凈化鋁材配件-無菌物品的管理
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- 發(fā)布日期：2017-04-13 17:23:02
1)手術(shù)物品的滅菌是控制感染的重要對(duì)策之一。凈化鋁材配件原則上用高壓蒸汽滅菌，對(duì)于不能耐髙溫、耐濕的物品首選環(huán)氧乙烷，環(huán)氧乙烷是有效的低濕滅菌的物品（橡膠類、塑料類）最佳消毒方法。對(duì)于顯微器械、腹腔鏡、膀胱鏡、纖維腸鏡等髙危險(xiǎn)度手術(shù)用品的消毒采用質(zhì)量分?jǐn)?shù)為2%的戊二醛浸泡，且要大于30min，如需滅菌必須浸泡大于10h,每次滅菌前必須用濃度指示卡檢測(cè)其最低的有效濃度（一般要求大于1.5%)。醫(yī)院應(yīng)對(duì)各科室使用的各種消毒液進(jìn)行嚴(yán)格監(jiān)控，器械浸泡液由院制劑室統(tǒng)一配制、醫(yī)院感室監(jiān)控，在使用過程中嚴(yán)格掌握浸泡時(shí)間、濃度，消毒液應(yīng)定期更換。滅菌包的內(nèi)外均放置3cm滅菌指示卡和滅菌指示膠帶，且保證在有效期限內(nèi)使用。熏蒸消毒以福爾馬林化學(xué)反應(yīng)法和自然揮發(fā)法聯(lián)合應(yīng)用，熏蒸消毒的手術(shù)物品必須在6h后方可使用，所有無菌物品要每月采樣作細(xì)菌培養(yǎng)。
(1) sterilization is one of the important measures to control the infection. Purification of aluminum accessories principle with high-pressure steam sterilization, for not resistant high temperature and humidity items preferred epoxy ethane, ethylene oxide is effective humidity sterilization items (rubber, plastic) the best disinfection method. For the disinfection of instruments for microsurgery, laparoscopic, cystoscopy, fiber colonoscopy high risk operation activities by mass fraction of 2% glutaraldehyde, and to more than 30 minutes, such as sterilization needs must soak for more than 10 hours, every time before sterilization must concentration indicator card detected the lowest effective concentration (typically requires more than 1.5%). Hospitals should be used in all departments to carry out a variety of disinfection liquid for strict monitoring, equipment immersion liquid prepared by the hospital preparation room, the hospital room monitoring, in the use of the process to strictly grasp the immersion time, concentration, disinfection liquid should be regularly replaced. The sterilization bags are placed inside and outside the 3cm sterilization indicator card and sterilization indicating tape, and guarantee the use of the effective period. Fumigation to formalin chemical reaction method combined with natural volatilization, fumigation operation items must be at the rear of the 6h, all sterile articles to monthly sampling for bacterial culture.
(2)一次性手術(shù)用品應(yīng)專柜存放，離地面30cm,柜內(nèi)清潔干燥，通風(fēng)良好，室內(nèi)空氣含菌量小于或等于200CFU?m3,溫度與濕度要適中，要定期進(jìn)行空氣消毒；要專人管理一次性手術(shù)用品的計(jì)劃、領(lǐng)取，每日清潔貨架、貯物箱、檢查手術(shù)用品的外包裝有無破損、霉變、有效日期及數(shù)量，按日期先后順序發(fā)放使用，并及時(shí)反饋一次性無菌物品的使用情況。手術(shù)后未開啟包裝的無菌物品應(yīng)重新消毒后，給下一臺(tái)手術(shù)使用，不再收回貯存間，避免污染貯物箱內(nèi)的其他物品。
(2) disposable surgical activities should counter storage, off the ground 30cm, the cabinet in a clean, dry, well ventilated, indoor air containing bacteria amount less than or equal to the 200CFU? M3, temperature and humidity should be moderate, regular air disinfection; plans to personnel management, one-time operation activities, receive, daily cleaning of the shelf, storage bins, check operation activities outside of the packaging with and without damage, mildew, effective date and quantity, by date sequence distribution and use, and timely feedback the use of disposable sterile items. After the operation is not open the packaging of sterile items should be disinfected, to the next operation, no longer to recover the storage room, to avoid contamination of other items in the storage box.
(3)無菌持物鉗消毒方法改進(jìn)手術(shù)室無菌持物鉗經(jīng)歷了由“濕置—干置—取消”的改進(jìn)，其方法效果可靠、方便、節(jié)省成本。取消無菌持物鉗與使用傳統(tǒng)干、濕無菌持物鉗對(duì)照監(jiān)測(cè)結(jié)果表明，效果明顯優(yōu)于干、濕兩組，差異有顯著性。干置無菌持物鉗使用1～4h，合格率為100%，超過4h則有污染，須在4h內(nèi)更換無菌持物鉗，而濕置無菌持物鉗由于使用質(zhì)量分?jǐn)?shù)為2%的戊二醛消毒液，因此成本高。因此采用取消無菌持物鉗屬于最佳方法，方法簡(jiǎn)便易行，只需將手術(shù)室的物品單獨(dú)打包高壓滅菌。采取取消無菌持物鉗減少了污染環(huán)節(jié)，使無菌物品免受二次污染，也降低了凈化鋁材配件 http://www.jnjkjh.com/ 的成本。所以取消無菌持物鉗非常符合凈化室感染要求及科室經(jīng)濟(jì)管理。
(3) the improvement of the sterile holding forceps in the operation room has been improved by the method of "wet dry", and the method is effective, convenient and cost saving. The results showed that the effect of the control on the use of sterile holding forceps and the traditional dry and wet aseptic holding forceps was significantly better than that of the dry and wet two groups. Dry sterile holding forceps using 1 ~ 4h, the qualified rate of 100%, more than 4h, there is pollution, must be replaced in 4H sterile holding forceps, and wet aseptic holding forceps due to the use of 2% glutaraldehyde disinfection liquid, so high cost. Therefore, the use of the abolition of sterile holding forceps is the best method, the method is simple and easy to use, only the operation room of the article packaged separately packaged high pressure sterilization. Take the abolition of sterile holding forceps to reduce the pollution of the link, so that sterile items from the two pollution, but also to reduce the cost of cleaning aluminum parts. So the abolition of sterile holding forceps is very much in line with the requirements of the clean room and economic management.
