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从感染预防和控制的角度评估德国医院手术室再处理的实践。

Evaluation of the practice of reprocessing ORs in German hospitals from an infection prevention and control perspective.

机构信息

Department of Anesthesiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Department of Infection Control and Infectious Diseases, University Medical Center Göttingen, Göttingen, Germany.

出版信息

Infection. 2024 Aug;52(4):1575-1584. doi: 10.1007/s15010-024-02303-z. Epub 2024 Jun 3.

Abstract

BACKGROUND

The aim of this study was to analyze the cleaning and disinfection of operating rooms (ORs) status quo focusing on hygiene plans in German hospitals.

METHODS

In 2016, a structured online survey was sent to infection prevention and control (IPC) specialists at the cost calculation hospitals of the Institute for the Hospital Remuneration System (InEK) and all university hospitals in Germany (n = 365).

RESULTS

With a response rate of 27.4%, 78% stated that written hygiene plans were available. After cleaning and disinfecting an OR with a "septic" patient, 55% waited until surfaces were dry before reusing in accordance with national recommendations, 27% waited > 30 min. Additionally, 28% of hospitals had ORs only for "septic" patients. In 56% "septic" patients were only operated on at the end of the program. Postoperative monitoring of patients with bacteria with special IPC requirements took place in the post anesthesia care unit (PACU) (29%), operating room (OR) (52%), intensive care unit (ICU) (53%), and in the intermediate care unit (IMC) (19%).

DISCUSSION AND CONCLUSIONS

Despite written hygiene plans in place the partly long duration of OR nonuse time following IPC measures, the consistent continued use of stratification for "septic" patients and the postoperative follow-up care of patients with colonizing/infecting bacteria with special IPC requirements in the OR and high care areas represent relevant potential for improvement.

摘要

背景

本研究旨在分析德国医院手术室(OR)清洁消毒的现状,重点关注卫生计划。

方法

2016 年,对感染预防和控制(IPC)专家进行了一项结构在线调查,调查对象为德国 Institute for the Hospital Remuneration System(InEK)成本核算医院和所有大学医院(n=365)。

结果

响应率为 27.4%,78%表示有书面卫生计划。根据国家建议,在对“感染”患者进行清洁和消毒后,55%的人等待表面干燥后再重新使用,27%的人等待时间>30 分钟。此外,28%的医院只设有“感染”患者专用的 OR。在 56%的情况下,只有在程序结束时才对“感染”患者进行手术。对具有特殊 IPC 要求的细菌感染患者进行术后监测,监测地点分别为麻醉后护理单元(PACU)(29%)、手术室(OR)(52%)、重症监护病房(ICU)(53%)和中级护理病房(IMC)(19%)。

讨论和结论

尽管制定了书面卫生计划,但部分 OR 在执行 IPC 措施后长时间不能使用,持续对“感染”患者进行分层以及对具有特殊 IPC 要求的定植/感染细菌患者在 OR 和高护理区进行术后随访,这表明存在改进的相关潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5305/11289043/4ee475812964/15010_2024_2303_Fig1_HTML.jpg

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