2015-2019年南阳市某二级医院胃镜消毒效果监测及影响因素分析  

Monitoring of disinfection effect of gastroscope and analysis of influencing factors in a secondary hospital in Nanyang from 2015 to 2019

作　　者：白石莹 陈旭 韩笑 BAI Shi-ying;CHEN Xu;HAN Xiao(Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院,河南473000

出　　处：《应用预防医学》2021年第6期488-492,537,共6页Applied Preventive Medicine

摘　　要：目的了解2015-2019年南阳市某二级医院胃镜消毒效果,分析影响消毒效果的相关因素,为持续改进胃镜消毒效果干预措施提供依据。方法采用现场随机抽查、采样送微生物实验室检测的方法对胃镜及相关用品的消毒效果进行监测,同时以2018年实施消毒技术规范化干预为节点,观察干预前、后胃镜及相关用品消毒效果的改善情况;采用问卷调查、现场询问、实地观察消毒操作等方式收集并分析影响胃镜消毒效果的相关因素。结果 2015-2019年共采样349份,合格251份,总合格率为71.92%,各年份合格率依次为41.79%、59.15%、68.12%、91.43%和97.22%,呈逐年上升趋势(趋势χ^(2)=31.72,P<0.01)。2015-2019年不同采样部位的合格率总体均上升,其中活检钳合格率上升幅度最大(67.78%);各采样部位不同年份合格率差异均有统计学意义(P值均<0.05);不同采样部位的总体合格率,镜身的最高(85.96%),活检钳的最低(58.00%)。2018年实施干预前、后总合格率分别为56.52%和94.37%,差异有统计学意义(χ^(2)=59.73,P<0.01)。多因素logistic回归分析显示,清洗消毒设施配备是否完善(OR=11.457)、清洗消毒工具配备是否齐全(OR=18.395)、消毒剂是否及时更换(OR=13.524)、清洗消毒流程是否规范(OR=11.721)、掌握胃镜结构及相关知识程度(OR=13.964)是影响胃镜消毒效果的独立影响因素。结论南阳市某二级医院胃镜消毒合格率总体水平偏低,存在潜在交叉感染风险。提示应从完善清洗消毒设施和工具、保证消毒剂有效浓度以及加强规范化培训等方面开展干预,以改善该院胃镜的消毒效果。Objective Understand the disinfection effect of gastroscope in a secondary hospital in Nanyang from 2015 to 2019, analyze the relevant factors affecting the disinfection effect, and provide a basis for the continuous improvement of intervention measures to enhance the disinfection effect of gastroscope.Methods Use on-site random inspections and samples to be sent to the microbiological laboratory for testing to monitor the disinfection effect of gastroscopes and related supplies. At the same time, with the implementation of standardized disinfection technology intervention in 2018 as the node, observed the improvement of the disinfection effect of gastroscope and related supplies before and after the intervention.Questionnaire survey, on-site inquiry, field observation of disinfection operation, and other methods were adopted to collect and analyze related factors that affect the disinfection effect of gastroscope. Results A total of 349 samples were sampled from 2015 to 2019, and 251 were qualified. The total qualification rate was 71.92%. The qualification rate of each year was 41.79%, 59.15%, 68.12%, 91.43%, and 97.22%,respectively, with an upward trend year by year(χ^(2)=31.72, P<0.01). From 2015 to 2019, the qualification rate of different sampling sites increased overall, of which the rate of biopsy forceps increased the most(67.78%). The difference in the qualification rate of the same sampling site in each year was statistically significant(P value<0.05). Among the qualification rate of different sampling sites, the lens body was the highest(85.96%), and the biopsy forceps had the lowest pass rate(58.00%). In 2018, the total pass rates before and after the intervention were 56.52% and 94.37%, respectively, and the difference was statistically significant(χ^(2)=59.73,P<0.01). Multi-factor logistic regression analysis showed that whether the cleaning and disinfection facilities were completed(OR=11.457), whether the cleaning and disinfection tools were all set(OR=18.395), whether the disinfectant was repl

关 键 词：胃镜 清洗消毒 监测 影响因素 干预措施 

分 类 号：R197.39[医药卫生—卫生事业管理]