Gorse G J, Messner R L
Division of Infectious Diseases, St. Louis University School of Medicine, MO 63104.
Infect Control Hosp Epidemiol. 1991 May;12(5):289-96. doi: 10.1086/646341.
To ascertain current infection control practices, endoscope cleaning procedures, perceived risks of infection, and implementation of universal precautions in gastrointestinal endoscopy units in the United States.
National mailed survey of gastroenterology nurses and associates conducted anonymously in March 1988.
Completed surveys were received from all 50 states and Puerto Rico and from all practice settings. The most common practice setting was private/community hospitals (66%).
Of the 4,952 survey forms mailed to all members and to interested nonmembers of the Society of Gastrointestinal Nurses and Associates, 2,158 (44%) were returned and 2,030 (41%) were completed and evaluable. Of the respondents, 1,487 (73%) were registered nurses.
Sixty-seven percent (n = 1,358) of the respondents routinely used an enzymatic cleaner as a step in the instrument decontamination process; 93% (n = 1,879) chemically disinfected instruments after each case; and 88% (n = 1,779) disinfected endoscopes with an aqueous glutaraldehyde product. Respondents reported that they and a significantly smaller proportion of physicians (p less than .001) employed barrier precautions for all endoscopic cases involving possible contact with blood/body fluids of patients known (66% versus 57%, respectively) and not known (12% versus 8%, respectively) to have a bloodborne infection. Endoscopy-related infections, usually bacterial, were reported to have occurred at their institutions by 6% (n = 116) of respondents.
We conclude that cleaning, disinfection, and sterilization procedures for gastrointestinal endoscopic instruments vary, that appropriate protective apparel is not always worn, and that some practices may lead to preventable endoscopy-related infection in patients.
确定美国胃肠内镜检查科室当前的感染控制措施、内镜清洁程序、感知到的感染风险以及通用预防措施的实施情况。
1988年3月对胃肠病学护士及相关人员进行的全国性邮寄调查，采用匿名方式。
收到了来自美国所有50个州、波多黎各以及所有执业环境的完整调查问卷。最常见的执业环境是私立/社区医院（66%）。
在向胃肠病学护士及相关人员协会的所有成员和感兴趣的非成员邮寄的4952份调查问卷中，2158份（44%）被退回，2030份（41%）填写完整且可用于评估。在受访者中，1487人（73%）为注册护士。
67%（n = 1358）的受访者在器械去污过程中常规使用酶清洁剂；93%（n = 1879）在每例检查后对器械进行化学消毒；88%（n = 1779）使用戊二醛水溶液产品对内窥镜进行消毒。受访者报告称，在所有可能接触已知（分别为66%和57%）和未知（分别为12%和8%）患有血源性感患者血液/体液的内镜检查病例中，他们以及比例明显较小的医生（p <.001）采取了屏障预防措施。6%（n = 116）的受访者报告称，他们所在的机构发生过与内镜检查相关的感染，通常为细菌感染。
我们得出结论，胃肠内镜器械的清洁、消毒和灭菌程序各不相同，并非总是穿戴适当的防护服装，并且一些做法可能导致患者发生可预防的与内镜检查相关的感染。
