基层医学论坛
基層醫學論罈
기층의학론단
PUBLIC MEDICAL FORUM MAGAZINE
2014年
13期
1659-1661
,共3页
徐月美%陈宜华%金翠萍%陈蓉美
徐月美%陳宜華%金翠萍%陳蓉美
서월미%진의화%금취평%진용미
消毒供应中心%脉动真空灭菌器%湿包%医院感染%对策
消毒供應中心%脈動真空滅菌器%濕包%醫院感染%對策
소독공응중심%맥동진공멸균기%습포%의원감염%대책
Sterilized supply center%Pulsing vacuum steam sterilization%Wet pack%Hospital infection%Countermeasure
目的：分析脉动真空灭菌器灭菌产生湿包的原因，探讨杜绝脉动真空灭菌器灭菌时产生湿包的对策。方法将采用棉布、无纺布、无纺布+皱纹纸、纸塑袋包装的基础护理包、同类专科器械、大小一致的手术室器械包和手术室布类包、外来器械，按不同待灭菌包种类，分别采取分类装载和混合装载的方式，利用科室2台灭菌器，选择织物程序按脉动真空灭菌器的正常操作流程运行一个灭菌周期。根据出锅时间及冷却时间的不同，观察湿包出现的部位、多少、种类；每天各选择2批次共8批次，连续监测7 d。结果56批次共2660个灭菌包，其中出现湿包32个。不同包装材质引起灭菌包出现湿包现象不同，纸塑包装最易湿包、双层无纺布次之、其次是无纺布+皱纹纸，棉布引起湿包发生现象最少；灭菌包不同材质，大小、重量可影响湿包产生，金属器械较布类易湿包，体积大、量重者容易湿包；不同的装载方式及冷却方式对湿包的产生有一定的影响，混合装载比分类装载更容易出现湿包；不同部位湿包产生不同，灭菌器最下层较上两层易湿包，灭菌包靠近灭菌器内腔壁容易湿包；冷却时间越短越容易湿包。结论加强消毒供应中心环节控制，规范器械物品干燥、包装、灭菌、卸载等流程操作，可有效控制湿包产生，防止因消毒供应中心灭菌物品不合格所致医院感染发生。
目的：分析脈動真空滅菌器滅菌產生濕包的原因，探討杜絕脈動真空滅菌器滅菌時產生濕包的對策。方法將採用棉佈、無紡佈、無紡佈+皺紋紙、紙塑袋包裝的基礎護理包、同類專科器械、大小一緻的手術室器械包和手術室佈類包、外來器械，按不同待滅菌包種類，分彆採取分類裝載和混閤裝載的方式，利用科室2檯滅菌器，選擇織物程序按脈動真空滅菌器的正常操作流程運行一箇滅菌週期。根據齣鍋時間及冷卻時間的不同，觀察濕包齣現的部位、多少、種類；每天各選擇2批次共8批次，連續鑑測7 d。結果56批次共2660箇滅菌包，其中齣現濕包32箇。不同包裝材質引起滅菌包齣現濕包現象不同，紙塑包裝最易濕包、雙層無紡佈次之、其次是無紡佈+皺紋紙，棉佈引起濕包髮生現象最少；滅菌包不同材質，大小、重量可影響濕包產生，金屬器械較佈類易濕包，體積大、量重者容易濕包；不同的裝載方式及冷卻方式對濕包的產生有一定的影響，混閤裝載比分類裝載更容易齣現濕包；不同部位濕包產生不同，滅菌器最下層較上兩層易濕包，滅菌包靠近滅菌器內腔壁容易濕包；冷卻時間越短越容易濕包。結論加彊消毒供應中心環節控製，規範器械物品榦燥、包裝、滅菌、卸載等流程操作，可有效控製濕包產生，防止因消毒供應中心滅菌物品不閤格所緻醫院感染髮生。
목적：분석맥동진공멸균기멸균산생습포적원인，탐토두절맥동진공멸균기멸균시산생습포적대책。방법장채용면포、무방포、무방포+추문지、지소대포장적기출호리포、동류전과기계、대소일치적수술실기계포화수술실포류포、외래기계，안불동대멸균포충류，분별채취분류장재화혼합장재적방식，이용과실2태멸균기，선택직물정서안맥동진공멸균기적정상조작류정운행일개멸균주기。근거출과시간급냉각시간적불동，관찰습포출현적부위、다소、충류；매천각선택2비차공8비차，련속감측7 d。결과56비차공2660개멸균포，기중출현습포32개。불동포장재질인기멸균포출현습포현상불동，지소포장최역습포、쌍층무방포차지、기차시무방포+추문지，면포인기습포발생현상최소；멸균포불동재질，대소、중량가영향습포산생，금속기계교포류역습포，체적대、량중자용역습포；불동적장재방식급냉각방식대습포적산생유일정적영향，혼합장재비분류장재경용역출현습포；불동부위습포산생불동，멸균기최하층교상량층역습포，멸균포고근멸균기내강벽용역습포；냉각시간월단월용역습포。결론가강소독공응중심배절공제，규범기계물품간조、포장、멸균、사재등류정조작，가유효공제습포산생，방지인소독공응중심멸균물품불합격소치의원감염발생。
Objectve We will analyze the reason of wet pack appeared after pulsing vacuum steam sterilization.In order to bring forward the methods and countermeasures of control to reduce the appearance of wet pack.Methods For the basic nursing pack packed by cotton or non-woven or non-woven+crepe paper or paper-plastic bag,the similar specialized instrument,the same size of operating room surgical apparatus pack and operating room cloth pack,the foreign apparatus,we will take types of classified loading and mixed loading according to the different kinds of sterilization package,choose the fabric process taking addvantage of the two sterilization in the department,run a sterilization cycle according to the normal operating procedure of pulsing vacuum steam sterilization,observe the position,amount and variety of wet pack according to the different pan time and cooling-down time. We will choose 2 batch-totally 8 batch and contiously monitor 7 days everday.Results There were 32 wet packs appeared among the 56 batch-totally 2660 sterilization packages.Different materials have a variety of phenomena of wet pack.The first one is paper-plastic bag ,next is non-woven,then the third is non-woven+crepe paper,and the last is cotton.The material,size and weight could effect on the appearance of wet pack.The metallic apparatus is easier than mercery.The larger volume and the more weight,the easier of wet pack appeared.Different loading and cooling-down methods have an influence on wet pack.The mixed loading is easier than the classified loading.All of wet pack have all kinds of position.The lowest is easier than the two floors above it.And the sterilization package closing to the lining of sterilization is easier to the wet pack appeared. The shorter cooling-down time,the easier.Conclusion Strengthen the control of sterilized supply center and standard operation proceduce,such as drying equipment items,package,sterilization and unload,could effectively control the appearance of wet pack and prevent the hospital infection,for the unqualified sterilization items,from appearance.
