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目的了解二级以下医疗机构小型压力蒸汽灭菌器使用现状,以便规范小型压力蒸汽灭菌器的管理。方法通过问卷、现场调查和监测的方法,对2016年湖北省小型压力蒸汽灭菌器的管理和使用进行调查统计分析,对存在的问题进行整改。结果调查不同级别医疗机构117所,共132台灭菌器,其中下排气式灭菌器占54.55%,灭菌器械类型中,手术器械占40.51%;消毒员专业中,护士、工人、其他专业分别占71.79%、10.26%、17.95%,消毒员经培训持证上岗率为29.06%;二级、一级及民营医疗机构中,注册证持有率分别为45.28%、25.45%、22.22%,说明书持有率分别有75.47%、43.64%、55.56%,均未安装高效过滤器;灭菌器1、3、5年年检率分别为7.69%、3.42%、2.56%,其中86.32%的医疗机构灭菌器无年检,日常维护由厂家维护占12.82%,医院负责占32.48%,科室负责占42.74%,无维护占11.97%;81.20%的医疗机构持有操作规程;灭菌温度、灭菌压力、灭菌时间及干燥时间合格率分别为90.60%、79.49%、85.47%及62.39%;物理、化学及化学监测开展率分别为49.57%、64.96%及32.47%,进行现场生物监测100例次,合格98例次,合格率为98.00%。结论二级以下医疗机构尤其是民营医院和一级医疗机构小型压力蒸汽灭菌器管理不规范,在人员培训及资质、灭菌器操作和监测方面存在缺陷,经加强培训及督导,加大供应室硬件设施投入,促进工作改进,取得了明显成效。
Objective To understand the current status of the use of small pressure steam sterilizers in medical institutions below the second level in order to regulate the management of small pressure steam sterilizers. Methods Through questionnaire, field investigation and monitoring methods, the investigation and statistical analysis of the management and use of small pressure steam sterilizer in Hubei Province in 2016 were made, and the existing problems were rectified. Results A total of 117 medical institutions of different levels were surveyed, with 132 sterilizers in total, of which 54.55% were under-venting sterilizers and 40.51% were surgical instruments in sterilizing equipment types. In sterilizers, nurses, workers and other Professional accounted for 71.79%, 10.26%, 17.95%, disinfection workers training certificate post 29.6%; two, one and private medical institutions, the registration rate of 45.28%, respectively, 25.45%, 22.22% , The instructions holding rate was 75.47%, 43.64%, 55.56%, no installation of high efficiency filters; sterilizer 1, 3, 5 annual inspection rates were 7.69%, 3.42%, 2.56%, of which 86.32% of the medical Institutional sterilizer without annual inspection, routine maintenance by the manufacturer to maintain 12.82%, the hospital is responsible for 32.48%, department is responsible for 42.74%, 11.97% non-maintenance; 81.20% of the medical institutions hold operating procedures; sterilization temperature, sterilization The passing rates of pressure, sterilization time and drying time were 90.60%, 79.49%, 85.47% and 62.39% respectively. The rate of physical, chemical and chemical monitoring was 49.57%, 64.96% and 32.47%, respectively. , 98 cases were qualified, with a pass rate of 98.00%. Conclusion The management of small pressure steam sterilizers in medical institutions below the second level, especially in private hospitals and primary medical institutions, is not standardized. There are deficiencies in personnel training and qualification, operation and monitoring of sterilizers. After more training and supervision, the supply of small steam sterilizers Room hardware facilities investment, promote job improvement, and achieved remarkable results.