县级医疗机构胃镜消毒效果的影响因素

目的掌握某省县级医疗机构胃镜消毒效果的影响因素。方法选取9所县级二级综合医疗机构,采用问卷调查与现场询问的方法,填写调查问卷,实地观察清洗消毒操作,并针对可能的风险因素采取干预措施。比较干预前后胃镜清洗消毒效果。结果干预前后各采集胃镜样本45份,干预前胃镜清洗消毒合格率为11.11%,干预后为100%,差异有统计学意义(χ~2=72.00,P0.001)。多因素logistic回归分析表明,是否合理配置清洗消毒设备(OR=23.813)、清洗消毒流程是否符合规范要求(OR=13.223)、是否熟练掌握胃镜相关知识与技能(OR=9.265)、是否合理配置清洗消毒工具(OR=7.745)、清洗剂与消毒剂是否正确使用(OR=0.076)5项因素为影响胃镜消毒效果的独立影响因素。结论县级医疗机构胃镜清洗消毒合格率低,应合理配置清洗消毒设备和工具,加强培训,规范清洗消毒流程和清洗剂消毒剂的使用,提高工作人员的相关知识水平。

Influencing factors for disinfection efficacy of gastroscope in county-level medical institutions

Objective To understand the influencing factors for disinfection efficacy of gastroscope in county-level medical institutions of a province. Methods Nine secondary county-level comprehensive medical institutions were selected, questionnaire survey and on-site inquiry were adopted to fill in the questionnaire, on-site observation on cleaning and disinfection was conducted, intervention measures were taken against possible risk factors. Cleaning and disinfection efficacy of gastroscope before and after intervention was compared. Results 45 specimens of gastroscope were taken before and after intervention, qualified rates of gastroscope cleaning and disinfection before and after intervention were 11.11% and 100% respectively, difference was statistically significant (χ²=72.00,P<0.001). Multivariate logistic regression analysis showed that whether installed rational cleaning and disinfection equipment (OR=23.813), whether the cleaning and disinfection process met the specifications (OR=13.223), whether knowledge and skills of gastrocope were mastered proficiently (OR=9.265), whether cleaning and disinfection tools were equipped rationally (OR=7.745), whether detergent and disinfectant were used correctly (OR=0.076) were independent influencing factors for gastroscope disinfection efficacy. Conclusion The qualified rate of gastroscope cleaning and disinfection in county-level medical institutions is low, it is necessary to rationally equip cleaning and disinfection equipment and tools, strengthen training, standardize the cleaning and disinfection process as well as the use of detergent and disinfectant, and improve the relevant knowledge level of staff.