黑龙江省2015-2017年医疗机构消毒质量监测分析
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摘要
目的掌握黑龙江省消毒与管理质量现状及存在的问题,发现可能存在的发生医院感染的关键环节,为相关法规和标准的修订提供依据。方法按照中国疾控中心环境与健康相关产品安全所下发的《全国医院消毒与感染控制监测方案》要求,于2015-2017年对黑龙江省两所哨点医院进行监测。结果 2015-2017年两所综合医院共采集样本1 867份,检测合格样本为1 698份,平均合格率90.95%,不同年度总体合格率有统计学差异(χ~2=22.342,P<0.01)。物体表面、污水、医疗器械清洗效果和内镜监测合格率均在90.00%以上,手术室空气(静态)、医疗用水、压力蒸汽灭菌效果和医护人员手监测合格率较低,分别为89.36%、80.48%、79.19%和87.84%。其中以压力蒸汽灭菌效果合格率最低为79.19%,医疗器械清洗效果的合格率最高为95.42%。结论两所医院2017年消毒效果总体好于2015和2016年,但仍低于国内其他类似报道。说明连续开展监测工作对两所哨点医院起到了督导作用,医疗机构对消毒工作重视程度有所提高,但是还应继续加强监管。
Objective To grasp the current situation and existing problems of disinfection and management quality,find out the key links of possible hospital infection,so as to provide reference for the revision of relevant laws,regulations and standards.Methods The monitoring was conducted on two hospitals in Heilongjiang province from 2015 to 2017 in accordance with the requirements of " Controlling and Monitoring the Disinfection and Infection Program of National Hospitals" issued by the National CDC Environment-related Product Safety.Results One thousand eight hundred and sixty-seven samples were collected from two general hospitals from 2015 to 2017,1 698 tested samples were qualified,the average qualified rate was 90.95%.There was a statistical difference in the total qualified rate for different years(χ~2=22.342,P<0.001).The qualified rates of surfaces of objects,sewage,cleaning effect of medical instruments,endoscopic surveillance were all above 90.00%,the monitoring qualified rates of air of the operation room(static),medical water,effect of pressure steam sterilization and hand of medical staff were lower,respectively 89.36%,80.48%,79.19% and 87.84%.Among them,the qualified rate of pressure steam sterilization was the lowest(79.19%),and the qualified rate of cleaning effect of medical instruments was the highest(95.42%).Conclusion The disinfection effects of the two hospitals were generally better than that in 2015 and 2016,but still lower than other similar reports in China.It shows that carrying out the continuous monitoring work has played a supervisory role for the two sentinel hospitals.The medical institutions have paid more attention to the disinfection,but strengthening supervision should be continued.
Objective To grasp the current situation and existing problems of disinfection and management quality,find out the key links of possible hospital infection,so as to provide reference for the revision of relevant laws,regulations and standards.Methods The monitoring was conducted on two hospitals in Heilongjiang province from 2015 to 2017 in accordance with the requirements of " Controlling and Monitoring the Disinfection and Infection Program of National Hospitals" issued by the National CDC Environment-related Product Safety.Results One thousand eight hundred and sixty-seven samples were collected from two general hospitals from 2015 to 2017,1 698 tested samples were qualified,the average qualified rate was 90.95%.There was a statistical difference in the total qualified rate for different years(χ~2=22.342,P<0.001).The qualified rates of surfaces of objects,sewage,cleaning effect of medical instruments,endoscopic surveillance were all above 90.00%,the monitoring qualified rates of air of the operation room(static),medical water,effect of pressure steam sterilization and hand of medical staff were lower,respectively 89.36%,80.48%,79.19% and 87.84%.Among them,the qualified rate of pressure steam sterilization was the lowest(79.19%),and the qualified rate of cleaning effect of medical instruments was the highest(95.42%).Conclusion The disinfection effects of the two hospitals were generally better than that in 2015 and 2016,but still lower than other similar reports in China.It shows that carrying out the continuous monitoring work has played a supervisory role for the two sentinel hospitals.The medical institutions have paid more attention to the disinfection,but strengthening supervision should be continued.
引文
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[5] 游颖琦,王荷生,兰策介,等.无锡市2013-2016年医疗机构消毒质量监测结果分析[J].中国消毒学杂志,2018,35(8):593-595.
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[7] 彭明军,曾其莉,黄晓波,等.湖北省部分医院手术室空气质量监测[J].中国消毒学杂志,2013,30(7):643-645,648.
[8] 张晓春,许乐.消毒供应室灭菌器配置及效果监测现状调查[J].中国护理管理,2009,9(1):71-72.
[9] Hayden M K,Blom D W,Lyle E A,et al.Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patients' environment.[J].Infection Control and Hospital Epidemiology,2008,29(2):149-154.
[10] 吴赛萍,李凌芸.不同预处理方式对夜间急诊手术器械的清洗效果观察[J].中华卫生应急电子杂志,2018,4(3):172-175.
[11] 帖金凤,韩杰,武雪冰,等.医疗机构医疗器械消毒灭菌监测结果分析[J].中国消毒学杂志,2018,35(5):360-363,366.
[12] 肖佳庆,杜丽,陈微娜,等.不同级别医疗机构医疗用水消毒效果调查[J].现代医院管理,2017,15(6):41-42,45.
[13] 祝行琴,王绍杰,何悦,等.杭州地区口腔科综合治疗台水道污染调查[J].中国消毒学杂志,2009,26(6):648-650.
[14] 曹淦,张建陶,王鹂,等.常州市医疗机构消毒质量监测结果分析[J].中国消毒学杂志,2013,30(10):949-950,953.
[2] 陆凤安,刘秀兰,殷俊,等.2013-2016年盐城市区医疗机构消毒质量监测分析[J].中国消毒学杂志,2018,35(2):125-127.
[3] 班海群,李新武,张流波.全国医院消毒质量监测结果[J].中国消毒学杂志,2011,28(2):193-195.
[4] 曹原,王莹,梁琦,等.黑龙江省医疗机构消毒质量监测调查[J].中国公共卫生管理,2018,34(3):315-319.
[5] 游颖琦,王荷生,兰策介,等.无锡市2013-2016年医疗机构消毒质量监测结果分析[J].中国消毒学杂志,2018,35(8):593-595.
[6] 蒋国钦,何学军.2014-2016年绍兴市医疗机构消毒质量监测分析[J].中国消毒学杂志,2017,34(12):1132-1134.
[7] 彭明军,曾其莉,黄晓波,等.湖北省部分医院手术室空气质量监测[J].中国消毒学杂志,2013,30(7):643-645,648.
[8] 张晓春,许乐.消毒供应室灭菌器配置及效果监测现状调查[J].中国护理管理,2009,9(1):71-72.
[9] Hayden M K,Blom D W,Lyle E A,et al.Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patients' environment.[J].Infection Control and Hospital Epidemiology,2008,29(2):149-154.
[10] 吴赛萍,李凌芸.不同预处理方式对夜间急诊手术器械的清洗效果观察[J].中华卫生应急电子杂志,2018,4(3):172-175.
[11] 帖金凤,韩杰,武雪冰,等.医疗机构医疗器械消毒灭菌监测结果分析[J].中国消毒学杂志,2018,35(5):360-363,366.
[12] 肖佳庆,杜丽,陈微娜,等.不同级别医疗机构医疗用水消毒效果调查[J].现代医院管理,2017,15(6):41-42,45.
[13] 祝行琴,王绍杰,何悦,等.杭州地区口腔科综合治疗台水道污染调查[J].中国消毒学杂志,2009,26(6):648-650.
[14] 曹淦,张建陶,王鹂,等.常州市医疗机构消毒质量监测结果分析[J].中国消毒学杂志,2013,30(10):949-950,953.