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Objective To understand the current situation of pressure steam sterilization in medical institutions in Xi'an city,and provide reference for the monitoring and quality control of pressure steam sterilization.Methods Central sterile supply departments(CSSDs) in medical institutions in Xi'an in 2012-2014 were investigated.Physical,chemical,and biological monitoring methods were used to evaluate the pressure steam sterilizers.Results A total of 135 medical institutions in Xi' an were monitored,including 40 tertiary medical institutions and 95 secondary and below medical institutions.A total of 540 specimens were collected,454 were qualified,overall qualified rate was 84.07 ％.Qualified rate of monitoring result of pressure steam sterilization of tertiary medical institutions was higher than secondary and below medical institutions(93.13 ％ vs 80.26 ％,x2 =13.91,P＜0.01).Qualified rates of chemical PCD and biological test pack of tertiary as well as secondary and below medical institutions were 100％ and ＞90％ respectively.The qualified rate of recoded temperature in secondary and below medical institutions was 88.42 ％,but actually measured temperature was 38.95 ％,which was significantly lower than 72.50 ％ of tertiary medical institutions(x2 =12.68,P＜0.01).The rates of the measured temperature＞ 134℃ of pressure steam sterilizer in each year were all low,but measured temperature＜132℃ was about 50.00 ％,difference between actually measured temperature and recorded temperature was-4℃-1 ℃,difference between-2.5 ℃-0.5℃ accounted for 80.00％,the main unqualified temperature was 130℃-131 ℃,accounting for 82.61 ％.Conclusion Efficacy of pressure steam sterilization is different in different levels of medical institutions in Xi'an,physical monitoring measures are not standardized,the supervision of physical parameters in key sectors should be strengthened to ensure the sterilization quality of medical institutions and reduce the occurrence of iatrogenic infection.
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Objective To analyze the causes for the biological monitoring abnormal results of the pressure steam sterilizer to eliminate non-standard operation and hidden risks during biological monitoring.Methods Totally 34 secondary or above medical institutions in Chongqing were selected randomly,and questionnaire survey was carried out over biological monitoring abnormal results and main influencing factors of the pressure steam sterilizer.Results Of the 126 abnormal results,there were 63 positive results (accounting for 50％) and the main influencing factors included expiration,aged seal ring,low-efficiency vacuum pump,nonstandard loading,bioindicator reproduction before sterilization,false positive result,polluted moist incubator and etc;There were 35 cases of results related to fast reader (accounting for 27.78％) and the main factors consisted of failure of reading light,improper input of bioindicator,dusts in the reading hole and etc;There were 18 cases of bioindicator discoloration before culture (accounting for 14.28％) and the main factor was reproduction occurred before the gemma was inactivated;There were l0 cases of nondiscoloring in case of positive control (accounting for 7.94％) and the main factors included non-crushed indicating mediostratum cultured in the incubator,insufficient shaking after crushing mediostratum and etc.Conclusion The main factors for abnormal biological monitoring of the sterilizer involve in equipment,personnel and material,and the quality control has to be executed from the three aspects.
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Objective:To study daily maintenance and quality control of high pressure steam sterilizer in the hospital to provide effective methods and suggestions for medical equipment maintenance.Methods: 6 high-pressure steam sterilizers were selected and divided into three groups according to the brands and the departments which use them, in order to compare the data, analyze equipment failure, improve the maintenance process and control the risks.Results:The equipment failure rate reduced lower than 21% through the improvement of maintenance. And the equipment utilization rate was above 95% through improving personnel training. Conclusion: The pertinence of the medical equipment maintenance and training is of great significance to carrying out effective regular maintenance of equipment by the office personnel, and it can reduce the failure rate and ensure the equipment operate safely.
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Objective To explore problems of chemical indicative cards and adhesive tapes in the disinfection,and find out some measures for improving the sterilizing effect of the pressure steam sterilizer.Methods 100 stoves of time with various package,dressing and storage tank were disinfected by pulse pressure steam sterilizer and chemical indicative cards of 3M1250 pressure steam sterilizing package at the same pressure,time and temperature.All test wraps were examined and the real conditions were recorded after the sterilization.Results The discoloration of chemical indicative cards in 10 test wraps was not standard before the measures were taken.While after that,it didn't occur again.Conclusion The nonstandard discoloration of chemical indicative cards of 3M1250 pressure steam sterilizer is influenced by condensed water of steam during the steam sterilization.In order to make the chemical indicative cards change into standard black,the accurate using of chemical indicative cards,the standard stuff package and correct using of disinfector are required.
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Objective: To study the air removal efficiency of prevacuum sterilizers.Methods: The results of Bowie-Dick(BD) tests were monitored every day using the 3M disposable BD test pack,which was placed horizontally in the bottom section of the sterilizer rack near the exhaust opening.Results: Of the 1370 BD tests conducted with 3 autoclaves,1366 showed negative results and 4 positive.Conclusion: BD tests can be used to precisely assess the efficiency of prevacuum sterilizers.