Farrow S C, Kaul S, Littlepage B C
J R Coll Gen Pract. 1988 Oct;38(315):447-9.
Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results from 69 general practices and 21 health authority clinice in one health district are reported.Some form of sterilizer was used in 63 general practices. These included water boilers (49%), dry heat sterilizers (41%), autoclaves (5%) and pressure cookers (5%). Sixty one practices were using metal vaginal specula and of these 29 were disinfecting by boiling, three were using pressure cookers, 18 dry heat, seven chemical methods, three autoclaves and one the central sterile department of the local hospital. Of those who were boiling after simple washing, three practices boiled for five to 10 minutes and reused instruments during the same clinic. Of the 29 using simple boiling 20 (69%) were boiling for less than 20 minutes.The study highlights the fact that no formal advice has been given on disinfection practice by the DHSS, the health authorities or the family practitioner committees. The need to set up local guidelines and develop practical steps for their introduction are discussed.
对获得性免疫缺陷综合征疫情的担忧,促使一个健康区就全科医疗和卫生当局诊所中器械交叉感染的危险展开讨论。为了确定当前正在采用哪些消毒措施,采用了电话调查这种快速简便的数据收集方法。收集了关于消毒责任人的信息以及每件器械消毒方式的详细情况。报告了一个健康区69家全科诊所和21家卫生当局诊所的调查结果。63家全科诊所使用了某种形式的消毒器。其中包括水煮器(49%)、干热消毒器(41%)、高压灭菌器(5%)和高压锅(5%)。61家诊所使用金属阴道窥器,其中29家通过煮沸消毒,3家使用高压锅,18家使用干热消毒,7家使用化学方法,3家使用高压灭菌器,1家送往当地医院的中央消毒科室。在那些简单清洗后煮沸的诊所中,有3家煮沸5至10分钟并在同一诊疗期间重复使用器械。在29家采用简单煮沸消毒的诊所中,有20家(69%)煮沸时间不到20分钟。该研究突出了这样一个事实,即卫生和社会保障部、卫生当局或家庭医生委员会尚未就消毒措施给出正式建议。文中讨论了制定地方指导方针并为实施这些方针制定切实可行步骤的必要性。