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目的分析医院胃肠内镜清洗消毒效果不合格原因,为采取有效干预措施提供依据,确保内镜诊疗安全。方法分别调查分析2010年1月-2013年1月和2013年2月-2014年6月医院使用中清洗消毒后的胃肠内镜1 042镜次和507镜次的监测结果。对每镜次监测结果不合格者进行原因分析,提出干预措施并落实,直至重新采样监测结果合格。结果共采样清洗消毒后的胃肠内镜1 042镜次,合格率为98.37%,有17镜次不合格与日诊量最高时患者独占时间、清洗消毒人员清洗消毒不规范、手工刷洗不彻底、采样过程污染、终洗用水质量不合格、采样后检测不及时等有关。采取综合性干预措施后,2013年2月-2014年6月再对清洗消毒后的胃肠内镜随机采样检测507镜次,合格率提高到99.80%,仅1个不合格的镜次,携菌量最大为56 cfu/镜,与采取干预措施前监测结果比较,有统计学意义(P<0.05)。结论及时分析导致医院胃肠内镜清洗消毒效果不合格原因,采取综合性干预措施,不断完善和修订内镜中心操作流程和管理制度,能明显提高内镜清洗消毒质量。
Objective To analyze the causes of unacceptable gastrointestinal endoscope cleaning and disinfection in hospitals and provide evidences for effective interventions to ensure the safety of endoscopic diagnosis and treatment. Methods The monitoring results of 1 042 and 507 mirror images of gastrointestinal endoscope after cleaning and disinfection in hospital from January 2010 to January 2013 and February 2013 to June 2014 were analyzed. Analysis of the causes of unqualified surveillance results for each mirror, propose interventions and implement until the re-sampling monitoring results pass. The results of a total of sampling after cleaning and disinfection of gastrointestinal endoscopy 1 042 mirror, with a pass rate of 98.37%, there are 17 times the highest number of unqualified patients and patients exclusive time, cleaning and disinfection of non-standard cleaning and disinfection, manual brushing is not complete , Sampling process pollution, water quality after the end of unqualified, sampling after testing is not timely and so on. After comprehensive interventions were taken, the number of 507 microscopic samples taken after cleaning and disinfection of gastrointestinal endoscopy was tested again from February 2013 to June 2014, the pass rate was increased to 99.80% and only 1 failed mirror was carried. The maximum amount of bacteria was 56 cfu / mirror, which was statistically significant compared with the monitoring results before intervention (P <0.05). Conclusions Timely analysis of the causes of hospital gastrointestinal endoscopic cleaning and disinfection failure causes, take comprehensive interventions, and constantly improve and revise the endoscopic operation procedures and management system, can significantly improve the quality of endoscopic cleaning and disinfection.