| BACKGROUNDThe clean of medical equipment is an important part of the work in a disinfection and supply center, is also a key link before sterilization of medical instruments, which is related to the safety of medical treatment. Currently the disinfection equipment in my hospital is a semi-automatic washing machine, and the auxiliary cleaning equipments are the U-shape frames and cleaning baskets provided by manufacturers, more than 90% medical devices are axis section instruments, due to a single U-frame size, which is only fit for a few of axis section instruments, most of them are not suitable for display but in the washing basket which is very likely to make friction and collision between the instruments, resulting in instrument damage, blunt blade; open shaft section of the instrument will be re-closed, which will result in an not complete clean; Repeated clean would waste manpower, resource and time. Forceps are non-axial section instruments, which clean in traditional way need to be tiled or overlapped in basket. But in this way forceps have not been fixed effectively, the forceps would be overlapped each other which effected the progress of clean and the evaporation. Oxygen inhalation therapy is one of commonly used in clinical nursing skills. The data of modern hospital infection showed that the infection of respiratory was in the first place of the infections during hospital, respiratory infections are closely related to the pollution of oxygen humidifier bottles. In traditional way, the process of clean and evaporate the oxygen bottles has a series of problems, such as low-efficient and labor-intensive; dry not enough to inhibit the grow of bacterium; polluted recessively by oxygen wet bottle wall. To solve these problems, new cleaning equipment shelves were research to improve cleaning quality, ensure the quality of disinfection, reduce the loss of equipment, decrease occupational injuries to staff and improve efficiency.Research Purpose1. Develop "a kind of cleaning shelf for medical instruments", "a kind of loading shelf for forceps cleaning", "a kind of loading shelf for oxygen humidifier bottles and inner cores", and discuss their advantages and values in the cleaning process of relative medical instruments.2. Development on series of loading shelves for instruments cleaning can improve the cleaning quality of disinfection and supply center, ensure the quality of disinfection and sterilization products, and avoid the inflection incurrence of the hospital.Methods:1. Evaluation for the design and effectiveness of "a kind of cleaning shelf for medical instruments".The round support, made of 5mm stainless steel, is composed of support, ring hook, frame back and base.Effectiveness evaluation:1222 pieces of cardo instruments can be randomly divided into experimental group and control group by instruments resource and then by the type, and there shall be 615pieces of instruments in experimental group and 607 pieces of instruments in control group. In experimental group, it is operated by one fixed operator, and the self-made shelf for medical instruments cleaning shall be used. In control group, the type U fixture and cleaning basket provided by the manufacturer shall be used, and the applicable instruments shall be fixed on the type U fixture, while the inapplicable instruments shall be directly put into the cleaning basket. The same cleaning methods shall be used for the two groups. (1) Flushing:the recycled instruments shall be washed by flowing water, brushed its cardo and slits for times by the hairbrush, and then washed by flowing water. (2) Cleaning and rinsing: the experimental group shall put the shelf for medical instruments cleaning and the instrument into each rinse tank of the semi-automatic cleaner; while the control group shall put the cleaning basket with type U fixture and the instruments into each rinse tank of the semi-automatic cleaner, and then the two groups shall start cleaning in accordance with the following procedures:presoaking for the ultrasonic cleaning→rinsing→disinfection for high temperature groove→soaking for lubrication oil→drying for the drying tank. The cleaning effectiveness and cleaning time of the two groups of instrument shall be compared.2. Evaluation for the design and effectiveness of "a kind of shelf for forceps cleaning"The frame is designed by 3mm stainless steel round support, and the forceps bracket including several grid quadrangles for laying up the forceps, is formed by 1.05 mm crisscrossing stainless round steels.Effectiveness evaluation:the 2000 recycled forceps shall be randomly divided into experimental group and control group, and there shall be 1000 forceps in each group, operated by one fixed personnel. The experimental group shall load the forceps by self-made load shelf for forceps cleaning; while the control group shall load the forceps by tile mode. The same cleaning methods shall be used for the two groups (Details, please see cleaning methods for the cleaning shelves of medical instruments). Make comparisons for the time for loading forceps and the effectiveness of the forceps cleaning.3. Evaluation for the design and effectiveness of "a kind of loading shelf for oxygen humidifier bottles and inner cores"The rectangular upper and lower brackets are constructed by 4mm stainless steel round support, and the inner core bracket constructed by 4mm stainless steel round support, is designed at the side of the upper and lower bracketsEffectiveness evaluation:the 1200 recycled oxygen humidifier bottles and the inner cores socked in chlorine disinfect solution shall be randomly divided into loading group and control group, and there shall be 600 sets in each group, operated by one fixed personnel. The loading group shall make the end rinsing by oxygen humidifier bottles and loading shelves of the inner cores, and then drying in air dry oven. Make comparisons for the time for end rinsing and loading, drying effectiveness and the rollover of oxygen humidifier bottles and inner cores in the two groups.The statistical process for data analysis shall use Excel 2003 Chinese version and statistical software SPSS13.0.Results1. A kind of cleaning shelves for medical instrumentsAfter the same pre-processing of the cardo instruments, the cleaning effectiveness of the loading shelves for medical instruments cleaning is obviously better than the effectiveness of type U fixture and cleaning basket. The acceptability of the experimental group is 97.88%, obviously higher than 85.33% of the control group (x2=62.8778, p=0.000), and it shows that the cleaning effectiveness of the experimental group is much better. For improving work efficiency and cleaning time of the instruments, the experimental group has saved 160 minutes comparing to the control group. The advantages are as following:1.1 Improvement for cleaning quality. While using the cleaning shelf, the instrument cardo and joints are completely opened and fixed. Without the prevention of the iron wire in the cleaning basket, the transmission of the ultrasonic wave can be promoted, and the multienzyme or alkaline washing liquid can contact with each parts of the instrument to completely decompose the organics; at the same time, the washing liquid can be completely washed to avoid residue of the washing liquid and improve the cleaning quality.1.2 Having reduced instruments wear. Locating the instrument behind the cleaning shelf can avoid swing and pulling the instrument away the washing tank; at the same cleaning shelf, the sharp instruments and other instruments shall be located separately to avoid the instruments release, damages and loss, and blunting of the edge, instruments wear and extend the use life of the instruments.1.3 Reducing occupational injury. The operator need not support the cleaning shelf by hands while picking and placing the instruments and can carry out shelving to reduce the risk of injury by sharp instruments. At the same time, because the sharp instruments, such as the points of scissors and knife edge, are placed with same direction, when picking the instruments, the operator can just support the cardo parts of the instruments and pick several instruments at one time to reduce the occupational injury.1.4 Wide application scope. The support spacing of the shelf for medical instruments cleaning is designed in accordance with the size of normal instruments, taking account of the specifications of the specific instruments. The instruments can be placed adjacent two supports or each one or two supports, with application to instruments with various specifications.1.5 Improvement for work efficiency. The instruments can be placed in order on the shelves for medical instruments cleaning, and it is easy to check the quality and quantity after cleaning and pick instruments by lot at one time with safety and high efficiency.2. A kind of loading shelf for forceps cleaningThe difference of the loading time for experimental group and control group is not obvious (t=0.195, P=0.846), so there is no time difference between the two groups. The dryness factor 96.3% of experimental group is higher than the dryness factor 87.9%(x2=48.489, P=0.000) of experimental group, and it shows that the drying effectiveness of experimental group is much better. The advantages are as following:2.1 Improvement for cleaning quality. The forceps are inserted vertically in the loading shelf for cleaning, with complete exposure of the forceps and without any shelter, in order that the cleaning agent can contact each part of the forceps to improve cleaning quality efficiently.2.2 Improvement for drying effectiveness. As the forceps are placed vertically, the cleaning agent can flow from high to low to avoid the residue of the cleaning agent to improve drying effectiveness.2.3 With much loading quantity. Comparing to the tile mode, the loading quantity is much more, and every forceps only occupies the two adjacent grid quadrangles. A forceps loading shelf can load about150 forceps, more 100 than the tile mode, and more 50 than overlap method.3. A kind of loading shelf for oxygen humidifier bottles and inner coresComparing to the time for end rinsing, loading oxygen humidifier bottles and inner cores, time for the loading group is obviously less than the control group (t =-18.557, P=0.000); the dryness factor of the loading group is obviously higher than the dryness factor 82.8%(x2=42.074, P=0.000)of the control group, and it shows that the drying effectiveness of the loading group is much better. The rollover factor 0% of the loading group is obviously lower than the rollover factor 16%(x2= 104.348, P=0.000) of the control group, it shows that the rollover factor of the loading group is much lower. The effectiveness is as following:3.1 Good fixing and drying effectiveness, and effective and stable drying process. The oxygen humidifier bottles are inverted on the upper and lower brackets and the fixed effect is good. As the action of the gravity is benefit for the flowing of the residue water on the wall of oxygen humidifier bottles and the openings f the bottles are downward, the drying speed can be improved. The oxygen humidifier bottles are fixed on the bracket 3, which can avoid the rollover of the oxygen humidifier bottles, and the inner cores are placed on the inner core bracket 4, which can keep good drying effectiveness.3.2 Improvement for work efficiency. After using the loading shelves, the loading shelves, oxygen humidifier bottles on the brackets and the inner cores fixed on the inner core brackets shall be put into the drying oven for drying, and after the drying, the shelves can be picked out directly, which has greatly improved work efficiency.3.3 With much loading quantity and good integrity for workflow. The loading shelf can only accommodate 30 oxygen humidifier bottles (including inner cores) each time. The loading quantity is much more, as the inner cores are tiny and can be lost easily, while the loading shelf can not only load the oxygen humidifier bottles, but also load the inner cores, which can avoid the loss of inner cores to keep good operation property.Conclusion"A kind of shelf for medical instruments cleaning" has the advantages of improving cleaning quality, decreasing the instruments damages, reducing the occupational injuries, wide application scope and high work efficiency. "A kind of loading shelf for forceps cleaning" has the advantages of improving cleaning quality and drying effectiveness, with great loading quantity. "A kind of loading shelf for oxygen humidifier bottles and inner cores has the advantages of good fixing and drying effectiveness, continuously effective and stable drying process, improving work efficiency, great loading quantity and good integrity for workflow. The three kinds of loading shelves for instruments cleaning researched in this paper, comparing to the traditional ways, have some specific advantages in cleaning quality, drying effectiveness and work efficiency, which are worthy to be popularized and utilized, and they are the ideal assistant cleaning tools for disinfection and supply center in hospital. |
PDF Full Text Request