2012-2021年无锡市直管医疗机构消毒质量监测分析  

Monitoring and analyzing the disinfection efficiency in Wuxi municipal medical institutions from 2012 to 2021

作　　者：游颖琦 兰策介[1] 钱静娟 刘蕴华[1] 邹亚明[1] 朱丁[1] YOU Ying-qi;LAN Ce-jie;QIAN Jing-juan;LIU Yun-hua;ZOU Ya-ming;ZHU Ding(The Affiliated Wuri Center for Disease Control and Prevention of Nanjing Medical University,Wuri Center for Disease Control and Prevention,Wuri,Jiangsu 214023,China;不详)

机构地区：[1]无锡市疾病预防控制中心(南京医科大学附属无锡疾病预防控制中心)消媒与血寄地病防制科,江苏无锡214023 [2]无锡市第五人民医院院感科,江苏无锡214061

出　　处：《中华医院感染学杂志》2024年第24期3823-3827,共5页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康委科研课题项目(Y12023003);无锡市科技局“太湖之光”科技攻关(医疗卫生)项目(Y20212041)。

摘　　要：目的对2012-2021年无锡市直管医疗机构消毒质量进行总结,分析影响消毒质量的因素,为提高医疗机构感染控制水平提供科学依据。方法2012-2021年监测了9家直管医疗机构的空气、医护人员手、物体表面、使用中消毒剂、医疗器材、内镜、透析用水和医疗污水的菌落总数,压力蒸汽灭菌器的灭菌效果和紫外线灯的辐照强度,分析各类样品的消毒合格率及不合格样品的超标情况。采用基于熵权的TOPSIS法对直管医疗机构消毒质量进行综合评价。结果2012-2021年累计监测样本共6722份,总合格率97.35%,不同年份合格率差异有统计学意义(χ^(2)=67.575,P<0.001),并呈显著上升趋势(r=0.754,P=0.012)。10年间医护人员手合格率最低为93.48%,其次为透析用水96.89%,灭菌器和紫外线灯合格率均为100%,不同监测项目合格率差异有统计学意义(χ^(2)=113.770,P<0.001)。各医疗机构合格率差异有统计学意义(χ^(2)=27.773,P=0.001),医疗机构总体消毒质量分为高、中、低3个等级(F=6.551,P=0.040),合格率依次为98.13%、97.67%和95.98%。超标倍数低于10倍的样品数占67.72%,在低于10倍超标样品中低于2倍的占64.49%。结论无锡市直管医疗机构的消毒质量整体良好,监测和监管总体上显著提高了医疗机构消毒质量,但仍存薄弱环节,管理力度和依从性不够可能是导致不合格的主要因素。OBJECTIVE To summarize the disinfection efficiency of municipal medical institutions in Wuxi from 2012 to 2021,analyze the influencing factors,and provide the scientific basis for improving the medical institu-tions'infection control.METHODS Bacterial colonies from air,medical staff's hands,the inanimate surfaces,dis-infectants in use,the medical equipment,endoscopes,water for dialysis and hospital sewage were collected from 9 municipal medical institutions,the effects of pressure steam sterilizers and the irradiation intensity of ultraviolet lamps were monitored,and the pass rates of various disinfected objects and unqualified conditions were analyzed.The TOPSIS method based on entropy weight was used to evaluate the disinfection efficiency of municipal medical institutions.RESULTS From 2012 to 2021,a total of 6722 samples were collected with an overall pass rate of 97.35%;from year to year,the pass rates were significantly different(χ^(2)=67.575,P<0.001)and showed a noticeable upward trend(χ^(2)=0.754,P=0.012).There was significant differences in the pass rates of eight differ-ent monitoring items(χ^(2)=113.770,P<0.001),among them,medical staff's hands showed the lowest pass rate 93.48%,followed by the dialysis water 96.89%,and sterilizer and ultraviolet lamp 100%.There were significant differences in the pass rates among each medical institution(χ^(2)=27.773,P=0.001);the overall pass rates of medical institutions were divided into three grades(F=6.551,P=0.040)with the pass rate 98.13%,97.67%and 95.98%,respectively.Totally 67.72%of the samples exceeded the standard by less than 10 times,and 64.49%of the samples exceeded by less than duplation.CONCLUSION The disinfection quality of medical institu-tions directly under the direct management of Wuxi City is generally good,in which the monitoring and supervi-sion play an important role;however,there are still weak points,the main reason for which may be the insuffi-cient management and compliance.

关 键 词：医疗机构 消毒质量 监测 菌落总数 

分 类 号：R187[医药卫生—流行病学]