低温甲醛蒸汽灭菌器灭菌效果研究

[目的]探讨低温甲醛蒸汽灭菌器的安全性和灭菌效果。[方法]采用低温甲醛蒸汽灭菌器进行灭菌,检测工作环境中的空气和所排废水中甲醛浓度,采用生物指示物和染菌载体进行灭菌效果监测。[结果]灭菌程序运行过程中,空气中甲醛浓度〈0.1mg/m3,废水中甲醛浓度〈20mg/L;载体定性灭菌试验全部合格,有3次模拟现场灭菌试验灭菌运行失败。[结论]低温蒸汽甲醛灭菌是一种安全有效低温灭菌处理方式,但低温蒸汽甲醛灭菌器适用的灭菌物品范围需进行科学界定。     

低温等离子体灭菌的应用

目的 探讨低温等离子体灭菌方式对不耐热物品灭菌的步骤与效果.方法 采用低温等离子体灭菌器,通过适当的介质,选择相应的待处理物品,按照规范的操作流程,包括灭菌前准备、包装、火菌、卸载、存放等进行操作.结果 低温等离子体灭菌效果可靠、监测方便、时间短、器械周转快、利用率高,可大大提高手术例数.结论 低温等离子体灭菌是一种快速安全有效低温火菌方式,通过这种方式灭菌,无菌物品灭菌质量得到保证,降低医院感染率,并且灭菌后物品储存期长,满足了临床对无菌物品的要求.     

等离子体灭菌器在手术室工作中的应用

目的了解等离子体灭菌器的性能、灭菌特点及效果。方法操作等离子体灭菌器,观察灭菌过程,采用化学和生物学方法监测灭菌效果;将其灭菌电刀线与甲醛氧化熏蒸消毒进行对照,观察电刀线使用次数。结果等离子体灭菌器灭菌后物品的化学和生物学检测均符合灭菌要求,电刀线使用寿命延长,操作简单,灭菌完毕即可使用,对人体无害。结论等离子体灭菌器使用范围广,低温、低湿、无毒,灭菌周期短,灭菌效果可靠,对物品损伤小,可节约资源,增加收入。     

低温蒸汽甲醛灭菌技术

目的：介绍１种国内全新的低温灭菌方法低温蒸汽甲醛灭菌（ＬＴＳＦ）。方法利用甲醛气体和蒸汽的混合气体在负压的条件下对热敏物体进行灭菌。结果ＬＴＳＦ完全达 灭菌效果监测标准。结论在低温灭菌方法中，ＬＴＳＦ是１种比较好的选择。     

脉动真空压力蒸汽灭菌器灭菌效果的监测

目的高压蒸汽灭菌是医院医疗器械和物品的主要灭菌方式,探讨使用脉动真空压力蒸汽灭菌器的灭菌效果,为消毒灭菌提供参考依据。方法回顾性调查2006-2009年共监测用脉动真空压力蒸汽灭菌器的灭菌的医疗器械及物品共18 978份,依据原卫生部《清洗消毒及灭菌技术操作规范》对灭菌物品进行正确包装、装载及卸载,同时加强灭菌设备的管理,注重灭菌员的专业知识技能培训;对所有灭菌物品分别进行生物监测、B-D测试及化学监测,找出影响灭菌效果的相关因素。结果 18 978份灭菌医疗器械及物品进行生物监测201次,合格率为88.56%;B-D测试3 250次,合格率为89.78%;化学监测共进行15 527次,平均合格率为91.50%,经干预后合格率达99.27%。结论脉动真空压力蒸汽灭菌器具有灭菌时间短、灭菌彻底的优点,有效降低医院感染的发生,保障了灭菌物品的质量安全。     

低温等离子灭菌器在内镜灭菌中的应用效果

目的 研究低温等离子灭菌器在内镜消毒中的效果,选择最佳的内镜消毒方法,提高内镜灭菌效果.方法 通过对该技术的研究和使用,确定它的适用范围,并结合手术室340个灭菌结果的记录找出灭菌失败的原因.结果 在340个低温灭菌使用中,332个灭菌合格,合格率为97.64％;8个灭菌循环终止,其中3个物品潮湿,3个物品包装不合格,1个有机物残留,1个舱内物品摆放不准确,经过处理,重新灭菌均达标.结论 严格按照低温等离子灭菌器的操作规范,由专业人员操作,保证灭菌前物品干燥及正确灭菌舱内物品的摆放和包装,就能保证灭菌程序的顺利完成及内镜灭菌效果,从而保证患者的健康及预防医院感染.     

过氧化氢低温等离子灭菌质量控制及持续质量改进方法

目的：通过对过氧化氢低温等离子灭菌器质量控制及持续质量改进,确保灭菌物品合格,满足临床和手术需要。方法：严格按照过氧化氢低温等离子体灭菌操作流程,加强人员培训,对器械清洗,包装、装载、机器维护,制定持续改进措施。结果：灭菌物品合格率达100％。结论：物品从清洗到灭菌过程进行严格质量控制和持续质量改进,提高灭菌成功率及灭茵效果,为急需手术器械的灭菌提供可靠的保障。     

压力蒸汽灭菌物品卸载环节质量控制

目的规范压力蒸汽火菌物品卸载环节质量管理。方法对灭菌效果的分析判断和物品放行标准、物品卸载时间、器械包质量检查内容和方法、操作人员及环境物品准备、灭菌信息的记载存档五个环节进行细化和标准化。由护士长和专职质控护士不定期抽查。结果卸载环节器械包质量控制流程达到了标准化和规范化,避免了卸载操作的随意性。结论建立全面的压力蒸汽灭菌卸载环节质量控制方案有利于规范卸载人员的行为,确保无菌物品质量摔制。     

手术室应用低温等离子灭菌的管理

目的 探讨手术室在低温等离子灭菌过程中的管理,对灭菌效果进行观察,找出影响因素及正确使用方法,指导今后更好地开展此项工作,确保物品的灭菌质量.方法 对2011年手术室低温等离子灭菌失败结果进行分析,严格按灭菌的操作程序、规范步骤进行管理控制.结果 监测低温等离子灭菌共计1507锅次,合格1385锅次,合格率为91.90％;122锅次不合格的主要原因包括人为因素、技术操作因素及核查不仔细等.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,确保低温等离子灭菌合格,从而保证低温等离子灭菌器的安全使用,确保灭菌效果,提高低温消毒物品的灭菌质量.     

压力蒸汽灭菌技术应用中的问题及对策

1　 存在的问题1.1　 灭菌知识欠缺　医院感染管理人员及供应室宣教力度不足 ,不能把压力蒸汽灭菌知识 ,如其灭菌原理、灭菌范围、物品灭菌方式的选择、灭菌监测、待灭菌物品的要求等对临床科室广泛宣教 ,致使临床科室灭菌知识欠缺。1.2　 灭菌方式选择错误　压力蒸汽灭菌只适用于耐高温、高湿、蒸汽易于穿透的医疗用品的灭菌。油类、粉类因蒸汽不易穿透 ,故不可选用此法 ,采用干灭菌法。其他如内镜等精密仪器 ,也不宜选用此法 ,而采用气体灭菌法。由于科室对物品灭菌方式选择知识缺乏 ,而将油类、粉类物品装入贮槽、灭菌包、袋内进行灭菌 ,…     

A comparative study of ethylene oxide gas, hydrogen peroxide gas plasma, and low-temperature steam formaldehyde sterilization.

OBJECTIVE: To compare the efficacies of ethylene oxide gas (EOG), hydrogen peroxide gas plasma (PLASMA), and low-temperature steam formaldehyde (LTSF) sterilization methods. METHODS: The efficacies of EOG, PLASMA, and LTSF sterilization were tested using metal and plastic plates, common medical instruments, and three process challenge devices with narrow lumens. All items were contaminated with Bacillus stearothermophilus spores or used a standard biological indicator. RESULTS: EOG and LTSF demonstrated effective killing of B. stearothermophilus spores, with or without serum, on plates, on instruments, and in process challenge devices. PLASMA failed to adequately sterilize materials on multiple trials in several experiments, including two of three plates, two of three instruments, and all process challenge devices. CONCLUSIONS: Our results suggest that PLASMA sterilization may be unsuccessful under certain conditions, particularly when used for items with complex shapes and narrow lumens. Alternatively, LTSF sterilization demonstrates excellent efficacy and is comparable to EOG sterilization. LTSF could potentially act as a substitute if EOG becomes unavailable due to environmental concerns.     

Evaluation of a low-temperature steam and formaldehyde sterilizer

We evaluated a low-temperature steam and formaldehyde (LTSF) sterilizer based on the draft European Standard prEN 14180. Microbiological tests were conducted on small and full loads using process challenge devices in five programs (P1-P5). With small loads all tests showed no growth of Bacillus stearothermophilus (ATCC7953) spores. However, positive cultures were observed with full-load tests using P5 (sterilization temperature, 50 degrees C). Our data indicated that the load influenced the efficacy of the LTSF sterilizer. Desorption tests were conducted to determine residual formaldehyde in indicator strips. The mean concentrations of formaldehyde in P1-P5 were 31.9, 56.3, 54.9, 82.2 and 180.6 microg, respectively, which are below the limits allowed by the draft Standard. Our results indicate that the LTSF sterilizer is useful for sterilization because of its excellent efficacy, short handling time, and safety.     

Residual formaldehyde on plastic materials and medical equipment following low-temperature steam and formaldehyde sterilization

We measured the amount of residual formaldehyde on 16 plastic materials and five medical devices following low-temperature steam and formaldehyde (LTSF) sterilization, based on the European Standard EN14180. The amounts of formaldehyde residue on the plastic materials were compared with that on a filter paper of similar dimensions. The amount of residual formaldehyde on polyamide 6, polyurethane, natural rubber and polyacetal was higher (21.9, 15.2, 3.0 and 2.1 times, respectively) than that on the filter paper. The amount of formaldehyde recovered from a breathing circuit, anaesthesia circuit, oxygen tubing, airway tube and tweezers was 260, 240, 594, 56 and 0 microg, respectively, following LTSF sterilization. Our results emphasize the need to verify the main material composing the medical equipment before LTSF sterilization, as the amount of formaldehyde retrieved following sterilization varies according to the material used for construction.     

医院消毒供应中心信息管理系统的运用

消毒供应中心作为清洗消毒、灭菌物品的生产物流中心,其主要任务是向手术室、临床科室及其他辅助科室提供无菌物品、一次性物品。信息系统的建立,保证了供应的无菌物品的质量,极大提高了工作质量和工作效率,并提高了消毒供应中心的服务水平和管理水平。     

二级医院区域化消毒供应中心医院感染管理的实践

目的:探讨二级医院区域化消毒供应中心对基层医疗机构实行集中供应,在实践过程中控制医院感染的措施?方法:通过合理的布局和设备资源管理,严格实施清洗质量和灭菌效果监测,通过增加信息追溯系统?加强科室质控等方法,提升无菌物品供应质量,加强医院感染管理?结果:加强医院感染管理后,区域化消毒供应中心的消毒无菌物品和可重复使用器械等灭菌合格率达99%,强化了专业规范执行?结论:加强区域化消毒供应中心实践过程中的感染环节控制,对提高物品灭菌质量?控制医院感染十分重要?     

过氧化氢等离子低温灭菌器在消毒供应中心的应用

目的：探讨过氧化氢等离子低温灭菌器在消毒供应中心的应用。方法：在消毒供应中心随机选取80个灭菌包,平均分为两组,每组40个灭菌包,标记为A组、B组。A组40个灭菌包给予过氧化氢等离子低温灭菌器消毒,B组40个灭菌包给予传统低温灭菌器处理,比较过氧化氢等离子低温灭菌器与传统低温灭菌器的灭菌效果。结果：A组采用过氧化氢等离子低温灭菌器灭菌效率为95.0%,B组采用环氧乙烷低温灭菌器灭菌效率为62.5%,两组比较差异有统计学意义（P〈0.05）。结论：过氧化氢低温等离子体灭菌器灭菌的物品可长期保持无菌,安全有效,多种精密、贵重且不耐高温的器械和物品顺利地应用于手术,对手术的安全性和预防院内感染起到保驾护航的作用。     

Forty years of control of healthcare-associated infections in Scandinavia

In the early 60s the first specialists for hospital hygiene came on the scene in Scandinavia too. From the outset this new discipline was based on cooperation between doctors and nurses, with the support of hospital-based microbiology laboratories and of sterilization departments. Teaching programs were soon devised, with training being underpinned by manuals featuring working instructions. Automated washing facilities for bedpans, etc. or washing machines for medical instruments became widespread practice very quickly; these initially used hot water, and later steam, for disinfection. For many years now, this equipment is found not only in hospitals but in virtually all healthcare establishments too. This has considerably helped to reduce chemical disinfection of medical instruments. As regards disinfection of heat-sensitive instruments the Scandinavian countries adopted different approaches: Finland gave preference to ethylene oxide sterilization, while Sweden opted for lower temperatures and for formaldehyde (low-temperature, steam formaldehyde (LTSF) sterilization), a technique imported from England and further developed in Sweden. During the 70s there were several cases of hepatitis B infections contracted in hospitals, particularly in dialysis units and by hospital personnel. The requirement that gloves be worn when carrying out working procedures has resulted in a major decrease in the infection rate and has helped to prevent HIV (AIDS) infections. However, to date it has not been possible to offset the risk of bloodborne infection against latex intolerance. Infection statistics were introduced in the 80s and since the late 90s we, too, are waging battle (later than other countries) against resistant bacteria (MRSA, VRE, multi-resistant Gram-negative bacteria). For some years now we no longer use the term “hospital hygiene” either, using instead “infection in healthcare settings” in view of the extended fields of application. Whether our strategy has proved successful for prevention of infection? Who could give a clear answer to such a question? Cost pressures in the healthcare sector will have a negative effect on the infection rate despite the fact that the progress made by science should really bring about a reduction in this rate. This conjures up a situation analogous to that of a downward escalator that one is trying to ascend: it is as if one were not moving, not making any progress.     

四川省乡镇卫生院消毒技术应用效果评价

目的了解四川省乡镇卫生院消毒工作现状,探索解决基层医疗机构消毒技术的有效应用方法。方法采用现况调查与实验室检测等评价手段。结果共调查15所乡镇卫生院,46.67%消毒供应室存在污染区、清洁区、无菌区三区划分不清或人流物流交叉;33.33%灭菌物品管理混乱;消毒灭菌设备配置基本齐全的占53.3%;合理使用消毒剂占66.7%;33.33%定期开展消毒灭菌效果的自我监测;86.67%未修建专用污水消毒处理站(池),污水粪便也未经消毒处理直接排放。调查医务人员的消毒技术应用相关知识问卷调查平均正确率为68.67%。对其中9所乡镇卫生院进行消毒效果监测,监测合格率56.77%。结论四川省乡镇卫生院消毒设备及消毒手段单一;医院污水普遍缺乏有效处理;消毒供应室建筑布局不合理,灭菌物品管理较混乱;普遍缺乏消毒效果自我监测;医护人员消毒技术应用相关知识知晓率不高;消毒效果监测合格率较低。     

低温等离子体灭菌的研究进展

相对于传统的灭菌方法（加热灭菌、化学药剂灭菌、紫外线灭菌等）来讲,利用等离子体灭菌有许多优点,尤其表现在对高温敏感材料所进行的低温等离子体灭菌中。笔者重点介绍了等离子体灭菌的特点、适用范围,等离子体灭菌的机制,综述了国内外对等离子体灭菌的研究现状,其中包括液相灭菌、表面灭菌和气相灭菌,介绍了影响等离子体灭菌效果的因素,并提出了采用等离子体灭菌中存在的问题及有待于进行研究的方面。     

The use of sterile and low microbial diets in ultraisolation environments

The evidence for the use of sterile and low microbial diets in ultraisolation environments is reviewed. Studies have suggested that sterile food is not required for gut sterilization when oral nonabsorbable antibiotics are used, but if a low microbial food contains an antibiotic-resistant organism, colonization can occur. There may be a beneficial effect on the incidence of infection by serving pathogen-free foods, either sterile or low microbial, to the immunosuppressed patient regardless of type of environment, yet the comparative effectiveness of sterile and low microbial diets in preventing introduction of new pathogens accessing the host via the mouth, oropharynx, and esophagus has not been systematically evaluated.