HOSPITAL OVERALL DISINFECTION SOLUTION SERVICE PROVIDER

Endoscopy center and personal protection for medical and decontamination personnel


Release time:

2020-04-10

According to the work deployment of the network telephone standing Committee (enlarged) meeting of the 8th Chinese medical association digestive endoscopy branch on January 31, 2020 and the requirements of linghu enqiang chairman, in order to deal with the epidemic situation of novel coronavirus pneumonia (new coronary pneumonia, NCP), the digestive endoscopy branch has formulated a number of guiding documents in accordance with the information disclosed by the national authority and in combination with the diagnosis and treatment characteristics of digestive endoscopy center and the actual sensing control. [Mirror Art Association] Excerpts from the "Recommendations for Cleaning and Disinfection of Digestive Endoscopy Center under the Epidemic Situation of Novel Coronavirus Pneumonia" by the Digestive Endoscopy Branch of the Chinese Medical Association, and attaches the "Protection Process for Surgical Medical Staff"

According to the work deployment of the network telephone standing Committee (enlarged) meeting of the 8th Chinese medical association digestive endoscopy branch on January 31, 2020 and the requirements of linghu enqiang chairman, in order to deal with the epidemic situation of novel coronavirus pneumonia (new coronary pneumonia, NCP), the digestive endoscopy branch has formulated a number of guiding documents in accordance with the information disclosed by the national authority and in combination with the diagnosis and treatment characteristics of digestive endoscopy center and the actual sensing control. [Mirror Art Association] Excerpts from the "Recommendations for Cleaning and Disinfection of Digestive Endoscopy Center under the Epidemic Situation of Novel Coronavirus Pneumonia" by the Digestive Endoscopy Credit Association of the Chinese Medical Association, and attaches the "Protection Process for Surgical Medical Staff" for your reference.

Diagnosis and treatment area and disinfection

1. According to the relevant provisions of Class A infectious diseases in the infectious disease prevention and control law, referring to the technical guidelines for the prevention and control of novel coronavirus infection in medical institutions (First Edition), the prevention and control plan for novel coronavirus pneumonia (Fourth Edition), the technical specification for hospital isolation, the management specification for hospital air purification, or the control requirements of the hospital infection control departments on new crown pneumonia, Each hospital chooses the appropriate diagnosis and treatment place according to the actual situation.

2. After the diagnosis and treatment of each patient, the diagnosis and treatment places and equipment shall be terminally disinfected.
3. In the process of diagnosis and treatment, it is recommended to use medical dynamic air disinfection equipment for continuous air disinfection in the diagnosis and treatment place.
4. Terminal disinfection shall be carried out according to the relevant provisions of the Technical Specification for Disinfection in Medical Institutions and the Management Specification for Air Purification in Hospitals:

① The endoscope host, operating console, monitor, electrosurgical workstation and diagnosis and treatment bed shall be wiped and disinfected with 75% alcohol, disinfectant wet wipes and chlorine-containing disinfectant in accordance with the regulations, and the chlorine-containing disinfectant shall be wiped with clean water after 30 minutes of action.

The ground using chlorine disinfectant, chlorine dioxide disinfectant disinfection, the role of 30 minutes after the wipe clean.

③ Indoor air: medical dynamic air disinfection equipment can be used for disinfection (disinfection time follows the product instructions);3% hydrogen peroxide, 5000mg/L peracetic acid or 500mg/L chlorine dioxide and other disinfectants, or atomization/vaporization hydrogen peroxide disinfection machine disinfection; UV disinfection can also be used.

④ after disinfection, need to open the window ventilation after use.

5, with reference to the "new coronavirus pneumonia prevention and control program (fourth edition)" when necessary, the disinfection effect of the surface, air and hands should be evaluated in a timely manner.

Cleaning and disinfection of endoscopes

1. Strictly clean and disinfect endoscopes according to Technical Specification for Cleaning and Disinfection of Flexible Endoscopes. Bedside pretreatment is not recommended. Follow the procedure of first disinfection, then cleaning and then sterilization.

2. Immediately after the operation, put the endoscope and reusable accessories into a double-layer yellow medical waste bag and seal it, mark the 2019-nCoV logo, and transfer it to the endoscope center decontamination room.

3. Immerse the endoscope and reusable accessories immediately in 0.2~0.35 peracetic acid or acidified water with an effective chlorine concentration of 60±10mg/L for disinfection for 5 minutes. It is recommended to use a syringe to fill each pipeline with disinfectant to ensure that each pipeline of the endoscope is fully soaked. Clean and sterilize according to specifications.

4, manual cleaning must be effective, thorough washing to ensure that all debris and cleaning agents are removed.

5. The cleaning solution is replaced by one person, and the cleaning tank and rinsing tank are disinfected by one person.

6. Determine the concentration once after the disinfectant is prepared, and monitor before each use.

7, the choice of sterilization agents, it is recommended to choose peracetic acid and chlorine-containing preparations, can also choose other sterilization agents that meet the requirements.

8, automatic cleaning and disinfection machine should be used after its own disinfection.

9. At the end of daily cleaning and disinfection work, the cleaning tank, rinsing tank, perfusion device and cleaning brush should be thoroughly cleaned, and disinfected with chlorine-containing disinfectant, peracetic acid or other disinfectant in line with relevant national regulations. The disinfectant should be wiped clean after 30 minutes of action.

10. With reference to the relevant provisions of the "Regulations on the Management of Medical Waste", the sewage discharged from the cleaning tank, rinsing tank or automatic cleaning and disinfection machine needs to be disinfected with medical wastewater disinfection equipment before being discharged into the hospital sewage treatment system.

11. Medical waste shall be packaged with double-layer yellow medical waste bags and marked with the 2019-nCoV logo, and shall be disposed of in accordance with the relevant provisions of the Regulations on the Management of Medical Waste and the Measures for the Management of Medical Waste in Medical and Health Institutions.

Medical and decontamination personnel protection

1. Strictly implement the body temperature monitoring system: all staff in the endoscopy center are required to measure their body temperature on and off work every day, and record in detail:(1) whether there are accompanying symptoms such as fatigue and dry cough. (2) Whether there is a history of contact with a confirmed or suspected case of pneumonia infected with the novel coronavirus. If there is any abnormality, immediately leave the working environment, report to the competent leader, conduct a detailed risk assessment, and give medical intervention; if necessary, stop working and take isolation measures.

2. Strictly implement hand hygiene standards: wash hands correctly according to the "seven-step hand washing method" for 2 minutes, or use quick-drying hand disinfectant for hand hygiene disinfection, wearing gloves can not replace hand washing.

3. Personal protection during work at the Endoscopy Center:

(1) When entering the hospital and the diagnosis and treatment area, you must wear a mask. The mask should be replaced in time after it is wet, polluted or used for more than 4 hours.

(2) The reservation desk staff and decontamination personnel shall follow the general protection specifications.

(3) Operating doctors, anesthesiologists, nurses or technicians as assistants: must wear impermeable isolation gowns, medical protective hats, N95 or medical surgical masks, goggles/protective masks, gloves, shoe covers, etc.

(4) During tracheal intubation, sputum suction and other operations that may cause cough droplets or splash, while the above-mentioned primary protection, protective clothing and breathing hood should be worn when necessary, and should be replaced in time once contaminated.

(5) Tissue specimens obtained during endoscopy should be stored in a fixed area.

(6) The report of endoscopy should be written by the assistant to avoid cross infection.

(7) After the operation: correctly take off the isolation gown and protective equipment, wash hands or disinfect hands immediately after taking off, and it is strictly forbidden to wear gloves instead of washing hands.

4. Personal protection when going out for consultation:(1) Non-fever and isolation ward consultation: After general protection, you can go to the consultation. After arriving at the consultation department, if you need to upgrade the protection requirements, you can protect according to the relevant requirements of the consultation department. (2) Consultation in fever and isolation ward: personal protection shall be fully carried out in advance. After arriving at the consultation department, staff passage shall be taken and relevant regulations shall be strictly implemented for protection.

5. Contact with suspected patients: If the protection requirements are not met, medical personnel should be isolated immediately after contact with suspected patients. During the observation of abnormal, should be timely treatment.

 

Attached: Surgical Medical Personnel Protection Process (Reference)

Strictly control the number of medical staff in infection surgery, and prevent visitors from entering the operation room. Medical staff involved in surgery should do personal protection and wear protective equipment (see the last attachment of this article).

 

1. Protection requirements: wear hand washing clothes or work clothes, medical protective masks, disposable work caps, goggles, inner sterile gloves, disposable protective clothing, middle sterile gloves and inner boot covers; Wear hats, surgical masks, protective screen, outer boot covers, disposable surgical gowns and outer sterile gloves.

 

2. Dressing sequence:

Before operation-wear: wear hand washing clothes or work clothes inside → hand disinfection → wear medical protective mask → wear disposable work cap → surgical hand disinfection → wear goggles → wear inner sterile gloves → wear disposable protective clothing → wear middle sterile gloves → wear inner boot sleeve → wear outer hat → wear surgical mask → wear protective face screen → wear outer boot sleeve → hand disinfection → wear disposable surgical gown → hand disinfection → wear outer sterile gloves.

 

After operation-removing: hand disinfection → spraying disinfection in the operation room → removing disposable surgical gown → hand disinfection → removing protective face screen → hand disinfection → removing surgical mask → hand disinfection → removing outer hat → hand disinfection → removing outer boot cover → hand disinfection → removing outer sterile gloves → leaving the operation room, go to the buffer room → hand disinfection → take off the inner boot cover → hand disinfection → take off the disposable protective clothing → hand disinfection → take off the middle sterile gloves → hand disinfection → take off the goggles → hand disinfection → take off the disposable work cap → hand disinfection → take off the inner sterile gloves → hand disinfection → take off the medical protective mask → hand disinfection → leave the buffer room → hand disinfection → wear surgical mask and disposable work cap to leave → enter the third floor through the medical channel → hand disinfection → take off the disposable work cap → hand disinfection → take off the surgical mask → change shoes → enter the dressing room to bathe and change clothes.

 

Flow chart of surgical wearing and removing protective equipment for suspected or confirmed novel coronavirus infection

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