综合性监测后评估反馈对洁净手术室运行维护效果影响的多中心研究

 目的 评价综合性监测后评估反馈对洁净手术室运行维护效果的影响。方法 以《医院洁净手术部建筑技术规范》为监测和判断标准，于2017年2—5月对云南省34所医院共81间洁净手术室进行基线综合性监测，将监测结果及评估后整改建议以纸质报告形式反馈给各医院，并于2017年11月—2018年3月再次进行综合性监测，将基线与评估反馈后监测结果进行比较。结果 二三级医院评估反馈后监测结果与基线相比，洁净手术室内微粒直径≥0.5 μm和≥5.0 μm两类尘埃粒子合格率、浮游菌合格率比较，差异均无统计学意义（均P>0.05）。评估反馈后截面风速、风速不均匀度β和风速盲区的监测合格率高于基线监测结果，差异均有统计学意义（均P<0.05）；温度、相对湿度、换气次数、静压差、噪声和照度评估反馈前后合格率比较，差异均无统计学意义（均P>0.05）。二级医院存在洁净手术室"维护人员不专业"整改阻碍因素的比率高于三级医院，差异有统计学意义（P=0.014）。结论 洁净手术室综合性监测后评估反馈可提高洁净手术室运行维护效果，应定期对洁净手术室进行综合性监测，同时配备专业的维护人员负责洁净手术室的正常运行与维护。

Multicenter study on effect of evaluation and feedback after comprehensive monitoring on the operation and maintenance of laminar airflow operating rooms

Objective To evaluate the effect of evaluation and feedback after comprehensive monitoring on the operation and maintenance of laminar airflow operating rooms. Methods Technical code for construction of hospital clean operating department was used as the monitoring and judgment standard, from February to May 2017, 81 laminar airflow operating rooms in 34 hospitals in Yunnan Province were conducted baseline comprehensive monitoring, monitoring results and rectification suggestions after evaluation were fed back to each hospital, comprehensive monitoring was carried out again from November 2017 to March 2018, the baseline monitoring results were compared with the monitoring results after evaluation and feedback. Results Compared with the baseline level, the monitoring results of dust particle with particle diameter ≥0.5 μm and ≥5.0 μm as well as planktonic bacteria in laminar airflow operating rooms in secondary and tertiary hospitals were not significantly different (both P>0.05). After evaluation and feedback, the qualified rates of monitoring on cross-section wind speed, non-uniformity of wind speed β and blind zone of wind speed were all higher than those of baseline monitoring results, differences were all statistically significant (all P<0.05); the qualified rates of temperature, relative humidity, air change times, static pressure difference, noise and illumination before and after evaluation and feedback were all not significantly different (all P>0.05). The proportion of obstacle to rectification of "unprofessional maintenance personnel" in laminar airflow operating rooms in secondary hospitals was higher than that in tertiary hospitals, difference was significant (P=0.014). Conclusion The evaluation and feedback after comprehensive monitoring on laminar airflow operating rooms can improve the effect of operation and maintenance of laminar airflow operating rooms, comprehensive monitoring on laminar airflow operating rooms should be carried out regularly, and professional maintenance personnel should be equipped to take charge of the normal operation and maintenance of laminar airflow operating rooms.