目的 了解国内医院消毒供应中心对精密手术器械的管理现状,为制订精密手术器械的标准处理流程提供参考.方法 采用便利抽样法,选择全国30个省、自治区、直辖市共616所不同等级医院的消毒供应中心进行问卷调查.结果 368所(59.74％)设有精密手术器械清洗专岗,426所(69.16％)设有清洗质量检查专岗,382所(62.01％)设有装配包装专岗;347所(56.33％)为厂家培训,299所(48.53％)为自学厂家说明书,420所(68.18％)采取科室内部培训;116所(18.83％)为手工清洗,413所(67.05％)为手工加超声清洗,87所(14.12％)为机械清洗;518所(84.10％)采用高压蒸汽灭菌,398所(64.61％)采用过氧化氢低温等离子灭菌,222所(36.04％)采用环氧乙烷灭菌.结论 精密手术器械的专岗人员设置不足;精密手术器械管理人员的培训有待加强;精密手术器械的清洗方式以手工加超声清洗为主,灭菌方式以压力蒸汽灭菌法为主.建议针对不同的精密器械,制订统一的器械清洗和灭菌规范.%Objective To investigate the status of treating precision surgical instruments in disinfection supply center,and to provide fundamental data for standardizing treatment procedure.Methods We chose 616 disinfection supply centers in hospitals from 30 provinces,autonomous regions,and municipalities,and sent investigation forms (digital) on treatment of precision surgical instruments,asking head nurses of disinfection supply centers to fill the forms according to real situation.Results Among 616 hospitals receiving treatment of precision surgical instruments,59.74％ had specific cleaning post,69.16％ had specific post for cleaning quality inspection,62.01％ had specific post for assembly and packaging,only 56.33％ had training from manufacturers,48.53％ self-studied instructions provided by manufacturers;18.83％ performed manual cleaning,67.05％ performed manual cleaning followed by ultrasonic cleaning,only 14.12％ performed mechanical cleaning;for method of sterilization,84.10％ used high pressure steam sterilizer,64.61％ used hydrogen peroxide low-temperature plasma sterilization,36.04％ used ethylene oxide sterilization.Conclusion There was a lack of specific posts for precision surgical instruments,especially for cleaning;training for specific posts should be enhanced;cleaning methods were mainly manual and ultrasonic,high pressure steam sterilization was the main method for sterilization.Standardized regulations for cleaning and sterilization are recommended to be made according to different precision surgical instruments.
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