The Cross-sectional Study Of Health Care Facility Sterilizer And Its Operation In Shanghai

BACKGROUNDSterilizers used in health care facilities for sterilization of medical and surgical instruments,devices,and supplies protect medical staff and patient from nosocomial infection.Nowadays,the management and use of sterilizers is still the weakness of infection control in health care facilities because of backward in management and improper use of sterilization processing.With the many recent advances in medical and surgical care, sterilizers in health care facilities in Shanghai also have had great changes that new types of sterilizers are keeping on emerging.And as the result of economical promotion,private health care facilities are booming.To assist health care facilities to promote sterility assurance level and prevent nosocomial infection is one of the duties for Shanghai Municipal Health Inspection(SMHI).SMHI could not do this duty well unless grasps current situation of sterilizers in health care facilities in Shanghai.However,there are little publications related to it,which means an obstacle for SMHI when making policy.AIMTo find out something important on sterility assurance level of sterilizers through this cross-sectional study of sterilizers, sterilization processing personnel and sterilization procedures in health care facilities.MEANING AND CONTENTThe research findings can help SMHI to make more effective policies and promote the level of sterilization quality control in health care facilities,which will reduce drain on human and economic resources, avoiding human suffering and higher health care costs.The content of this study includes:(â… ) the cross-sectional study of equipment and management of sterilizers; (â…¡) the cross-sectional study of sterilization processing personnel's knowledge,attitude,and skill situation;(â…¢) using biological indicators to monitor the sterilization efficacy of sterilizers sampled.METHODS AND MATEIAL238 health care facilities having health care practicing license in Shanghai are sampled by proportion allocation in stratified random sampling.Questionnaire is designed to collect these facilities' information about sterilizer equipment,management,maintenance, calibration,malfunction,quality control,and efficacy monitoring.254 sterilization processing personnel are questioned about knowledge level, attitude tendency,and skill level of sterilization.307 sterilizers sampled randomly are monitored the efficacy of sterilization.RESULTS AND CONCLUSIONSaturated steam under pressure is still the most common agent used in health care facilities for sterilization.There is a tendency that pre-vacuum and pulsation vacuum steam sterilizers are taking place of under-pressure exhaust steam sterilizers.Health care facilities differ in their sterilizers according to amount of medical services and clinical needs.In different types of health care facilities,the efficacy pass rate of sterilization in Tierâ…¢hospitals,tierâ…¡hospitals,and out-patient departments(for-profit) are above 97%while that of tierâ… hospitals, private hospitals,and clinics are relatively lower:91%.Among different types of sterilizers,the efficacy pass rate of ethylene oxide sterilizers is the highest:100%while that of hand-held and desktop pressure steam sterilizers is the lowest:88.9%.Management level of sterilizers is jagged from different types of health care facilities.There are several unsatisfactory phenomena in maladministration health care facilities,for example,laying too much stress on sterilizers repairing,ignoring of maintenance and calibration, not complying with efficacy monitor technical regulation,improper operation during sterilization procedures,updating knowledge not in time, low training rate of sterilization processing personnel in private health care facilities including private hospitals,out-patient department (for-profit),and clinics.The research achievements indicate that tierâ… hospitals should be paid more attention to in public hospitals.As to tierâ…¢and tierâ…¡hospitals,the evaluation of efficacy of new type sterilizers is more meaningful.It's necessary to explore a new pattern of supervision for private health care facilities comparatively to public hospitals to settle some special problems.In addition,drawing up guidelines of sterilizers' management in health care facilities,improving training and continuing education,getting external sterilization services on the right track are also need to consider.