2009,81(1):132-139.
[19] Kuan WH,Chen YL.Bottle material and cleansing procedures of infant feeding bottles[J].Southeast Asian J Trop Med Public Health,2016,47(1):142-151.
[20] "Bottle feeding advice".www.nhs.uk.https://a2nutrition.com.au/resources-for-parents/bottle-feeding-advice/
[21] "Bottle Feeding" (PDF).wch.sa.gov.au.Women's and Children's Hospital and Government of South Australia.Archived from the original (PDF) on 2011-04-23.Retrieved 2016-04-01.Printed November 2008.
[22] "Should You Sterilize Your Baby's Bottles?".WebMD.Reviewed by Roy Benaroch,MD on May 24,2014.https://www.webmd.com/parenting/baby/should-you-sterilize-your-babys-bottles.
[23] 中华人民共和国国家卫生和计划生育委员会.关于发布《医疗机构消毒技术规范》等2项推荐性卫生行业标准的通告[EB/OL].http://www.nhc.gov.cn/fzs/s7852d/201204/2a75e255894a4b28827bb996def3cf02.shtml,2012-4-17.
[2] Sanchez-Carrillo C,Padilla B,Marin M,Rivera M,et al.Contaminated feeding bottles:the source of an outbreak of Pseudomonas aeruginosa infections in a neonatal intensive care unit[J].Am J Infect Control,2009,37(2):150-154.
[3] Molina-Cabrillana J,Artiles-Campelo F,Dorta-Hung E,et al.Outbreak of Pseudomonas aeruginosa infections in a neonatal care unit associated with feeding bottles heaters[J].Am J Infect Control,2013,41(2):e7-9.
[4] Redmond EC,Griffith CJ,Riley S.Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health[J].Persp Public Health,2009,129(2):85-94.
[5] 龙奇志,何志敏,陈友群,等.一例由阪崎肠杆菌感染引起的婴儿腹泻调查[J].实用预防医学,2017,24(8):954-956.
[6] 简少霞,付玉震,李敏.3种不同奶瓶、奶嘴消毒方法对预防新生儿鹅口疮的效果观察[J].中国实用神经疾病杂志,2009,12(16):61-62.
[7] 陈荣川,李苑,张海龙.5 岁以下儿童轮状病毒腹泻危险因素的研究[J].中国热带医学,2012,12(4):471-473.
[8] 颜玉炳,苏成豪,牛建军,等.厦门市手足口病发病危险因素研究[J].中华疾病控制杂志 2012,16(1):85-87.
[9] 中华人民共和国国家卫生和计划生育委员会.关于发布《食品安全国家标准食品接触材料及制品通用安全要求》(GB 4806.1-2016)等53项食品安全国家标准的公告[EB/OL].http://www.nhc.gov.cn/sps/s7891/201611/06ed87a09dad4cf6aee48cd89efbef35.shtml.2016-10-19.
[10] Gillham C.For safer baby bottles[J].Newsweek,2007,150(21):71.
[11] 中华人民共和国中央人民政府.卫生部印发《新生儿病室建设与管理指南(试行)》[EB/OL].http://www.gov.cn/gzdt/2010-01/13/content_1509150.htm.
[12] 中华人民共和国国家卫生和计划生育委员会.卫生部办公厅关于印发《三级综合医院评审标准实施细则(2011年版)》的通知[EB/OL].http://www.nhc.gov.cn/wjw/gfxwj/201304/454a7d3f203448c785fb7619d29aa899.shtml,2011-11-25.
[13] 陈娟,彭兰兰,金绍梅,等.控制轮状病毒院内感染的护理策略及效果分析[J].中国全科医学,2012,15(27):3198-3200.
[14] Rowan NJ,Anderson JG.Effectiveness of cleaning and disinfection procedures on the removal of enterotoxigenic bacillus cereus from infant feeding bottles[J].J Food Prot,1998,61(2):196-200.
[15] 秦姣红,徐文娟,朱玉叶.探讨PDCA循环在新生儿室医院感染质量管理中的应用[J].中国医学创新,2014,11(15):133-135.
[16] 邵惠明,彭叶,干蓉.综合医院新生儿监护室配奶感染控制与护理[J].内蒙古中医药,2011,30(13):155.
[17] 崔雪华,王玲,黄劲华.循征医学在新生儿重症监护病房感染控制中的应用[J].中华现代护理杂志,2010,16(35):4265-4267.
[18] Ma L,Zhang G,Swaminathan B,et al.Efficacy of protocols for cleaning and disinfecting infant feeding bottles in less developed communities[J].Am J Trop Med Hyg,2009,81(1):132-139.
[19] Kuan WH,Chen YL.Bottle material and cleansing procedures of infant feeding bottles[J].Southeast Asian J Trop Med Public Health,2016,47(1):142-151.
[20] "Bottle feeding advice".www.nhs.uk.https://a2nutrition.com.au/resources-for-parents/bottle-feeding-advice/
[21] "Bottle Feeding" (PDF).wch.sa.gov.au.Women's and Children's Hospital and Government of South Australia.Archived from the original (PDF) on 2011-04-23.Retrieved 2016-04-01.Printed November 2008.
[22] "Should You Sterilize Your Baby's Bottles?".WebMD.Reviewed by Roy Benaroch,MD on May 24,2014.https://www.webmd.com/parenting/baby/should-you-sterilize-your-babys-bottles.
[23] 中华人民共和国国家卫生和计划生育委员会.关于发布《医疗机构消毒技术规范》等2项推荐性卫生行业标准的通告[EB/OL].http://www.nhc.gov.cn/fzs/s7852d/201204/2a75e255894a4b28827bb996def3cf02.shtml,2012-4-17.