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.
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 study the disinfection effect of hand disinfectants containing alcohol after heating, and the comfortable feeling of using warm disinfectants among the medical staff in operation rooms. Methods Between November 2016 and January 2017, we analyzed the disinfection effect of two alcohol-containing hand disinfectants after heating in operation rooms through on-the-spot disinfection and inspection. Questionnaire was used to investigate the comfortable feeling of using warm hand disinfectants. Results After standing for 7 days at a temperature of 37℃, the major content of the two disinfectants decreased by less than 10%. Three minutes of disinfection by using the two kinds of disinfectants had an average natural-bacteria killing logarithm higher than 1.00, and they both had a qualified disinfection effect. Moreover, 96.7% of the medical personnel believed that warm disinfection products were more comfortable. Conclusion After heating, the two kinds of alcohol-containing hand disinfectants are effective in hand disinfection and more comfortable to use, which can improve hand hygiene compliance in surgical staff.
In order to promote the implementation of the three standards of central sterile supply department (CSSD), new standards for cleaning and disinfection/sterilization of flexible endoscope, dental instruments, and environmental surface in healthcare, this article elaborates about central management of CSSD; management of loaners and implants; technique of autoclave sterilization, ethylene oxide sterilization, and hydrogen peroxide sterilization; high level disinfection or sterilization of flexible endoscope; disinfection and sterilization of dental instruments; daily and enhanced cleaning and disinfection of environmental surface in healthcare facilities. This could help clinical healthcare workers to implement these new standards, effectively prevent nosocomical infection, and guarantee the personal safety of patients.
ObjectiveTo compare the disinfection effect of peracetic acid versus glutaraldehyde in disinfection of flexible endoscope, and provide suggestions for choosing endoscopic disinfectant.MethodsWe searched literatures in PubMed, Embase, Cochrane Central Library, China National Knowledge Infrastructure, Wanfang database and VIP database, with the retrieval time from the establishment of each database to July 2017, screening and comparing the disinfection qualification rate of peroxyacetic acid versus glutaraldehyde in immersion disinfection of flexible endoscope. The number of flexible endoscopies after disinfection was the main effect index, and a fixed effect model analysis was performed.ResultsSix comparative studies were enrolled in this Meta-analysis, with a total of 786 flexible endoscopes. The result of Meta-analysis showed that the qualification rate of disinfection of peracetic acid was higher than that of glutaraldehyde with the same disinfection time [relative risk=1.09, 95% confidence interval (1.06, 1.13), P<0.000 01].ConclusionThe disinfection effect of peroxyacetic acid immersion method is better than that of glutaraldehyde.
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.
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.