2003—2008年某市医疗机构消毒灭菌工作质量评价

目的 监测并评价2003--2008年株洲市不同级别医疗机构消毒灭菌工作质量及变化趋势，促进该市医疗机构的感染控制工作。方法每年度对该市4级医疗机构（三级医院、二级医院、一级医院、个体诊所）分层抽样，对抽样单位的空气、物体表面、使用中消毒液、医院污水、无菌医疗器械5类样品分类随机采集。采用基于熵权的TOPSIS法对一级、二级医院消毒灭菌质量进行综合评价并分组排序。结果2003--2008年该市医疗机构消毒灭菌总合格率为91．79％，并逐年上升（X^2：66．45，P=0．00）；不同级别医疗机构的消毒灭菌总合格率存在差异（X^2=60．14，P=0．00），以个体诊所较低；使用中消毒液、输注器材、压力蒸汽灭菌器的合格率均〉90．00％。对评价对象排序分为中下、中、中上、上4个等级，一级与二级医院各等级均有分布，但均只有一家医院为上等，除此外随等级提高，二级医院构成比增大，而一级医院减少。结论该市医疗机构消毒灭菌质量逐年提高，但仍应加强对基层医疗机构特别是个体诊所的消毒灭菌技术指导。

Disinfection and sterilization quality in medical institutions in a city between 2003—2008

Objective To monitor and evaluate disinfection and sterilization quality in medical institutions in different levels of hospitals in Zhuzhou city between 2003--2008, so as to improve infection control management. Methods On-the-spot sampling and laboratory examination methods were used to carry out survey of the medical institutions, samples included air, surface of objects, in-use disinfectants, hospital contaminated water, sterile medical instruments. The comprehensive qualities of the hospitals of class Ⅰ and Ⅱ were evaluated by TOPSIS based on coefficient of entropy. Results The total qualified rate of disinfection and sterilization in medical institutions in the city between 2003--2008 was 91.79%, which rose year by year （X^2 = 66. 45, P = 0. 00） ; There was significant difference in the total qualified rate of disinfection and sterilization between different levels of hospitals（X^2 = 60. 14, P = 0. 00）, the lowest rate was in individual clinics; The qualified rate of in-use disinfectant, transfusion material, auto- claves were all 〉90. 00%. There were 4 levels in the order of the evaluated objects, the constituent ratio in 4 levels was different. Conclusion The disinfection and sterilization quality in the medical institutions in the city improved year by year, but some technical advices should be given, especially for individual medical institutions.