宁波市某三甲医院消毒与灭菌效果监测分析  

Monitoring and analysis of disinfection and sterilization effects of a 3A hospital in Ningbo

作　　者：马晓[1] 陈小英[1] 徐明[1] 许小敏[2] 

机构地区：[1]宁波市疾病预防控制中心消毒与媒介生物防制所,浙江宁波315010 [2]宁波市第二医院医院感染管理科,浙江宁波315010

出　　处：《中华医院感染学杂志》2018年第4期614-618,共5页Chinese Journal of Nosocomiology

基　　金：宁波市优秀中青年卫生技术人才基金资助项目(2011145);浙江省医药卫生科技计划基金资助项目(2014KYA197)

摘　　要：目的了解宁波市某三甲医院消毒质量现状,为进一步加强医院消毒质量分级监测管理及提高消毒质量提供依据。方法 2013年1月-2016年12月通过现场采样和微生物检测方法对医院室内空气、医务人员手、物体表面、医疗器械、内镜清洗、压力蒸汽灭菌器、血透液和医院污水进行采样监测,并对监测结果进行分析。结果2013-2016年共采样1295份,合格1199份,总体合格率为92.59%,各年合格率分别为93.23%、95.10%、90.72%和91.12%。Ⅰ类环境合格率为98.18%高于Ⅱ~Ⅳ类环境69.23%;共监测134条内镜,其中胃镜86条,肠镜32条,支气管镜13条,膀胱镜3条,内镜清洗消毒效果监测结果均合格;四年中监测医护人员手卫生合格率为85.56%,其中外科手合格率为91.55%(65/71)高于卫生手合格率为80.40%(160/199)(P<0.05);医疗器械清洗效果ATP监测合格率为35.62%,年度波动较大;二氧化氯法监测污水合格率78.43%,2015-2016年低于2013-2014年;四年间医疗器械清洗效果监测采用肉眼裸视合格率为100.00%,放大镜合格率为99.65%。结论医院消毒与灭菌效果总体状况良好,但手卫生、医院污水和医疗器械清洗效果的合格率相对较低,应加强重视,以进一步提高医院消毒灭菌质量。OBJECTIVE To know the current situation of disinfection quality in a 3 Ahospital in Ningbo,so as to provide evidence for reinforcing disinfection monitoring management and improving the disinfection quality in the hospital.METHODS Field sampling and microbiological detection methods were used to monitor the indoor air in hospital,medical staff hands,object surface,medical instruments,endoscopes cleaning,pressure steam sterilizer,hemodialysis fluid and hospital sewage from Jan.2013 to Dec.2016,and the monitoring results were analyzed.RESULTS A total of 1295 samples were collected during the year 2013 to 2016,and 1199 were eligible with the total qualified rate of 92.59%.The qualified rates during the four years were 93.23%,95.10%,90.71%,and91.12%,respectively.The qualified rate of environment type Ⅰ was 98.18%,which was obviously higher than that of typeⅡ~Ⅳ of 69.23%.A total of 134 endoscopes were monitored,including 86 gastroscopes,32 enteroscopes,13 bronchoscopes and 3 cystoscopes.The results of the endoscopic cleaning and disinfection efficacy were all qualified.The qualified rate of hand hygiene was 85.56%,and that of surgical hand was 91.55%（65/71）,which was significantly higher than 80.40%（160/199）of hygienic hand（P〈0.05）.The ATP bioluminescence assay for evaluating the cleaning effect showed that the qualified rate of medical instrument was 35.62%,and annual variation was great.The chlorine dioxide monitoring results showed that the qualified rate of sewage was 78.43%,and that of 2015-2016 was lower than 2013-2014.The qualified rate of cleaning effect of medical instruments with the naked eye was 100.00%,and with magnifier was 99.65%.CONCLUSIONThe disinfection and sterilization effects of the hospital are good in general,but the qualified rates of hand hygiene,hospital sewage and endoscopes cleaning were relatively low,so more attention should be focus on these items,so as to improve the quality of disinfection and sterilization.

关 键 词：消毒 灭菌 监测 

分 类 号：R187[医药卫生—流行病学]