Huang Juanli, Yi Liangying, Chen Yanhua, Hu Juan
Department of Sterile Processing Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Heliyon. 2024 Jan 5;10(2):e24194. doi: 10.1016/j.heliyon.2024.e24194. eCollection 2024 Jan 30.
Improper cleaning is one of the main causes of sub-optimal levels of sterilization, and also a risk factor in terms of nosocomial infections. We aimed to investigate the factors associated with the cleaning quality of the reusable medical devices and prescribe improvement measures for ensuring the safe use of the devices and for iatrogenic infection control.
An expert consultation was conducted to identify the factors associated with the cleaning quality of reusable medical devices. A self-designed quality inspection form for reusable medical device cleaning was used to collect the data concerning the factors associated with the cleaning quality of the reusable medical devices cleaned at our hospital's central sterile supply department (CSSD) during January to June 2022. We also investigated the cleaning personnel's perceptions and knowledge of medical devices cleaning by means of a self-designed questionnaire.
Statistically significant differences ( < 0.05) were identified among incorrect cleaning procedures, improper cleaning methods, non-standard pre-treatment, wrong perceptions or lack of knowledge of medical device cleaning, and complex device structure. Correct cleaning procedures (odds ratio (OR) = 0.216, 95 % confidential interval (CI): 0.170-0.275), choice of cleaning method (ultrasonic cleaning OR = 3.995, 95 % CI: 2.937-5.434; spray cleaning OR = 0.893, 95 % CI: 0.735-1.085), standard pre-treatment (OR = 1.470, 95 % CI: 1.191-1.815), complex device structure (OR = 1.534, 95 % CI: 1.247-1.888) and cleaning personnel's correct perceptions of medical device cleaning (OR = 0.530, 95 % CI: 0.436-0.645) were the independent factors associated with the cleaning quality.
The quality of reusable medical device cleaning should be improved by: adherence to standard cleaning procedures, choosing the correct cleaning method and pre-treatment, improving cleaning personnel's knowledge and perceptions of medical device cleaning, and disassembling the medical devices with complex structures so as to reduce the quality defects of medical device cleaning.
清洁不当是导致灭菌水平未达最佳的主要原因之一，也是医院感染的一个风险因素。我们旨在调查与可重复使用医疗设备清洁质量相关的因素，并制定改进措施，以确保设备的安全使用和控制医源性感染。
进行专家咨询以确定与可重复使用医疗设备清洁质量相关的因素。使用自行设计的可重复使用医疗设备清洁质量检查表，收集2022年1月至6月在我院中心供应室（CSSD）清洁的可重复使用医疗设备清洁质量相关因素的数据。我们还通过自行设计的问卷，调查了清洁人员对医疗设备清洁的认知和知识。
在清洁程序不正确、清洁方法不当、预处理不规范、对医疗设备清洁的认知错误或知识缺乏以及设备结构复杂等方面，存在统计学显著差异（P<0.05）。正确的清洁程序（优势比（OR）=0.216，95%置信区间（CI）：0.170-0.275）、清洁方法的选择（超声清洁OR=3.995，95%CI：2.937-5.434；喷雾清洁OR=0.893，95%CI：0.735-1.085）、标准预处理（OR=1.470，95%CI：1.191-1.815）、设备结构复杂（OR=1.534，95%CI：1.247-1.888）以及清洁人员对医疗设备清洁的正确认知（OR=0.530，95%CI：0.436-0.645）是与清洁质量相关的独立因素。
应通过以下方式提高可重复使用医疗设备的清洁质量：遵守标准清洁程序，选择正确的清洁方法和预处理，提高清洁人员对医疗设备清洁的知识和认知，并拆解结构复杂的医疗设备，以减少医疗设备清洁的质量缺陷。
