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.
Objectives To compare umbilical cord daily care protocol in the current clinical setting in which 75% alcohol sterile is used daily for the umbilical and surrounding skins with the WHO-recommended method (dry and clean). Methods A total of 283 full-term newborns were randomly divided into two groups: the trial group (n=181) receiving WHO “dry and clean” protocol that the umbilical cord was open to air (with losing clothes), cleaned by clear water instead of alcohol. The control group (n=102) used the traditional method that after the newborns’ bathing, the umbilical cord and surrounding skins were sterilized with 75% alcohol. The basic condition of the newborns, umbilical departure time and complications around the navel were assessed. And bacterial culture from the newborns’ skins was observed. Results There were no significant differences in departure time of the umbilical cord (7.64±3.29 day vs. 8.50±3.45 days t=1.82, Pgt;0.05), complications (6 patients with slight omphalitis in the trial group and 2 patients with slight omphalitis in the control group), and the skin flora culture between the two groups. The umbilical cord of the newborns dropped off safely. And no fever was found. Conclusion This study does not support that 75% alcohol can prevent the umbilical cord from being infected. Keeping the umbilical cord and surrounding skins dry is important for infection control.
ObjectiveTo investigate the impact of disposable tissue on blood pressure measurement, in order to prevent the sphygmomanometer cuff to be polluted. MethodsA total of 120 subjects including 60 patients with hypertension and 60 normal blood pressure subjects, treated between July 1 and July 31, 2012, were divided equally into two groups. Each group had 30 normal pressure and 30 high pressure subjects. Subjects in group A took blood pressure measurement without disposable tissue first, 1 to 2 minutes before another measurement with disposable tissue. Group B subjects took the measurement with disposable tissue at first, and then without it. We analyzed the influence of the use of disposable tissue and the sequence of tissue usage on the measurement result. ResultsNo significant difference was found in the systolic and diastolic blood pressure between measuring with and without tissue (P> 0.05). Diastolic blood pressure was not significantly influenced by the order of tissue usage (P>0.05), while systolic pressure was significantly influenced (P<0.05). Between the subjects with and without hypertension, the differences of systolic blood pressure and diastolic blood pressure measured with bare arms and disposable tissues were not statistically significant (P>0.05). ConclusionUsing disposable tissue or not does not affect blood pressure measurements whether the patient suffers from hypertension, but the order of disposable tissue usage may affect systolic blood pressure in non-hypertensive patients.
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 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.
目的 分析多功能空气消毒机在普通内科病房的动态消毒效果，为病房空气质量的控制提供参考依据。 方法 2010年9月－2011年4月对普通内科病房在动态状态下进行细菌检测并使用多功能空气消毒机消毒，并就消毒前后的空气细菌菌落总数进行分析比较。 结果 在动态状态下，病房关门关窗并开启空调机时，使用多功能空气消毒机消毒前的空气细菌菌落总数显著高于消毒后，差异有统计学意义（P＜0.05）；病房在开门开窗时，使用多功能空气消毒机消毒前后的空气细菌菌落总数比较，差异无统计学意义（P＞0.05）。 结论 普通内科病房在关门关窗并开启空调机动态状态下，使用多功能空气消毒机可以降低空气细菌菌落总数，改善房间空气质量。
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.
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 understand the economic burden of disinfection supply to medical institutions in Yibin City, and explore the feasibility of establishing a regional centralized management model of disinfection supply center in Yibin City.MethodsFrom April to May 2018, 263 medical institutions in the eight counties and two districts of Yibin City were investigated by means of mobile phone application-designed questionnaire, to obtain the information of cost accounting and economic burden of disinfection supply.ResultsThere were 263 medical institutions involved in the survey, in which 61 (23.19%) had set up the central sterile supply department (CSSD), including 43 public hospitals and 18 private hospitals; 202 medical institutions were without CSSD, which were mainly secondary hospitals [195 (74.14%), including 120 public hospitals and 75 private hospitals]. The higher the hospital level was, the larger the average area of the CSSD was; the difference was statistically significant (χ2=40.009, P<0.001). The higher the hospital level was, the more full-time personnel were employed, and the difference was statistically significant (χ2=31.862, P<0.001), and the care staff were the majority (66.23%). The cost burden of CSSD was more than 1 million yuan in the tertiary hospitals, which was 100 000 yuan or above in 61.90% of the secondary hospitals, and was below 100 000 yuan in hospitals below secondary level. The higher the hospital level was, the higher the total cost burden became; the difference was statistically significant (χ2=37.995, P<0.001). ConclusionIn view of the heavy economic burden of CSSD in medical institutions and the unbalanced setting up of medical institutions below secondary level, the establishment of a regional CSSD centralized management model is a new direction, new trend, and new model for future development, which is conducive to improving the quality of disinfection and sterilization, reducing medical care costs, making rational use of health resources, effectively preventing hospital infections, and ensuring the medical safety.