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目的 了解近几年淮北市医疗机构消毒工作质量状况 ,为预防和控制医源性感染提供依据。方法 依据《医院消毒卫生标准》(GB15 982 - 1995 )、《消毒技术规范》 ,于 1997～ 2 0 0 3年间对辖区医疗机构消毒工作质量进行调查。结果 监测总样本合格率由 1997年的 5 1.71%上升到 2 0 0 3年的 76 .99% (P <0 .0 1) ,其中市、厂矿、个体 (村 )诊所三级医疗机构合格率分别为 6 1.0 7%～ 87.78% (P <0 .0 1)、5 0 .30 %～ 76 .72 %(P <0 .0 1)、32 .5 3%～ 5 4 .19% (P <0 .0 1)。不同监测内容中以一次性使用医疗用品、使用中消毒液、灭菌医疗用品、压力蒸汽灭菌器消毒灭菌效果合格率较高 ,分别为 89.4 7%～ 10 0 .0 0 %、6 8.16 %～ 86 .6 7%、71.71%～ 86 .2 5 %、71.4 3%～ 82 .19% ;空气合格率最低 ,为 12 .6 9%～ 6 0 .4 7%。结论 市级医院有较完善的组织制度和自我监测系统 ,消毒方法合理、规范 ;而基层医疗机构 ,尤其是个体诊所、村卫生室消毒意识淡薄 ,消毒技术、方法更新较慢 ,消毒资金投入少 ,又缺乏有效的监督管理 ,是目前医院消毒管理工作的薄弱环节。
Objective To understand the quality of disinfection work in medical institutions in Huaibei in recent years and provide basis for preventing and controlling iatrogenic infection. Methods According to “Hospital Sanitation Standard” (GB15982 - 1995) and “Disinfection Technical Standard”, the quality of disinfection work in medical institutions in the area was investigated from 1997 to 2003. Results The total qualified rate of monitoring samples increased from 5 1.71% in 1997 to 76.99% (P <0. 01) in 2003, of which the qualified rate of tertiary medical institutions in cities, factories and mines and individual (village) clinics (P <0.01), 50.3% ~ 76.72% (P <0.01), 32.53% ~ 54.19% (P <0 .0 1). Among the different monitoring contents, the qualified rate of disinfection and sterilization with one-time use of medical supplies, disinfectant used, sterilization medical supplies and pressure steam sterilizer was higher, which were respectively 89.4 7% ~ 100.0% and 6 8.16 % ~ 86.67%, 71.71% ~ 86.25%, 71.4% ~ 82.19%; the lowest pass rate of air was 12.69% ~ 60.47%. Conclusions Municipal hospitals have better organizational system and self-monitoring system, and the disinfection methods are reasonable and standard. However, the awareness of disinfection in primary medical institutions, especially in individual clinics and village clinics is weak. The disinfection techniques and methods are updated more slowly and less disinfection funds are invested , And the lack of effective supervision and management is the weak link in the current hospital disinfection management.