医院内镜使用的两级管理  

Two-level management of application of endoscope

作　　者：王靖[1] 李莉[1] 周辉[1] 

机构地区：[1]荆州市第一人民医院感染管理办公室,湖北荆州434000

出　　处：《中华医院感染学杂志》2012年第23期5346-5347,共2页Chinese Journal of Nosocomiology

摘　　要：目的加强内镜医院感染规范化管理,避免因内镜清洗消毒缺陷引起医源性感染,保证患者及医务人员安全。方法通过医院感染管理办公室和科室医院感染监控小组两级管理组织,采用现场查看及抽样检测相结合的方法,分别对全院使用中的各种内镜检查其管理制度、消毒设施的配备、消毒程序的规范、消毒剂的使用方法及消毒效果;回顾性分析2010年1月-2011年6月使用内镜各项检查记录。结果院、科两级检查使用中内镜灭菌合格率存在差异,院级检测支气管镜、喉镜、胃镜、肠镜、关节镜、腹腔镜、膀胱镜、消毒剂、空气、物体表面、工作人员的手灭菌率合格率分别为85.7%、82.1%、87.6%、85.9%、97.9%、98.4%、96.9%、94.8%、92.5%、83.1%、87.2%,均比科级灭菌合格率低14.3%、15.9%、10.4%、11.2%、2.1%、1.6%、3.1%、5.2%、4.6%、14.9%、11.8%。结论医院感染管理办公室只有建立健全使用中内镜的医院感染规章制度,规范操作,定期对消毒效果进行监测及督导,才能杜绝因内镜消毒灭菌不严引发医源性感染的发生。OBJECTIVE To strengthen the standardized management of endoscope to avoid the iatrogenic infections due to the poor cleaning and disinfection of endoscope so as to ensure the safety of the patients and medical staff. METHODS Through the nosocomial infection administration office and the nosocomial infection monitoring team, by means of the on site inspection in combination with sampling testing, the management system, equiping facilities, disinfection procedure, the use of disinfectants,and the disinfection effect were examined~ the inspection records of using endoscopes from Jan 2010 to Jun 2011 were respectively reviewed. RESULTS There was difference in the qualified rate of the sterilization of endoseopes by the two-level of hospital and department, the qualified rate of the sterilization of bronchoscope by the hospital-level inspection was 14.3 % lower than that by the department- level inspection, 15. 9% lower of the laryngoscope, 10. 4% lower of the gastroscope, 11. 2% lower of the colonoscope, 2.1% lower of the arthroscope, 1.6% lower of the laparoscope, 3.1% lower of the cystoscope, 5.2% lower of the disinfectant, 4.6% lower of the air, 14.9% lower of the object surface and 11.8% lower of the staff＇s hands. CONCLUSION Only as the nosocomial infections control office establishes the sound regulations and systems, standardizes the operation procedure and regularly supervise the disinfection effect can eliminate the iatrogenic infections due to lax sterilization of endoscope.

关 键 词：内镜 监测质量 感染控制 管理 

分 类 号：R197.323[医药卫生—卫生事业管理]