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[牙科实践中消毒和灭菌过程的评估作为预防感染的重要因素]

[Assessment of disinfection and sterilization processes in dental practice as an important factors in prevention of infections].

作者信息

Podgórska Marta, Jakimiak Bozenna, Röhm-Rodowald Ewa, Chojecka Agnieszka

机构信息

Zakład Zwalczania Skazeń Biologicznych Narodowego Instytutu Zdrowia Publicznego-Państwowego Zakładu Higieny w Warszawie.

出版信息

Przegl Epidemiol. 2009;63(4):545-50.

Abstract

The dental health-care settings is an environment where disease transmission occurs easily. Prevention of cross infection is therefore a crucial aspect of dental practice and dental clinic stuffmust adopt certain basic routines while practicing. Infections may be transmitted in the dental operatory through direct contact with blood, oral fluids or other secretions; via indirect contact with contaminated instruments, equipment or environmental surfaces; or by contact with airborne contaminants present in either droplet splatter or aerosols of oral and respiratory fluids. Strategies to prevent dental patient infections have focused on disinfection and sterilization. This study evaluates basic routines in prevention of cross-infection in the dentistry. The sample comprised 100 dentists, who completed questionnaires. Based on inquires the conditions for disinfection and sterilization of medical devices were assessed. The following issues were taken into consideration: the way of disinfection and preparation of the disinfectants, the localization of disinfection, preparing to disinfection, washing and packing of dental devices, the frequency of disinfection, methods of sterilization and the monitoring system, type of sterilizers and the available cycles. The dental practices are well equiped to proceed the steam sterilization, but 33% of dentists don't know the available cycles in their autoclaves. Only 35% of them made sterilization process protocols. Very common are three failures of instruments disinfections: multiple use of disinfectant, adding of disinfectant, adding new instruments. There is still need for improvement in disinfection and sterilization in dental practice, especially including: monitoring and documentation of sterilization process, proper use of disinfectants according to manufactures instructions, frequent disinfection of surfaces which contact with patients. Dental stuff should take part in advanced training courses about disinfection and sterilization.

摘要

牙科保健场所是一个疾病容易传播的环境。因此,预防交叉感染是牙科诊疗的一个关键方面,牙科诊所工作人员在执业时必须采用某些基本程序。感染可能在牙科治疗室通过直接接触血液、口腔液体或其他分泌物传播;通过间接接触受污染的器械、设备或环境表面传播;或通过接触口腔和呼吸道液体的飞沫飞溅或气溶胶中存在的空气传播污染物传播。预防牙科患者感染的策略主要集中在消毒和灭菌方面。本研究评估了牙科预防交叉感染的基本程序。样本包括100名牙医,他们完成了问卷调查。根据调查情况评估了医疗器械的消毒和灭菌条件。考虑了以下问题:消毒剂的消毒方式和配制、消毒地点、准备消毒、牙科器械的清洗和包装、消毒频率、灭菌方法和监测系统、灭菌器类型和可用周期。牙科诊所具备进行蒸汽灭菌的良好设备,但33%的牙医不知道他们的高压灭菌器的可用周期。只有35%的人制定了灭菌过程方案。器械消毒存在三个非常常见的失误:多次使用消毒剂、添加消毒剂、添加新器械。牙科诊疗中的消毒和灭菌仍有改进的必要,特别是包括:灭菌过程的监测和记录、按照制造商说明正确使用消毒剂、频繁对与患者接触的表面进行消毒。牙科工作人员应参加关于消毒和灭菌的高级培训课程。

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