ICU高频接触物体表面消毒方法和效果评价的优选策略研究

目的通过与传统消毒方法对比，观察不同载体吸附消毒剂对重症监护室（ICU）高频接触物体表面清洁消毒效果，探索经济、方便、有效的消毒方法和频次。方法设置对照组和实验组，实验前采用含氯消毒剂+普通毛巾进行擦拭为对照组，实验组改用双链季胺盐消毒剂，分别采用消毒湿巾、超细纤维抹布和棉质水刺无纺布为载体对ICU高频接触物体表面进行擦拭消毒，消毒频次均为每日2次，工作状态下随机对对照组和实验组的消毒效果进行荧光检测和微生物检测，分别比较实验前后、不同材质载体消毒剂消毒方法的清洁消毒合格率，分析三种消毒方法的消耗成本。结果与实验前比较，实验组三种不同材质载体消毒效果的微生物检测法和荧光检测法的总合格率分别提高到95.43%和74.38%，差异有统计学意义（P < 0.01）。实验组3种不同载体吸附同一种消毒剂的消毒效果差异无统计学意义（P>0.05），消耗成本依次为4.4元/每日每床、1.58元/每日每床和1.66元/每日每床。结论双链季胺盐消毒剂可以作为ICU的常规消毒剂使用，以棉质水刺无纺布为载体的消毒方法，清洁消毒一步完成，价廉物美，每日2次，是保持高频接触物体表面低污染的一种经济有效的方法。

Study on the disinfection methods and optimal strategies for surface of high-frequency contact object in ICU

ObjectiveTo observe the cleaning and disinfecting effects of different carrier adsorption disinfectants on surface of high-frequency contact object in intensive care unit(ICU) by comparing with traditional disinfection methods, and explore the economic, convenient and effective disinfection methods and frequencies.MethodsBefore the experiment, the object treated with chlorine-containing disinfectant and ordinary towel was used as the control group, and the object treated with double-chain quaint salt disinfectant was set as the experimental group.The surfaces of high-frequency contact objects in ICU were treated with disinfecting wet wipes, microfiber rag and cotton spunlaced non-woven cloth as carriers to wipe and disinfect, and the disinfecting frequency was twice a day.The fluorescence and microbial detection in two groups were randomly carried out to identify the disinfection effects under the working state.The qualified rates of cleaning and disinfection of disinfectants with different material carriers before and after the experiment were compared, and the consumption cost of the three disinfection methods were analyzed.ResultsCompared with before experiment, the total qualification rates of the microbial detection method and fluorescent detection method in three different material carriers in the experimental group increased to 95.43% and 74.38%, respectively, and the difference of which was statistically significant(P < 0.01).There was no statistical significance in the disinfection effects among the same disinfectant adsorbed by three different carriers in the experimental group(P>0.05), and the consumption costs of disinfecting wet wipes, microfiber rag and cotton spunlaced non-woven cloth were 4.4 yuan/day per bed, 1.58 yuan/day per bed and 1.66 yuan/day per bed, respectively.ConclusionsDouble-chain quaternary amine salt disinfectant can be used as a routine disinfectant in ICU.At the cotton spunlaced non-woven fabric as the carrier of disinfection method, the cleaning and disinfection is completed in one step, which is cheap and good quality, twice daily, and an economic and effective method in maintaining the low pollution of surface of high-frequency contact.