内镜处理效率:对感染预防专家和临床医生进行现实检查和呼吁采取行动
Cori L Ofstead1, Abigail G Smart1, Lydia L Hurst1
1Ofstead & Associates, Inc., Bloomington, MN.
American journal of infection control
|April 11, 2025
概括
柔性内镜的高级消毒 (HLD) 通常无法消除微生物,导致疫情爆发. 改进再处理方案对于患者安全和减少感染风险至关重要.
科学领域:
- 感染控制 感染控制
- 医疗设备再加工 医疗设备再加工
- 公共卫生 公共卫生
背景情况:
- 灵活内镜是暴露于生物材料的关键医疗器械.
- 目前的指导方针要求在每次使用后进行高水平消毒 (HLD) 或杀菌.
- 不充分的再加工造成了微生物传播的重大风险.
研究的目的:
- 审查关于HLD在柔性内镜中的有效性的证据.
- 在现实环境中识别导致HLD故障的因素.
- 为提高内镜手术中患者安全的策略提供信息.
主要方法:
- 对同行评审期刊的综合文献综述 (2019-2024年).
- 食品和药物管理局 (FDA) 的不良事件报告分析.
- 包括关于内镜再加工的其他相关政府报告.
主要成果:
- 在临床实践中,HLD并不能可靠地消除所有微生物,包括弹性子.
- 显著的百分比的内镜仍然被生物负担和病原体污染后再加工.
- 已经报告了许多与受污染的内镜相关的疫情,包括多种耐药生物.
结论:
- 预防感染需要对HLD的有效性进行批判性审查,并遵守协议.
- 设施必须进行风险评估,并实施积极的质量改善策略.
- 加强警和改进再处理实践对于减轻感染风险和确保患者安全至关重要.
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