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目的为了解无锡市锡山区各级医疗机构消毒灭菌工作质量,找出管理过程中存在的问题,提高院内感染管理,减少院内感染的发生。方法采用现场抽检和细菌检测方法进行调查和实验室检测。结果灭菌物品、使用中消毒液、透析液、高压蒸汽灭菌锅的合格率基本为100%。室内空气3年合格率分别为88.31%、85.96%和91.43%(χ2=0.96,P>0.05)。医护人员手3年合格率分别为90.08%、77.39%和82.03%(χ2=7.40,P<0.05)。物体表面3年合格率分别为93.12%、86.36%和93.01%(χ2=5.70,P>0.05)。按3年检测各类样品的合格率分别为93.66%、87.41%和91.45%(χ2=11.96,P<0.01)。3级医疗机构样品合格率2009年分别为96.20%、94.66%和90.48%(χ2=4.30,P>0.05);2010年分别为87.86%、87.76%和78.95%(χ2=1.30,P>0.05);2011年分别为92.89%、90.70%和89.36%(χ2=1.24,P>0.05)。2010及2011年度紫外线灯强度检测合格率为60%。结论锡山区各级医疗机构的消毒和灭菌整体质量比较好,但在卫生消毒质量与院内感染管理上仍存在着一些薄弱环节。医疗机构必须加强内部管理,切实提高卫生消毒质量。
Objective To understand the quality of disinfection and sterilization in medical institutions at all levels in Xishan District of Wuxi City, find out the problems existing in the management process, improve the management of nosocomial infections and reduce the incidence of nosocomial infections. Methods The methods of on-the-spot sampling and bacterial testing were used for investigation and laboratory testing. Results Sterilization items, the use of disinfectant, dialysate, high-pressure steam sterilization pot pass rate of 100%. The indoor air three-year pass rates were 88.31%, 85.96% and 91.43% (χ2 = 0.96, P> 0.05). The pass rates of medical staff in three years were 90.08%, 77.39% and 82.03% respectively (χ2 = 7.40, P <0.05). The three-year pass rates of object surface were 93.12%, 86.36% and 93.01% respectively (χ2 = 5.70, P> 0.05). The qualified rates of all kinds of samples tested for three years were 93.66%, 87.41% and 91.45%, respectively (χ2 = 11.96, P <0.01). The passing rate of Grade 3 medical institutions was 96.20%, 94.66% and 90.48% respectively in 2009 (χ2 = 4.30, P> 0.05); in 2010 it was 87.86%, 87.76% and 78.95% respectively (χ2 = 1.30, ; Respectively, 92.89%, 90.70% and 89.36% in 2011 (χ2 = 1.24, P> 0.05). 2010 and 2011 UV lamp intensity test pass rate of 60%. Conclusion The overall quality of disinfection and sterilization of medical institutions at all levels in Xishan District is good, but there are still some weak links in the quality of disinfection and in-hospital infection management. Medical institutions must strengthen internal management and effectively improve the quality of disinfection.