本文選題：醫(yī)療機(jī)構(gòu) + 消毒質(zhì)量��； 參考：《青島大學(xué)》2013年碩士論文

【摘要】：目的：了解青島市各級(jí)醫(yī)療機(jī)構(gòu)消毒質(zhì)量現(xiàn)況,分析存在的問題,為醫(yī)療機(jī)構(gòu)消毒質(zhì)量監(jiān)測(cè)與醫(yī)院內(nèi)感染控制提供依據(jù)。 方法：選取青島市7家二級(jí)醫(yī)院和2家三級(jí)醫(yī)院,根據(jù)《全國(guó)醫(yī)院感染—消毒監(jiān)測(cè)方案》、《醫(yī)院消毒衛(wèi)生標(biāo)準(zhǔn)》(GB15982-1995)和《消毒技術(shù)規(guī)范》(2002)規(guī)定的消毒對(duì)象分類、實(shí)驗(yàn)室檢測(cè)方法和結(jié)果判斷標(biāo)準(zhǔn),2007-2011年每年度對(duì)被監(jiān)測(cè)單位醫(yī)療器械清洗、手術(shù)室空氣、一般物體表面、醫(yī)護(hù)人員手衛(wèi)生、內(nèi)鏡、口腔醫(yī)療用水、醫(yī)院污水和壓力蒸汽滅菌器的消毒滅菌質(zhì)量進(jìn)行檢測(cè)分析。采用Excel2003和SPSS17.0進(jìn)行數(shù)據(jù)處理與統(tǒng)計(jì)分析,采用卡方檢驗(yàn)對(duì)不同項(xiàng)目、不同年度、不同級(jí)別醫(yī)院的消毒質(zhì)量監(jiān)測(cè)結(jié)果進(jìn)行統(tǒng)計(jì)分析。 結(jié)果：①2007-2011年共監(jiān)測(cè)1798份樣品(不包括醫(yī)療器械清洗樣品),合格1172份,總合格率為65,2%,不同項(xiàng)目監(jiān)測(cè)合格率由高到低依次為：物體表面99.6%、壓力蒸汽滅菌器97.6%、外科手87.8%、漂洗用水85.7%、污水85.7%、內(nèi)鏡79.6%、手術(shù)室空氣71.1%、衛(wèi)生手為66.0%、口腔用水37.5%；不同年度總合格率無(wú)顯著性差異。 ②手衛(wèi)生監(jiān)測(cè)外科手消毒、衛(wèi)生手消毒和手依從性合格率依次降低,差異有顯著性(χ2=317.149,P0.0001)；無(wú)手衛(wèi)生、洗手、手消毒、洗手+手消毒的合格率依次增高(χ2=18.489,P=0.0003)；不同手衛(wèi)生時(shí)間合格率隨時(shí)間增加而提高(χ2=4.103,P=0.043)。醫(yī)療器械清洗放大鏡法檢測(cè)鑷子、剪刀和止血鉗的合格率分別為90.0%(63／70)、80.9%(174／215)和76.3%(145／190),鑷子合格率高于止血鉗(χ2=6.148,P=0.046)。胃鏡和腸鏡監(jiān)測(cè)的合格率分別為80.6%(54／67)和78.9%(71／90),差異無(wú)顯著性�？谇皇謾C(jī)噴水和沖洗水監(jiān)測(cè)合格率分別為30.2%(106／350)和44.5%(138／310),差異有顯著性(χ2=14.287,P=0.0002)。 ③三級(jí)醫(yī)院和二級(jí)醫(yī)院外科手、衛(wèi)生手和腸鏡監(jiān)測(cè)合格率無(wú)顯著性差異,但手依從性、胃鏡、口腔手機(jī)噴水和沖洗水監(jiān)測(cè)合格率均有顯著性差異(χ~2=61.237、5.612、35.577、9.792,P0.0001、=0.018、0.0001、=0.0002)。 結(jié)論：①不同監(jiān)測(cè)樣品消毒滅菌質(zhì)量存在差異,環(huán)境物體表面、中心供應(yīng)室生物監(jiān)測(cè)以及醫(yī)院污水消毒滅菌質(zhì)量較好,醫(yī)護(hù)人員的手衛(wèi)生情況、手術(shù)室空氣、內(nèi)鏡消毒、口腔科醫(yī)療用水安全是今后醫(yī)院感染管理的重點(diǎn)。②青島市不同級(jí)別醫(yī)療機(jī)構(gòu)的消毒滅菌質(zhì)量也存在差異,應(yīng)進(jìn)一步擴(kuò)大對(duì)轄區(qū)醫(yī)療機(jī)構(gòu)監(jiān)測(cè)范圍,加強(qiáng)醫(yī)療機(jī)構(gòu)的消毒技術(shù)指導(dǎo)和監(jiān)督,提高醫(yī)院感染的控制能力。
[Abstract]:Objective: to understand the current situation of disinfection quality of medical institutions at all levels in Qingdao and analyze the existing problems, and to provide the basis for the quality monitoring of medical institutions and the control of infection in hospitals.
Methods: 7 grade two hospitals in Qingdao and 2 grade three hospitals were classified according to the National Hospital Infection disinfection monitoring scheme, the hospital disinfection hygiene standard (GB15982-1995) and the disinfection technical specification (2002), the laboratory testing method and the result judgment standard, and the medical instruments of the monitored units for 2007-2011 years each year. Cleaning, operation room air, general object surface, medical staff hand hygiene, endoscopy, oral medical use water, hospital sewage and pressure steam sterilizer quality were detected and analyzed. Excel2003 and SPSS17.0 were used for data processing and statistical analysis, and the cards were checked for different projects, different years and different levels of hospitals. The results of drug quality monitoring were statistically analyzed.
Results: (1) 1798 samples (excluding medical equipment cleaning samples) were monitored for 2007-2011 years. The total qualified rate was 65,2%. The qualified rate of different items from high to low was 99.6%, pressure steam sterilizer 97.6%, surgical hand 87.8%, rinse water 85.7%, sewage 85.7%, endoscopy 79.6%, and operation room 71.1%, 71.1%, sanitary, 71.1%, sanitary, 71.1%, and sanitary ware in the operation room 71.1%. Hand was 66%, oral water was 37.5%; there was no significant difference in total qualification rate in different years.
Second, hand hygiene monitoring surgical hand disinfection, hygienic hand disinfection and hand compliance rate decreased in turn, the difference was significant (x 2=317.149, P0.0001), no hand hygiene, hand washing, hand disinfection, hand disinfection of hand increased (chi 2=18.489, P=0.0003), the qualified rate of different hand hygiene time increased with time (x 2=4.103, P=0.043). The qualified rate of the instrument cleaning magnifier was 90% (63 / 70), 80.9% (174 / 215) and 76.3% (145 / 190), the tweezers were higher than the hemostatic forceps (chi 2=6.148, P=0.046). The qualified rates of gastroscope and enteroscopy were 80.6% (54 / 67) and 78.9% (67), respectively. The pass rate of washing water monitoring was 30.2% (106 / 350) and 44.5% (138 / 310) respectively, with significant difference (2=14.287, P=0.0002).
(3) there was no significant difference in the qualified rate between the three level hospitals and the two level hospitals, but the compliance rates of hand compliance, gastroscope, oral cell phone water spray and irrigation water were significantly different (x ~2=61.237,5.612,35.577,9.792, P0.0001, =0.018,0.0001, = 0.0002).
Conclusion: (1) there are differences in disinfection and sterilization quality of different monitoring samples, surface of environmental objects, biological monitoring of central supply room and good quality of disinfection and sterilization in hospital sewage, hand hygiene of medical and nursing staff, air in operation room, disinfection of endoscopy, and safety of medical water in Department of Stomatology, the key point of hospital infection management in the future. (2) different grades in Qingdao There are also differences in the quality of disinfection and sterilization in medical institutions. The monitoring range of medical institutions in the area should be further expanded, the guidance and supervision of disinfection technology in medical institutions should be strengthened and the control ability of hospital infection should be improved.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R181.3

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本文編號(hào)：1810077