CAJ | 학술논문

目的寻找并发现纤维内镜管道内腔细菌监测不合格的原因,提高内镜清洗消毒合格率.方法应用失效模式与效应分析法对纤维内镜管道内腔细菌监测不合格结果进行分析,进行流程改造.同时用细菌学监测的方法对整改前后纤维内镜管道内腔进行抽样监测.结果管道内腔手工清洗时刷洗次数对监测结果有影响,修订管道内腔清洗消毒流程并进行员工培训,纤维内镜管道内腔监测结果较整改前有提高,合格率由84.15%提高到98.65%,差异显著.对内镜清洗消毒失效风险指数进行计算,风险较高的前2项是:操作员管腔内刷洗次数的RPN=640,管腔内刷洗方法的RPN=480,是影响监测质量的关键因素.结论对管道内腔刷洗次数进行调整,采用细菌学监测的方法对效果进行检验,管道内腔刷洗应不少于5次,可提高管道内腔细菌监测的合格率.
목적 심조병발현섬유내경관도내강세균감측불합격적원인,제고내경청세소독합격솔.방법 응용실효모식여효응분석법대섬유내경관도내강세균감측불합격결과진행분석,진행류정개조.동시용세균학감측적방법대정개전후섬유내경관도내강진행추양감측.결과 관도내강수공청세시쇄세차수대감측결과유영향,수정관도내강청세소독류정병진행원공배훈,섬유내경관도내강감측결과교정개전유제고,합격솔유84.15%제고도98.65%,차이현저.대내경청세소독실효풍험지수진행계산,풍험교고적전2항시:조작원관강내쇄세차수적RPN=640,관강내쇄세방법적RPN=480,시영향감측질량적관건인소.결론 대관도내강쇄세차수진행조정,채용세균학감측적방법대효과진행검험,관도내강쇄세응불소우5차,가제고관도내강세균감측적합격솔.
Objective To identify and investigate the cause of the unacceptable bacteria level inside the lumen of fiberendoscope during monitoring so as to increase the pass rate of its cleaning and disinfection. Methods A failure mode effect analysis of the cause was done and the workflow was thereafter improved. Meanwhile, pre and post bacteriological monitor was applied to the fiberendoscope lumen samples. Results The number of scrubbing times while manual cleaning affected the monitoring results. The scrubbing times was amended and the pass rate increased from 84.15% to 98.65%. The results were significantly different The failure mode risk index of endoscope cleaning and disinfection was calculated, and the highest two items were: The number of scrubbing times the operators execute RPN=640, the method of lumen cleaning RPN=480. These were the key factors of qualification of monitoring. Conclusions After the amendment, no less than 5 times' scrubbing was required and the bacteriological monitoring method was used to analyze the effects,thereafter the pass rate of lumen bacteria monitoring can be increased significantly.