The quality of disinfectant, disinfection devices and disposable medical devices is closely related to the patients' safety. Hospital infection management department must carry out the audit responsibilities for qualification documents of disinfectant, disinfection devices and disposable medical devices, to guarantee legality, safety and effectiveness of products used in hospital. This paper mainly introduces the implementation of qualification documents audit in West China Hospital, Sichuan University, including system construction, process reengineering, documents audit scope and key points, and document management.
This article reviews the current status and characteristics of disinfection technologies in the modern era, including physical, chemical, and integrated disinfection methods. It focuses on the latest research advances, advantages, and limitations of novel disinfection technologies, such as plasma-activated systems, photocatalytic oxidation, and synergistic chemical-physical or bio-chemical composite techniques. The study reveals that single disinfection methods often fail to meet the demands of complex environments, while integrated technologies demonstrate significant advantages in improving disinfection efficiency and environmental compatibility. However, challenges remain in terms of cost, standardization, and long-term safety. Future development of disinfection technologies should prioritize intelligent multi-technology integration, green and sustainable practices, targeted disinfection, personalized applications, and international standardization.
ObjectiveTo evaluate the high-level disinfection effect of flexible endoscopes in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu, explore the key links of flexible endoscope cleaning and disinfection, and provide theoretical guarantee and technical support for the next step of the endoscope center work.MethodsWe sampled and monitored the lumens, water and air injection ports and biopsy ports of 19 flexible endoscopes after high-level disinfection in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu. A total of 307 specimens were collected from 108 flexible endoscopes. We compared the disinfection effects of different flexible endoscopes and different sampling sites, and compared the microbial detection status of different flexible endoscopes.ResultsThe qualified rates of disinfection of gastroscopes, colonoscope and duodenoscopy were 79.22%, 86.21% and 100.00%, respectively, and the difference was not statistically significant (P=0.721). The qualified rates of disinfection of the endoscopic lumen, water and air injection port and biopsy port were 87.04%, 93.00% and 94.95%, respectively, and the difference was not statistically significant (χ2=4.585, P=0.101). The qualified rates of the lumen, water and air injection port and biopsy port of gastroscope, colonoscope and duodenoscope were 84.42%, 93.10%, 100.00%, 92.96%, 92.59%, 100.00%, 94.29%, 96.30%, 100.00%, respectively. There was no statistically significant difference in the disinfection effect of various parts of different flexible endoscopes (P>0.05). Bacteriological identification showed that of the 28 specimens with excess bacteriological standards, 16 gram-positive bacteria (57.1%), and 12 gram-negative bacteria (42.9%) were found.ConclusionThe cleaning and disinfection effect of flexible endoscopes has certain defect. Endoscope should be treated in strict accordance with the technical specifications for cleaning and disinfection of the flexible endoscope to further improve the disinfection effect of the flexible endoscope.
Endoscopic retrograde cholangiopancreatography is one of the main methods for the diagnosis and treatment of biliary tract and pancreatic diseases. Compared with other digestive endoscopes, duodenoscopy has a special structure. Since the outbreaks of nosocomial infections caused by the transmission of multidrug-resistant organism through duodenoscopy in 2010, the reprocessing and design of digestive endoscopes represented by duodenoscopy have faced new challenges. This article reviews the international advances in duodenoscopy reprocessing in the past 10 years including the structural characteristics of duodenoscope, related infection outbreak cases, outbreak control measures, and the use of disposable duodenoscopy, so as to provide guidance and reference for the duodenoscopy reprocessing and related nosocomial infections prevention and control work in China.
ObjectiveTo evaluate the effect of disinfection measures in the isolation ward of ICU in severe patients infected with the Omilkerong variant of the new coronavirus, and to optimize the infection control measures. MethodsReferring to the patient's epidemiological and nucleic acid sample data, nucleic acid sampling was performed on the isolated ward environment by surface sampling method, and the nucleic acid Ct value of virus was detected by parallel fluorescence PCR method. The aerosol was collected by a wet-wall cyclone sampler, and the nucleic acid Ct value of the virus was detected by parallel fluorescence PCR. ResultsBefore daily disinfection, SARS-CoV-2 positive samples were found on the surface of the patient's ward and air sampling after the tracheoscopic tracheostomy. No positive samples of SARS-CoV-2 were found on the surface of articles and air in the patient's ward after daily disinfection. ConclusionThe daily disinfection measures of the hospital can achieve the effect of SARS-CoV-2 disinfection, which suggests that the surface of the articles in the ward after invasive operations such as tracheostomy and tracheoscopy, especially within 2 meters of the tracheostomy and the tracheostomy, is the key part of disinfection, which needs to be paid attention to.
Objective To evaluate the disinfection efficacy of alcohol-based hand disinfectants for medical glove surface in continuous operation, and explore approaches of improving hand hygiene compliance. Methods Between March and July 2015, and between March and July 2016, all the nurses (n=5) in Blood Collection Room of Outpatient Department with many patients and frequent sterile operation needed were included in this study. Nurses wearing gloves for hand hygiene and disinfection between March and July 2016 were regarded as the observation group, and those who used alcohol-based disinfectants for routine hand hygiene without gloves between March and July 2015 were designated into the control group. The hand hygiene compliance was compared between the two groups. From March to July 2016, alcohol-based hand disinfectants were used for disinfection on the glove surface during continuous blood sampling by nurses with gloves on their hands. Fifty samples were collected respectively after the gloves were used for 1, 2, 5, 10, and 15 continuous times for blood sampling. Then, the samples were sent to the bacteriology room for culture. Results All of the 250 samples were qualified, and the bacterial colonies on the surface of gloves were equal to 10 cfu/mL2 or lower. NoStaphylococcus aureus,Escherichiacoli or other pathogens were detected on the glove surface. However, after the gloves were continuously used for 15 times, the gloves of two nurses could not meet the research criteria again because of significant sweating. Conclusions In the process of continuous blood sampling, it is effective to use alcohol-based hand disinfectants to disinfect the surface of medical gloves, which can promote hand hygiene compliance to a certain extent. However, there is a certain limit on the times of usage for medical gloves.
ObjectiveTo systematically review the safety of hand disinfectants. MethodsPubMed, EMbase, The Cochrane Library, INAHTA, WanFang Data, CNKI and VIP databases were electronically searched to collect studies on the safety of hand disinfectants from inception to February 1st, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, a systematic review was conducted. ResultsA total of 50 studies were included. The reported adverse events were eye and nasal mucosal irritation, hand adverse events with skin itching, rash, erythema, edema and so on. A total of 29 brands such as 3M Avagard and 26 ingredients such as ethanol were reported to be related to the above adverse events. Hand disinfectants containing glycerin, silicone oil, vitamin B, plant extracts and other emollients could reduce the incidence of adverse events. ConclusionCurrent evidence shows that hand disinfectants containing emollients and free from ethanol, chlorhexidine and other ingredients are related to fewer adverse events. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the problems in the use of quick-drying hand disinfectants and formulate intervention measures to improve the hand hygiene compliance of nursing staff.MethodsFrom February 2014 to June 2016, the hand hygiene compliance of nursing staff was continuously observed according to the hand hygiene observation table recommended by the World Health Organization. The questionnaire on the use of quick-drying hand disinfectants, which passed the reliability and validity test, was used to find out the reasons leading to the low compliance rate of hand hygiene among nurses, and pertinent interventions were formulated. From November 2016 to December 2017, intervention measures were gradually implemented throughout the hospital, and the hand hygiene compliance of nursing staff was continuously observed again. Then we compared the compliance rate of hand hygiene and the compliance rate of hygienic hand disinfection among nurses in the second quarter of 2016 (before intervention) with those in the last quarter of 2017 (after intervention).ResultsThe compliance rates of hand hygiene and hygienic hand disinfection among nurses before intervention were 62.15% and 49.77%, respectively, and those after intervention were 91.64% and 90.80%, respectively. The differences were statistically significant (P<0.05).ConclusionThe factors affecting the hand hygiene compliance of nursing staff are identified through questionnaires and targeted intervention measures have effectively improved the hand hygiene compliance rate of nursing staff.
With the development of medical diagnosis and treatment technology, ultrasound examination has been widely used in clinical practice, but it also faces certain safety hazards. If the ultrasound probe is not effectively disinfected after use, it may be contaminated by pathogenic bacteria transmitted from blood, mucous membranes, genital or rectal secretions, thus becoming a carrier for the transmission of pathogenic bacteria among patients. In addition, the frequent use of ultrasound probe and coupling agent is also an important factor affecting the occurrence of hospital infections. Multiple studies at home and abroad have shown that incomplete cleaning and disinfection of medical ultrasound probe can lead to hospital infection incidents, thereby affecting patient safety and medical quality. Exploring effective disinfection methods and disinfection effects of ultrasound probe is of great significance for hospital infection prevention and control. Therefore, this article provides a review of research related to disinfection of medical ultrasound probe.
ObjectiveTo evaluate the evidence of the experience with medical sewage treatment procedures in medical institutions in China. MethodsDatabases including CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were electronically searched to collect studies on the medical sewage treatment process, flow, and specifications in medical institutions in China. We used the quality evaluation system to classify and grade the experiences based on the principles and methods of evidence-based science and performed a descriptive analysis. ResultsAfter the SARS pandemic in 2003, China systematically established and standardized the technical criteria of medical sewage treatment and discharge. Moreover, a prevention system for the epidemic using medical sewage was constructed, which guaranteed that the quality of medical sewage treatment and discharge would meet the criteria and protect the citizens, and the technical specifications of medical sewage treatment would progress and increase strictly. At present, medical sewage treatment in medical institutions in China was based on mechanical and biological methods, and disinfection was mainly performed using chlorine and its compounds, ozone, and ultraviolet light. ConclusionThe COVID-19 pandemic requires a higher quality of medical sewage treatment and discharge criteria for medical institutions in China. To meet these criteria, all medical institutions in China should check, replace, and update their old facilities; strengthen personnel training and effectively ensure the quality of medical sewage treatment.