Price E, Weaver G, Hoffman P, Jones M, Gilks J, O'Brien V, Ridgway G
Honorary Consultant Microbiologist, Department of Infection, Barts Health NHS Trust, London, UK.
Human Milk Bank Manager, The Milk Bank, Imperial College Healthcare NHS Trust, London, UK.
J Infect Prev. 2016 Mar;17(2):53-62. doi: 10.1177/1757177415613566. Epub 2015 Dec 9.
A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a joint Working Group of the Healthcare Infection Society and the Infection Prevention Society.
The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing & Allied Health Literature, Midwifery & Infant Care and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources much of the guidance represents good practice based on the consensus view of the Working Group.
Breast pump milk collection kits should not be reused by different mothers unless they have been sterilized in a Sterile Services Department between these different users.When used by the same mother, a detergent wash followed by thorough rinsing and drying after each use gives acceptable decontamination for most circumstances, as long as it is performed correctly.Additional decontamination precautions to washing, rinsing and drying may be used if indicated by local risk assessments and on advice from the departmental clinicians and Infection Prevention and Control Teams. The microbiological quality of the rinse water is an important consideration, particularly for infants on neonatal units.If bottle brushes or breast/nipple shields are used, they should be for use by one mother only. Decontamination should be by the processes used for breast pump milk collection kits.Dummies (soothers, pacifiers or comforters) needed for non-nutritive sucking by infants on neonatal units, should be for single infant use. Manufacturers should provide these dummies ready-to-use and individually packaged. They must be discarded at least every 24 hours or immediately if soiled with anything other than the baby's saliva. No attempt should be made to decontaminate the dummies, either before or during use.
This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers.
目前有多种方法用于对吸奶器集乳套件及与婴儿喂养相关的物品进行去污处理。本文旨在为在家中和医院对该设备进行去污处理提供最佳实践指南。它由医疗保健感染学会和感染预防学会的联合工作组编撰。
该指南参考了对以下文献的检索结果:医学期刊数据库(Medline)、英国护理索引、护理及联合健康文献累积索引、助产与婴儿护理,以及2002/3年和2006年对英国新生儿病房的两项调查结果,还有2014年对感染预防学会成员的调查结果。由于从这些来源获得的高质量证据有限,所以本指南的大部分内容是基于工作组的共识观点得出 的良好做法。
吸奶器集乳套件不应被不同母亲重复使用,除非在无菌服务部门对其进行了灭菌处理。当由同一位母亲使用时,在大多数情况下,每次使用后用洗涤剂清洗,然后彻底冲洗并干燥,只要操作正确就能达到可接受的去污效果,但需视当地风险评估以及部门临床医生和感染预防与控制团队的建议,在清洗、冲洗和干燥之外采取额外的去污预防措施。冲洗水的微生物质量是一个重要考量因素,对于新生儿病房的婴儿尤其如此。如果使用奶瓶刷或乳房/乳头护罩,应仅供一位母亲使用。去污处理应采用与吸奶器集乳套件相同的流程。新生儿病房中婴儿非营养性吸吮所需的安抚奶嘴(橡皮奶头、安抚奶嘴或安慰物)应仅供单个婴儿使用。制造商应提供即用型且独立包装的安抚奶嘴。它们必须至少每24小时丢弃一次,或者如果被除婴儿唾液以外的任何东西弄脏则应立即丢弃。在使用前或使用过程中均不应尝试对安抚奶嘴进行去污处理。
本指南提供了实用建议,以支持对吸奶器集乳套件进行安全去污处理,供医疗保健专业人员使用并传达给其他群体,如父母和护理人员。