做好环氧乙烷灭菌器灭菌效果监测

环氧乙烷(EO)灭菌是当前应用最广泛的灭菌方法之一,近年来被广泛应用于不耐湿热医疗物品的灭菌,为全面提高医疗物品灭菌质量,加强对EO灭菌设备的监控,建立标准化监测程序,消除安全隐患,确保灭菌器的安全运行及灭菌效果监测,取得了较好效果.     

持续质量改进在环氧乙烷灭菌质量控制中的应用

目的探讨持续质量改进(Continuous Quality improvement,CQI)在环氧乙烷(EO)灭菌质量控制中的应用。方法对143锅EO灭菌器灭菌物品7 720包进行监测,发现不合格灭菌物品有286包,合格率为96.3%,分析问题发生的原因,采取相应的整改措施。结果实施改进后,EO灭菌包合格率达到99.6%。结论遵循CQI原则,使EO灭菌质量得到有效控制,提高EO灭菌成功率,确保器械安全及周转,提高工作满意度,增强员工职业荣誉感。     

加强手术室应用环氧乙烷灭菌的管理

目的探讨手术室在环氧乙烷（EO）灭菌过程中的管理及对灭菌效果的监测,确保物品的灭菌质量。方法采用化学指示卡和生物指示剂对灭菌过程监测,严格按灭菌的操作程序、规范步骤进行,应用生物、化学指示及对灭菌效果进行监测控制。结果2006年1-6月对150个灭菌包应用指示卡的监测,灭菌不合格占总数的4.6%,均为操作不当所致,重新灭菌后均合格。结论在灭菌工作中只要严格管理、灭菌及监测方法正确,才能确保灭菌效果,以提高灭菌质量,提供安全的手术无菌物品。     

3M Steri-Vac^TM 8XL环氧乙烷气体灭菌器检修

3MSteri -VacTM8XL环氧乙烷气体灭菌器是利用EO气体杀死包括细菌芽胞在内的所有微生物 ,并且灭菌物品可以被包裹 ,可保持使用前呈无菌状态 ,有很强的穿透性并灭菌形状不规则物品 ,而且配有生物监测系统和化学监测系统 (3MEO指示胶带、complyTM包内指示卡 )用于证实灭菌参数是否达到 ,灭菌是否有效。可用于精密器械、光学仪器、各种导管及塑料制品等的灭菌 ,所以国内外各大医院广泛采用。由于该型设备使用率高、年限增长 ,故障率增多 ,下面谈几点检修3MSteri-VacTM 8XL环氧乙烷灭菌器故障时的步骤及方法 ,供大家参考。故障现象1该机…     

加强环氧乙烷灭菌前的管理提高灭菌质量

通过用鲎试剂法对环氧乙烷(EO)灭菌物品的内毒素监测,就基层医院对待EO灭菌物品的清洁、包装等存在问题及改进措施作一探讨.     

消毒供应中心低温灭菌的管理体会

我院是拥有2100张床位的大型综合的三级甲等医院,其消毒供应中心低温消毒灭菌是医院主要的灭菌方法之一,主要针对不能用高温消毒灭菌的光学仪器、精密仪器、电子仪器及设备及特殊的一次性使用物品进行低温灭菌,通过灭菌过程严格的质量管理及各项物理化学生物监测的结果,灭菌效果可靠,我们的低温消毒灭菌包括了过氧化氢等离子体灭菌及3M环氧乙烷灭菌,按各临床科室及手术室使用物品的需求、灭菌器的特点和时间、物品的特有性,我们在每个工作日交替使用两个灭菌器,并注意规范的操作及灭菌器的保养,以保证低温灭菌物品质量和需求,取得了满意的效果,针对灭菌器的安全管理、质量管理、个人防护、服务质量、注意事项、和体会做以下工作总结.     

环氧乙烷气体灭菌失败的原因分析及对策

目的 分析3次环氧乙烷气体灭菌失败的原因并提出相应对策,确保无菌物品的质量.方法 从环氧乙烷气体灭菌失败的基本环节入手,查找原因,跟踪调查,制定对策.结果 包装材料不符合灭菌要求、包装方法不规范、灭菌前查对不认真、装载过挤均是引起灭菌失败的主要原因.结论 加强员工相关知识的培训,注重待灭菌物品的质量,熟练掌握环氧乙烷气体灭菌器的操作规程及注意事项,是保证灭菌成功的关键.     

3M STERI-VACTM^8XL环氧乙烷灭菌器故障检修

3M Steri-VacTM 8XL环氧乙烷气体灭菌器是利用纯环氧乙烷气体杀灭细菌,包括芽孢在内的所有微生物。环氧乙烷有较强的穿透性,物品采用纸塑材料包裹灭菌,可保持灭菌物品的无菌时间较长,环氧乙烷适用于精密器械、光学仪器、各种胶管及塑料制品等的灭菌,广泛应用于国内大型三级甲等医院。此设备使用率高、随着使用年限的增加,故障率也随着增加。我院3MSteri-Vac TM8XL环氧乙烷灭菌器常出的故障如下。     

手术室环氧乙烷灭菌生物监测方法的改进

目的 通过环氧乙烷生物灭菌监测方法的改进与分析,找出监测的影响因素及正确使用方法,指导今后更好地开展此项工作.方法 对2007年5-12月手术室环氧乙烷灭菌生物指示剂监测结果进行分析.结果 监测环氧乙烷灭菌包共计210例,合格202例,占96.1%,不合格8例,占3.9%.结论 操作人员必须严格执行操作规程,掌握灭菌器的使用方法,确保生物指示剂监测合格,从而保证环氧乙烷、灭菌器的安全使用,提高环氧乙烷消毒物品的灭菌质量.     

脉动真空压力蒸汽灭菌器灭菌效果监测的方法

目的总结脉动真空压力蒸汽灭菌器监测方法,保证灭菌物品质量的安全。方法通过完善物理、化学、生物监测的方法,保障灭菌质量。结果通过近年来严格注重环节监测,保证临床工作顺利进行,提高了物品的无菌保障水平。结论脉动真空压力蒸汽灭菌器具有灭菌时间短、灭菌后物品干燥、损害轻微、灭菌彻底等优点而被各级医院广泛采用,而有效的灭菌效果的监测是保证灭菌物品质量的安全。     

循证护理管理在消毒供应中心中的应用价值分析

目的探究消毒供应中心实行循证护理管理模式日常质量掌控的应用价值。方法 2017年1-12月于该院杀菌供应中心杀菌的260台设备被列入分析,概率性的分成观察组与对照组,每组130台。对照组实行了传统消毒供应中心的质量控制;观察组于对照组的基础之上实行循证护理管理。对于两组设备的清洁率,包装合格率,灭菌手动合格率,部门满意度,员工满意度等指标展开统计分析。结果观察组的清洁质量,包装质量与灭菌质量评分皆高于对照组,两组差异有统计学意义(P<0.05)。观察组工作人员的满意度与临床科室的满意度皆高于对照组,差异有统计学意义(P<0.05)。结论把根据证据的护理管理模型运用在杀菌供应中心的日常质量掌控可显着提升设备消毒,包装与灭菌操作的合格率。精确地提升了部门满意度与临床护理质量。     

正确使用环氧乙烷灭菌效果的监测方法

目的 探讨环氧乙烷灭菌过程有效性的监测手段。方法 采用生物指示剂、化学指示剂和控制灭菌过程的各种参数及机械状况，对灭菌效果进行全面监控。结果 加强有关标准和规范的落实，综合应用物理、化学、生物3种监测方法，才能提高灭菌质量。结论 监测方法的正确使用和严格质量控制是灭菌成功的关键。     

聚乳酸生物材料灭菌方法的研究

目的：本文旨在探索两种常用的灭菌方法（C060辐照灭菌和EO灭菌）对聚乳酸材料本身性能的影响。方法：采用测试和对比聚乳酸材料灭菌前后的抗压强度的方法评价不同灭菌方法对材料性能的影响。结果：C060灭菌后,聚乳酸材料发生脆性断裂,而EO灭菌对材料的抗压强度影响不显著。结论：C060辐射灭菌会对聚乳酸造成结构性的破坏从而影响其力学性能,EO灭菌则对此没有影响,但是聚乳酸材料对EO的吸附力较强,采用真空干燥法去除EO残留具有较好的效果。     

Problems associated with sterilization using ethylene oxide. Residues in treated materials

The paper deals with problems associated with reduction of undesirable effects of ethylene oxide in polymers in medical devices on the patient's health. The authors explain the need of careful elaboration and validation of the sterilization and aeration process incl assessment of ethylene oxide (EO) residues. The authors investigated the effect of the type of material and conditions of sterilization and aeration on the assessed EO concentration. For research of the behaviour of different polymers in the sterilization process model sterilizations of actual items of medical devices with a known composition proved more suitable than assessment in medical devices from medical institutions. The main conclusions of the investigation were a classification of polymers into those suitable and unsuitable for sterilization or resterilization, and attention was also drawn to poor reproducibility of results in old sterilizers, in particular those lacking effective aeration in aerators.     

做好消毒供应科全程工作质量管理的体会

目的探讨医院消毒供应科全程工作的质量管理方法。方法依据卫生部颁发的有关各项监测规定为准则,对消毒供应科全程工作进行分析,实施质量监控。结果使全程工作质量管理走向规范化、制度化、程序化。结论全程工作质量管理是确保无菌物品质量的合格率及保供率双达标的有效措施。     

不耐热手术器械的灭菌方法

目的比较两种低温灭菌方法在综合医院不耐热手术器械灭菌时的最佳方法。方法2008年6~12月对环氧乙烷和过氧化氢等离子低温灭菌的物品选择、灭菌时间、操作流程及灭菌成本等进行比较分析。结果环氧乙烷为传统的低温灭菌方法,是成熟的灭菌技术,其灭菌物品选择范围广,成本合理,灭菌时间长,操作简单易行,适用于综合医院手术室内各类物品的灭菌;过氧化氢等离子灭菌为新兴的低温灭菌方法,灭菌成本高,包装材料及操作流程均有严格要求,但其灭菌时间短,适用于紧急和连台手术时的专科手术器械的灭菌。结论两种灭菌方法各有其优缺点,环氧乙烷仍是医院最主要的低温灭菌手段。     

S90卫生器材灭菌车的性能试验

介绍了S—90卫生器材灭菌车的技术性能。通过试验和试用考核了技术性能的可靠性,确定了高压蒸汽灭菌条件及环氧乙烷(EO)灭菌和残留气清除条件。试用结果表明,该车适合部队医院使用。     

Occupational exposure to ethylene oxide: effects and control

Ethylene oxide (EO) is widely used in the health care industry as a gas sterilant for medical products that cannot withstand the high temperature and humidity associated with conventional steam sterilization. As a consequence, approximately 100,000 health care workers are exposed to residual EO each year. The acute toxicity of exposure to EO has been well documented, and recent concern about the mutagenic potential of occupational exposure to EO has resulted in an effort to further reduce workplace exposure levels to EO. The Environmental Protection Agency has issued a rebuttal presumption against registration of EO as a pesticide and the American Conference of Governmental Industrial Hygienists (ACGIH) has proposed a sharp reduction in the threshold limit value permitted for EO. Recognizing the need for environmental health personnel to become more familiar with this workplace hazard, it is appropriate to briefly review the toxic effects of acute and chronic exposure to EO residuals. The authors describe a gas sterilization system successfully utilized at the U.S. Public Health Service Hospital in New Orleans, La., which has demonstrated exposure concentrations well below the EO threshold limit value recently proposed by the ACGIH, while preserving the principal goal of assuring the sterility of reusable medical products which cannot be subjected to steam sterilization.     

Personal exposure level and environmental ethylene oxide gas concentration in sterilization facilities of hospitals in Japan

Personal and environmental (stationary) ethylene oxide (EO) gas concentrations in gas sterilization facilities were measured at six workplaces in five hospitals. An ethylene oxide gas monitor (3M #3551) was used for both personal and stationary samplings. A gas detector tube was also used for instantaneous sampling. In most workplaces, the personal exposure levels of EO were below the detection limit of the gas monitor. Most of the time-weighted average (TWA) concentrations by the stationary sampling were below the threshold limit value of EO (TLV-TWA = 1 ppm), but in one workplace, more than 4 ppm of EO were detected in front of the sterilizer in a clean room during a 24-hour measurement, although all the personal exposure levels were below the detection limit. Method of aeration after the sterilization was very important for reducing the EO exposure. The EO gas concentrations in two workplaces where sufficient aeration was carried out were below the detection limit in all the stationary samples. In one workplace where insufficient aeration was performed, EO was detected from 16 of 17 stationary samples, and more than 90-200 ppm of EO was determined by the gas detector tube near the worker's face at the moment when the door of the sterilizer was opened and the sterilized materials were removed.     

An investigation on ethylene oxide sterilization management in medical institutions]

The present study describes an investigation on the use and management of ethylene oxide (EO) which is used mainly as a sterilant in medical institutions in a Cabinet-order designated city. Information was obtained from a self-administered questionnaire on safety and health matters related to sterilization with EO gas. The questionnaire was sent to 189 medical institutions including major hospitals and randomly selected clinics. 127 questionnaire were returned and the analysis was carried out for 120 respondents, excluding seven respondents whose answers were found to be inappropriate. The proportion of medical institutions, employing more than 50 workers, in which an occupational health physician and/or health supervisor was appointed was 70% and was lower than for other industries. 1.6% of the employees engaged in EO sterilization activities in the hospitals, whereas in clinics the percentage was as high as 20%. Several problems were found both in the management and work methods with EO: operations were not isolated in 46%; gas leaks and back-streaming of exhaust gas were found in 59% and 41%, respectively; and personal protective clothing was not used in 69%. Improvement was found only for three items among the institutions where an occupational health physician was appointed. These results suggest that good workplace controls and practices are essential for medical institutions using hazardous materials including EO for sterilization.