ObjectiveTo investigate on preoperative hand-washing for analyzing the underlying problems, in purpose of preventing operation-related infection via strengthening the standardization of surgical hand-washing and hand-disinfection.
MethodsFrom July to September 2014, surveillance video of pre-operative hand-washing was studied and analyzed. We randomly selected 100 subjects, and assessment was performed based on the self-made surgical hand-washing and hand-disinfection protocol. Grading was done strictly. The passing score was 60 or higher; a score of 70-79 meant good; and a score of 80-100 indicated excellence.
ResultsIn the survey, 91 in the 100 subjects were qualified. Among the qualified subjects, there were 53% of excellence and 20% of good. The major problems included erroneous methods, step omissions, time lacking, pollution, wrong flushing method or dry-hand method, and insufficient washing time.
ConclusionBased on the survey, the administration department is advised to strengthen the regulatory supervision and education training based on standard surgical hand-washing and hand-disinfection criteria, especially training interns and new staff, in purpose of reducing the incidence of operation-related infection and improving hospitalization management qualities.
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.
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.
The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.
Objective To review the mechanism of cold atmospheric plasma (CAP) in the treatment of chronic skin ulcer, providing a new idea for ulcer therapy. Methods The literature about CAP in the treatment of chronic skin ulcers in recent years was extensively screened and reviewed. The treatment principle, active ingredients, and mechanism were summarized. Results CAP is partial ionized gas discharged by plasma generator in high frequency under high voltage. It contains electrons, positive and negative ions, reactive oxygen species, reactive nitrogen species, and ultraviolet rays. In vitro and animal experiments show that the active ingredients contained in CAP can inactive microorganisms, against biofilm, regulate immune-mediated inflammatory, promoting blood flow, stimulate tissue regeneration and epithelial formation in the course of wounds healing. Conclusion CAP play a role in different stages of chronic skin ulcer healing, with good effectiveness and safety, and broad clinical application prospects. But more studies are needed to explore the indications and dosages of CAP therapy.
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.
Objective
To compare germicidal effect of three disinfectants acting on frequently-touched surfaces in Intensive Care Unit (ICU) at different time points after disinfection so as to put forward the reasonable disinfection method and interval before the next disinfection.
Methods
We wiped the four frequently-touched surfaces in ICU with disinfectant containing acidic electrolyzed oxidizing water (EOW) from the building system of hospital, disinfectant wipes, and 500 mg/L chlorine respectively. The culture samples were collected from the surfaces before wiping, and 10 minutes, 30 minutes, 1 hour, 2 hours and 4 hours after wiping respectively. The bacterial clearance rate and the qualified rate of bacterial colony counts on the surfaces were compared among the three different disinfectants at different time points after disinfection.
Results
The bacterial killing rate of three methods for disinfection of object surfaces decreased with the passing of time. The bacterial killing rate of EOW from the building system of hospital was lower than that of the other two methods at all five time points after disinfection (P< 0.05). The bacterial killing rate at hour four after disinfection using chlorine-containing disinfectant and disinfectant wipes was higher than 90.0%. The qualified rate of bacterial colony counts on the surfaces at 10 and 30 minutes after disinfection among the three groups was not significantly different (P>0.05). The qualified rate of bacterial colony counts on the surfaces disinfected by EOW from the building system of hospital was lower than that in the other two groups at the other three time points (P<0.05), and it was totally unqualified at hour four after disinfection.
Conclusions
The germicidal effect of EOW from the building system of hospital is inferior to chlorine disinfectant and disinfectant wipes. Moreover, the surface can be easily recontaminated after disinfection. It is suggested that EOW should be used in ICU every other hour. and the other two disinfection methods should be used every two hours.
ObjectiveTo explore a better hygienic hand disinfection method to improve hand hygiene compliance, by evaluating and comparing the disinfection effects and the economic and time cost expenditures of three different types of hygienic hand disinfection methods.MethodsFrom March to July 2016, patients undergoing blood collection were randomly divided into three groups, and five blood collection nurses used one different type of hygienic hand disinfection method in each group when performing blood collection operation on the patients, including: direct hygienic hand disinfection (group A); wearing gloves, and doing hygienic hand disinfection without putting off gloves (group B); and changing gloves for each patient, and doing hygienic hand disinfection after putting off gloves (group C). Two hundred and ten specimens of the nurses’ hands or gloves surface after hand hygiene were collected from each group for the comparison of hygienic hand disinfection effect, and the differences in economic cost and time cost were compared.ResultsThe passing rates of the disinfection effect of the three different types of sanitary hand disinfection methods were all 100%. The economic cost of group A, B, and C was 9.66, 21.98, and 185.66 yuan, respectively, and the time cost of group A, B, and C was 5 250, 6 860, and 14 700 seconds, respectively. No sharp injury occurred.ConclusionSince direct hygienic hand disinfection does not implement the standard prevention principle, the method of wearing gloves and doing hygienic hand disinfection without putting off gloves is the best in the three different hygienic hand disinfection methods, which not only has the same disinfection effect, but also can save economic cost and time cost, which may improve the medical personnel’s hand hygiene compliance.
Objective To investigate the current situation of sterile supply management in primary healthcare institutions in Pudong New Area of Shanghai, analyze the existing problems, and provide a scientific basis for formulating and implementing follow-up improvement measures. Methods The primary healthcare institutions in Pudong New Area were surveyed from June to July 2024. The contents of the questionnaire included the nature of the institution, sterile supply mode, personnel, facilities and equipment configuration, quality monitoring and sterile supply management. Results A total of 71 valid questionnaires were collected, including 25 public institutions and 46 non-public institutions; 29.6% used the sterile supply mode outside the hospital, and 70.4% used the sterile supply mode inside the hospital. In primary healthcare institutions with in-hospital sterile supply mode, part-time staff accounted for 46.1%, staff under the age of 40 accounted for 69.5%, professional qualification holding rate was high (94.3%), and their education was mainly junior college (60.3%). Healthcare institutions were all equipped with steam sterilizers, and the configuration rate of cleaning and disinfection machines (92.0%) were high, but the configuration rate of water treatment and drying equipment (70.0%), information traceability system (48.0%) and low-temperature sterilizers (10.0%) were low. Disinfection and sterilization quality monitoring had been widely carried out (96.0%), but the cleaning quality monitoring rate was low (88.0%). The implementation rate of multiple requirements exceeded 96%, but the utilization rate of information traceability system was low (36.0%). The proportion of primary healthcare institutions with out-of-hospital sterile supply mode that conducted quality monitoring, requested quality reports and carried out on-site inspection on the goods provided by the service provider were less than 80%. The proportion of healthcare institutions with full-time personnel, contaminated equipment collection and temporary storage room and sterile goods handover and distribution room did not exceed 80%, and the utilization rate of information traceability system was also less than 50%. Conclusions There are still deficiencies in personnel allocation, equipment and facilities, quality monitoring and system implementation of sterile supply management in primary healthcare institutions in Pudong New Area.
ObjectiveTo evaluate the efficiency of hydrogen peroxide vapor (HPV) in disinfecting multidrug-resistant organisms (MDROs).MethodsWe searched Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database for before-after studies or case-control studies or cohort studies evaluating efficiency of HPV and published from January 2010 to December 2020 (the time range was from January 2000 to December 2020 in the snowball searching). RevMan 5.4 and R 4.0.2 softwares were used for meta-analysis.ResultsA total of 9 studies were included, consisting of 8 before-after studies and 1 cohort study. Six studies evaluated positive rate of environmental samplings, meta-analysis revealed that HPV combined with manual cleaning disinfected the environment efficiently [relative risk (RR)=0.03, 95% confidence interval (CI) (0.01, 0.08), P< 0.000 01] and HPV was more efficient than manual cleaning [RR=0.04, 95%CI (0.02, 0.10), P< 0.000 01]. Three studies evaluated the hospital-acquired MDROs colonization/infection rates, and the results of the 3 studies were consistent, revealing that HPV could reduce hospital-acquired MDROs colonization/infection rates.ConclusionHPV is efficient in reducing MDROs contaminated surfaces and hospital-acquired infection rate.
