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作者：王芳 胡卓 钟艳 方英 罗建平 杨林飞
【摘要】目的 病院是病人高度齐集的场所，病院内情况受到污染机遇多，污染的微生物种类复杂，搞好病院情况和物品消毒与灭菌是节制病院内传染的关键成分。为认识A市各级病院卫生消毒与灭菌质量情形，增强病院传染的灌注和节制设施，我们于2009～2010年一连2年对A市各级病院进行了消毒与灭菌效果监测。方式 用现场抽样检测方式进行采样和检测。效果 A市40家病院2009～2010年度消毒效果监测平均及格率离别为空气及格率为98.99%,物体外面消毒及格率为99.25%,医务人员手消毒及格率为96.89%,行使中的消毒液及格率为94.17%,透析液及格率为98.75%，病院污水及格率为98.75%。结论A市40家病院病院消毒质量集体水平较好,存在部门不足，应增强司法搜检。 结论 各级病院消毒与灭菌质量及格率呈现逐年上升趋向，但病院污水及灭菌物品及格率不是很高，消毒与灭菌质量还有待提高。
【关键词】病院 消毒与灭菌 效果 监测
【Abstract】Objective Investigated the quality of disinfection and sterilization in the hospital in the city of Panzhihua to provide a basis for the management of hospital infection. Method Examine the disinfection and sterilization condition of the hospitals. Results A total of 1683 samples were collected during the 3-year monitoring from 2006 to 2008; the total qualified rate was 94.41 percent. The qualified rate of municipal hospitals was 99.05 percent, the enterprises hospital was 93.51 percent, the hospitals belonged to country was 94.89 percent, the private hospitals was 91.95%; Among the different monitoring objects, the qualified rate of room air was 83.71 percent, the surface of was 100.00 percent, the hands of medical personnel was 96.13 percent, the used disinfectants was 99.53 percent, sterilization items was 100.00 percent, the effect of pressure steam sterilizer sterilization was 97.92 percent, the dialysis fluid was 97.44%, the hospital waste water was 91.43 percent. Conclusion The qualified rate of disinfection and sterilization quality in the hospitals has increased year by year, but the room air, sewage in hospital and the hands of hospital medical staff was low comparatively, the quality of disinfection and sterilization yet to be improved.
【Key words】hospital disinfection and sterilization effect monitoring
1 方式
1.1 监测器械与内容 监测器械为A市市属和病床位在100张以上的病院(含从事医学美容的私利病院)。监测内容为病院内各类情况室内空气、物体外面、医务人员手、行使中消毒剂、透析液、无菌物品和病院污水。
1.2 采样与检测方式 对室内空气用直径为9cm通俗营养琼脂平板，置于室内各采样点距离地面 1.5m高度，沉降5min采样，将采样平板置于37℃培育种植提拔18～48h，策画细菌总数；对物体外面和医务人员手，在消毒4小时内用浸有行使液的棉拭子进行涂抹采样；用浸有含响应中和剂的采样液的无菌棉拭子在划定区域内作涂抹采样，将采样棉拭子置于10ml中和剂采样液的试管中，经充裕振荡洗下细菌，取样进行活菌计数培育种植提拔，检测细菌总数和致病菌；行使中消毒剂取1ml插手到9ml响应中和剂溶液中混匀，进行活菌计数；取透析机的出进口液10ml，检测细菌总数和致病菌；医疗用品经压力蒸汽灭菌后抽样进行无菌检测；用无菌瓶采集消毒处置责罚后的病院污水500ml，送执行室检测粪大肠菌群数和致病菌。
1.3 效果剖断尺度 依据GB15982-1995《病院消毒卫生尺度》、GB15981-1995《消毒与灭菌效果的评价方式与尺度》、GB18466-2005《病院水污染物排放尺度》和卫生部发表的《消毒手艺范例》(2002年版)[2]划定的指标执行进行检测和评价。
2 效果
见表1
表1 消毒效果监测效果
