First, the disinfection technology (a) clear disinfection of the main object should be specifically analyzed the path of infection, the media involved and the type of pathogenic microorganisms, targeted use of disinfectants. (2) Adopting appropriate disinfection methods and selecting according to the disinfection object
First, disinfection technology
(1) Defining the main target of disinfection
The route of infection, the medium involved, and the type of pathogenic microorganism should be specifically analyzed, and the disinfectant should be used in a targeted manner.
(2) Adopt appropriate disinfection methods
According to the disinfection object, the disinfection method is simple, effective, non-damaged, rich in source and moderate in price.
The diagnosis and treatment equipment of hospitals can be divided into three categories according to the degree of harm caused by pollution and the different parts of human body contact:
Highly dangerous equipment
A device that passes through the skin, mucous membranes, into a sterile tissue or organ, or in close contact with a damaged skin and mucous membrane, such as surgical instruments, syringes, pacemakers, and the like. Efficient disinfection (sterilization) must be used.
2. Moderately dangerous equipment
It only comes into close contact with the skin and mucous membranes, and does not enter sterile tissues such as endoscopes, thermometers, oxygen tubes, ventilators and related instruments, anesthesia equipment, etc. Medium-effect disinfection should be used to kill various microorganisms other than spores.
3. Low-risk equipment and items
Do not enter human tissue, do not touch the mucous membrane, and only directly or indirectly contact with healthy and non-destructive skin. If there is not enough amount of pathogenic microorganisms to contaminate, there is generally no harm, such as masks, clothes, medicine cups, etc. The law is only for general sanitation. Only general bacterial propagules and lipophilic viruses are required to be removed.
(C) Control factors affecting the disinfection effect Many factors will affect the role of disinfectants, and the sensitivity of various disinfectants to these factors varies greatly.
1. Types of microorganisms
Different types of pathogenic microorganisms have different resistance to disinfectants, and therefore must be treated differently when disinfecting.
(1) Bacterial propagules
Easy to be disinfected by disinfectants, generally Gram-positive bacteria are more sensitive to disinfectants, and Gram-negative bacilli often have strong resistance. The propagule is sensitive to heat, and the disinfection method is mainly based on thermal disinfection.
(2) bacterial spores
Spores have the strongest endurance to disinfection factors, and the most reliable methods for killing bacterial spores are heat sterilization, ionizing radiation and ethylene oxide fumigation. Among chemical disinfectants, glutaraldehyde and peracetic acid can kill spores, but the reliability is not as good as thermal sterilization.
(3) Virus
The endurance of disinfection factors varies greatly depending on the type, and the tolerance of hydrophilic viruses is stronger than that of lipophilic viruses.
(4) Fungi
It has strong endurance to dryness, sunlight, ultraviolet rays and most chemical drugs, but it is not heat resistant (killing at 60 ° C for 1 hour).
2. Number of microorganisms
The greater the number of contaminated microorganisms, the longer it takes to sterilize and the greater the dose.
3. The presence of organic matter
1 The formation of a protective layer on the surface of the microorganism by the organic substance hinders the contact of the disinfectant with the microorganism or delays the action of the disinfectant, so that the microorganism gradually develops adaptability to the drug. 2 organic matter and disinfectant to form a compound with lower solubility than the original or less bactericidal effect than the original. 3 A part of the disinfectant interacts with the organic matter, and the concentration of the action on the microorganism is lowered. 4 organic substances can neutralize a part of the disinfectant. Heavy metals and surfactants in disinfectants are greatly affected by organic matter and have little effect on glutaraldehyde.
4. Temperature
As the temperature increases, the bactericidal effect increases, but the temperature changes have different effects on various disinfectants. If the humidity of formaldehyde, glutaraldehyde or ethylene oxide is doubled, the bactericidal effect can be increased by 10 times. Phenols and alcohols are less affected by temperature.
5. PH value
It affects the bactericidal effect from two aspects. 1 Effect on disinfectant: change its solubility and molecular structure. 2 pH too high or too low has an impact on the growth of microorganisms. Under acidic conditions, the negative charge on the surface of the bacteria is reduced, and the anionic disinfectant has a good sterilization effect. Under alkaline conditions, the negative charge on the surface of the bacteria is increased, which is beneficial to the action of the cationic disinfectant.
6. Treatment dose and monitoring
Ensure the dosage of disinfection and sterilization treatment, strengthen the effect monitoring, and prevent re-contamination.
Second, sterilization technology
(1) Precautions for high pressure steam sterilization
First, the sterile package should not be too large (less than 50cm × 30cm × 30cm), should not be too tight, there must be a gap between the packages, so that the steam can easily penetrate into the center of the package. Before disinfection, open the vent hole of the tank or box to facilitate steam circulation. Moreover, the steam can be quickly discharged when venting to keep the articles dry. After sterilization, close the vent of the tank or box to maintain the sterility of the item.
Second, cloth items should be placed on metal objects, otherwise the steam will be condensed into water droplets to make the cloth damp. Blocking steam into the center of the package seriously affects the sterilization effect.
Third, check the sterilization effect regularly. The aseptic package and aseptic container sterilized by autoclaving are valid for 1 week.
Monitoring of high pressure steam sterilization: There are three methods:
The first is process monitoring, also known as program monitoring. According to the measuring device (pressure gauge, thermometer, chronograph), chart, indicator needle, alarm, etc. installed on the sterilizer, it indicates whether the sterilization equipment is working normally or not. This method can quickly indicate the malfunction of the sterilizer, but it is not possible to determine whether the items to be sterilized meet the sterilization requirements. This method is used as a routine monitoring method and should be performed for each sterilization.
The second is chemical indicator monitoring. The characteristics of the chemical indicator to be discolored or deformed under a certain temperature and action time are used to determine whether the parameters required for sterilization are met.
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