Objective: To investigate the situation regarding the cleaning and sterilization of endonasal endoscopes in department of otolaryngology in Hunan Province, and to provide strategy for improving the level of sterilization and management of endonasal endoscopes.
Methods: A total of 100 medical institutions were investigated by spot assessment, check and sampling. Data was analyzed by multivariate analysis.
Results: The qualified rate of rules and regulations for endoscopy was 28.8% in the second-class hospitals and 45% in the top-class hospitals. The qualified rate of environment for endoscopy cleaning and sterilization was 36.3% in the second-class hospitals and 85% in the top-class hospitals. The main problems include lack of independent disinfection room, the space not large enough, and/or lack of ventilation system. The qualified rate of bacterial detection for post-sterilized endoscopes and biopsy forceps was 93.8% in the second-class hospitals and 95.0% in the top-class hospitals, and the main pathogenic bacteria was gram-positive cocci and gram-negative bacilli. The multivariate analysis showed that the influencial factors for endoscope cleaning and disinfection are as follows: staffs responsible for the cleaning and sterilization of otolaryngology endoscopes, the standard for cleaning and disinfection process, and the frequency of endoscope use.
Conclusion: The present situation of cleaning and sterilization for otolaryngology endoscopes is better in the top-class hospitals than that in the second-class hospitals. The sterilization and management of otolaryngology endoscopy are needed to be improved, and the staff training is needed, especially in the primary hospitals.
目的：了解湖南省耳鼻喉科内窥镜清洗和消毒的现状，为完善和提高内镜消毒管理提供对策。方法：通过现场评估、现场调查和现场采样对湖南省100家医疗机构耳鼻喉科内窥镜清洗消毒现状进行调查研究，并进行多因素分析。 结果：在制定耳鼻喉科内镜室各项相关规章制度方面，二级医院合格率为28.8%，三级医院合格率为45.0%。在内镜清洗消毒工作环境方面，二级医院达标率为36.3%，三级医院达标率为85.0%，存在的主要问题是无独立的消毒室、消毒室面积不达标、清洗消毒室没有排风系统。对消毒后的内镜和活检钳进行微生物学检测，二级医院达标率为93.8%，三级医院的达标率为95.0%，G+球菌和G–杆菌为主要检出的致病菌。多因素分析结果显示内镜清洗消毒人员的从业资质、规范的清洗消毒流程和内镜每天使用次数是影响内镜消毒质量的主要因素。结论：湖南省耳鼻喉科内镜清洗消毒的状况是三级医院比二级医院规范，但在内镜管理与清洗消毒操作方面均需进一步完善，特别需加强基层医院专科人员的培训。.