2007-2011年青岛市医疗机构消毒质量评价

发布时间：2018-04-27 08:55

本文选题：医疗机构 + 消毒质量　；参考：《青岛大学》2013年硕士论文

【摘要】：目的：了解青岛市各级医疗机构消毒质量现况,分析存在的问题,为医疗机构消毒质量监测与医院内感染控制提供依据。方法：选取青岛市7家二级医院和2家三级医院,根据《全国医院感染—消毒监测方案》、《医院消毒卫生标准》(GB15982-1995)和《消毒技术规范》(2002)规定的消毒对象分类、实验室检测方法和结果判断标准,2007-2011年每年度对被监测单位医疗器械清洗、手术室空气、一般物体表面、医护人员手卫生、内镜、口腔医疗用水、医院污水和压力蒸汽灭菌器的消毒灭菌质量进行检测分析。采用Excel2003和SPSS17.0进行数据处理与统计分析,采用卡方检验对不同项目、不同年度、不同级别医院的消毒质量监测结果进行统计分析。结果：①2007-2011年共监测1798份样品(不包括医疗器械清洗样品),合格1172份,总合格率为65,2%,不同项目监测合格率由高到低依次为：物体表面99.6%、压力蒸汽灭菌器97.6%、外科手87.8%、漂洗用水85.7%、污水85.7%、内镜79.6%、手术室空气71.1%、卫生手为66.0%、口腔用水37.5%；不同年度总合格率无显著性差异。 ②手卫生监测外科手消毒、卫生手消毒和手依从性合格率依次降低,差异有显著性(χ2=317.149,P0.0001)；无手卫生、洗手、手消毒、洗手+手消毒的合格率依次增高(χ2=18.489,P=0.0003)；不同手卫生时间合格率随时间增加而提高(χ2=4.103,P=0.043)。医疗器械清洗放大镜法检测镊子、剪刀和止血钳的合格率分别为90.0%(63／70)、80.9%(174／215)和76.3%(145／190),镊子合格率高于止血钳(χ2=6.148,P=0.046)。胃镜和肠镜监测的合格率分别为80.6%(54／67)和78.9%(71／90),差异无显著性。口腔手机喷水和冲洗水监测合格率分别为30.2%(106／350)和44.5%(138／310),差异有显著性(χ2=14.287,P=0.0002)。 ③三级医院和二级医院外科手、卫生手和肠镜监测合格率无显著性差异,但手依从性、胃镜、口腔手机喷水和冲洗水监测合格率均有显著性差异(χ~2=61.237、5.612、35.577、9.792,P0.0001、=0.018、0.0001、=0.0002)。结论：①不同监测样品消毒灭菌质量存在差异,环境物体表面、中心供应室生物监测以及医院污水消毒灭菌质量较好,医护人员的手卫生情况、手术室空气、内镜消毒、口腔科医疗用水安全是今后医院感染管理的重点。②青岛市不同级别医疗机构的消毒灭菌质量也存在差异,应进一步扩大对辖区医疗机构监测范围,加强医疗机构的消毒技术指导和监督,提高医院感染的控制能力。
[Abstract]:Objective: to understand the current situation of disinfection quality of medical institutions at all levels in Qingdao and analyze the existing problems, and to provide the basis for the quality monitoring of medical institutions and the control of infection in hospitals.
Methods: 7 grade two hospitals in Qingdao and 2 grade three hospitals were classified according to the National Hospital Infection disinfection monitoring scheme, the hospital disinfection hygiene standard (GB15982-1995) and the disinfection technical specification (2002), the laboratory testing method and the result judgment standard, and the medical instruments of the monitored units for 2007-2011 years each year. Cleaning, operation room air, general object surface, medical staff hand hygiene, endoscopy, oral medical use water, hospital sewage and pressure steam sterilizer quality were detected and analyzed. Excel2003 and SPSS17.0 were used for data processing and statistical analysis, and the cards were checked for different projects, different years and different levels of hospitals. The results of drug quality monitoring were statistically analyzed.
Results: (1) 1798 samples (excluding medical equipment cleaning samples) were monitored for 2007-2011 years. The total qualified rate was 65,2%. The qualified rate of different items from high to low was 99.6%, pressure steam sterilizer 97.6%, surgical hand 87.8%, rinse water 85.7%, sewage 85.7%, endoscopy 79.6%, and operation room 71.1%, 71.1%, sanitary, 71.1%, sanitary, 71.1%, and sanitary ware in the operation room 71.1%. Hand was 66%, oral water was 37.5%; there was no significant difference in total qualification rate in different years.
Second, hand hygiene monitoring surgical hand disinfection, hygienic hand disinfection and hand compliance rate decreased in turn, the difference was significant (x 2=317.149, P0.0001), no hand hygiene, hand washing, hand disinfection, hand disinfection of hand increased (chi 2=18.489, P=0.0003), the qualified rate of different hand hygiene time increased with time (x 2=4.103, P=0.043). The qualified rate of the instrument cleaning magnifier was 90% (63 / 70), 80.9% (174 / 215) and 76.3% (145 / 190), the tweezers were higher than the hemostatic forceps (chi 2=6.148, P=0.046). The qualified rates of gastroscope and enteroscopy were 80.6% (54 / 67) and 78.9% (67), respectively. The pass rate of washing water monitoring was 30.2% (106 / 350) and 44.5% (138 / 310) respectively, with significant difference (2=14.287, P=0.0002).
(3) there was no significant difference in the qualified rate between the three level hospitals and the two level hospitals, but the compliance rates of hand compliance, gastroscope, oral cell phone water spray and irrigation water were significantly different (x ~2=61.237,5.612,35.577,9.792, P0.0001, =0.018,0.0001, = 0.0002).
Conclusion: (1) there are differences in disinfection and sterilization quality of different monitoring samples, surface of environmental objects, biological monitoring of central supply room and good quality of disinfection and sterilization in hospital sewage, hand hygiene of medical and nursing staff, air in operation room, disinfection of endoscopy, and safety of medical water in Department of Stomatology, the key point of hospital infection management in the future. (2) different grades in Qingdao There are also differences in the quality of disinfection and sterilization in medical institutions. The monitoring range of medical institutions in the area should be further expanded, the guidance and supervision of disinfection technology in medical institutions should be strengthened and the control ability of hospital infection should be improved.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R181.3

【参考文献】