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复用硬式内镜清洗流程改进及效果评价
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太和医院 消毒供应中心

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Optimization and effect evaluation of cleaning process of reusable rigid endoscopes
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CSSD of Taihe Hospital

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    摘要:

    目的 优化复用硬式内镜的清洗流程并应用ATP生物荧光监测法和微生物培养法评价清洗后的效果,探讨两种不同的清洗流程对复用硬式内镜的清洗效果的影响,进而为改善其清洗质量提供依据。方法 选用医院2021年11月-2022年11月手术后的复用硬式内镜共600件作为研究对象,将其随机分为两组,对照组和试验组,对照组的清洗流程为:水冲洗→检查→拆卸→酶液中浸泡刷洗→高压水枪冲洗→超声清洗→纯水漂洗→热力消毒(90℃-5min)→润滑→干燥;试验组:水冲洗→检查→拆卸→高压水枪冲洗→机洗(酶洗、碱洗、超声漂洗、润滑、消毒、干燥)。对清洗后的器械采用ATP生物荧光监测法和微生物培养法进行检测器械的清洗效果。 结果 采用微生物培养法测得的对照组及试验组对应污染器械清洗后的合格率分别为93.3%和97.3%,采用ATP生物荧光检测法测得的对照组及试验组对应污染器械清洗后的合格率分别为87.7%和94.0%。数据差异有统计学意义(P<0.05)。结论 对污染后的硬式内镜,采用手工清洗结合专用硬式内镜清洗架机洗,能获得更好的器械清洗效果。

    Abstract:

    OBJECTIVE To optimize the cleaning process of reusable rigid endoscopes, evaluate the cleaning effect by using ATP biology fluorescence method and microorganism cultivation, and explore the impact of different cleaning process on the cleaning of reusable rigid endoscopes so as to improve the cleaning quality. METHODS 600 sets of contaminated rigid endoscopes collected from Nov. 2021 to Nov. 2022, are chosen as the research object. They were randomly divided into two experimental group and the control group according to the cleaning process. For the control group, the contaminated instruments followed the procedure: water washing→check→disassemble→ enzyme soaking→high-pressure spray→ultrasonic cleaning→pure water rinse→thermal disinfection(90℃-5min)→lubricate→dry;For the experiment group, the cleaning process is washing→check→disassemble→high-pressure spray→Automatic machine wash(including enzyme wash、alkaline-wash、ultrasonic-cleaning、lubricate、thermal disinfection and dry ). All the instruments washed and disinfected were examined by means of ATP biology fluorescence test and microorganism cultivation, and the difference value of visual inspection and ATP biology fluorescence test were calculated and compared. RESULTS The qualified rate of processed instruments of the two groups(control group、experiment group) are 93.3% and 97.3% by microorganism cultivation, 87.7% and 94.0% by ATP bioluminescence essay(P<0.05). CONCLUSION The cleaning process utilized hand washing together with professional rigid endoscopes cleaning frame can significantly improve the cleaning quality of the reusable rigid endoscopes , and could achieve better cleaning effect.

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司玉梅. 2022. 复用硬式内镜清洗流程改进及效果评价[DB/OL]. NursRxiv, DOI:10.12209/issn2708-3845.20221230001

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  • 收稿日期:2022-12-30
  • 最后修改日期:2022-12-30
  • 录用日期:2022-12-30
  • 在线发布日期: 2022-12-30
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