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目的采用ATP生物荧光法检测ICU环境物体表面清洁消毒质量,探讨集束化干预措施的效果,以预防多药耐药菌的传播。方法 2013年6月-2016年7月对某三级医院ICU医务人员手高频接触物体表面(各类仪器面板及表面,各类台面,门把手,电脑鼠标及键盘等)的清洁消毒效果进行采样监测,2015年1月起依据ATP生物荧光法检测数据,在ICU实行集束化干预措施,比较干预前后物体表面清洁消毒效果,应用SPSS16.0软件进行统计分析,率的比较采用χ2检验。结果采用集束化干预后,ICU物体表面ATP生物荧光检测合格率由20.8%提高至44.0%,差异有统计学意义(P<0.05);共采样147份标本,ATP读数以<100RLU/100cm2为洁净度合格标准,按环境物体表面类型分类,各类仪器面板及表面合格率33.3%,各类台面52.4%,门把手33.3%,电脑鼠标及键盘15.5%,电话机0,其他表面38.5%,四类物体表面洁净度最差的前3位采样点数据范围为377~9740RLU/100cm2。结论 ATP生物荧光法监测数据显示,集束化干预在ICU环境物体表面清洁消毒中的应用效果显著,但整体清洁效果仍不理想,是医院感染管理和多药耐药菌预防控制的重要隐患,应加强常规清洁消毒工作,提高环境物体表面整体洁净度。
Objective To detect the quality of cleaning and disinfection of the surface of ICU environment by ATP biofluorescence and to explore the effect of cluster intervention in order to prevent the spread of multidrug-resistant bacteria. Methods From June 2013 to July 2016, the cleaning and disinfection effects of high-frequency contact with the surface of the ICU medical staff (surface and various kinds of instruments, various kinds of worktops, door handles, computer mouse and keyboard, etc.) Sampling and monitoring. According to ATP biofluorescence test data from January 2015, cluster interventions were carried out in ICU to compare the surface cleaning and disinfection effects before and after intervention. SPSS16.0 software was used for statistical analysis, and the rate was compared using χ2 test. Results After the cluster intervention, the passing rate of ATP biofluorescence on the surface of ICU was increased from 20.8% to 44.0% (P <0.05). A total of 147 samples were collected and the ATP readings were less than 100 RLU / 100 cm 2 Degree of eligibility criteria, according to the type of surface classification of environmental objects, various types of instrument panel and surface pass rate of 33.3%, 52.4% of all types of tabletops, door handles 33.3%, computer mouse and keyboard 15.5%, telephone 0, other surfaces 38.5% The worst cleanliness of objects on the surface of the first three sampling points data range 377 ~ 9740RLU / 100cm2. Conclusion The results of ATP biofluorescence monitoring showed that the cluster intervention was effective in cleaning and disinfecting the surface of ICU objects, but the overall cleaning effect was still unsatisfactory, which was an important hazard in the management of hospital infection and prevention and control of multidrug-resistant bacteria. Strengthen routine cleaning and disinfection, improve the overall cleanliness of the surface of environmental objects.