HOSPITAL OVERALL DISINFECTION SOLUTION SERVICE PROVIDER

Observation on the effect of ultrasonic cleaning of medical instruments after manual brushing with multi-enzyme immersion


Release time:

2022-04-27

Abstract: OBJECTIVE To improve the cleaning quality of surgical instruments and prevent hospital infection. Methods The surgical instruments were divided into three groups for cleaning: the experimental cleaning group with multi-enzyme immersion and manual brushing followed by ultrasonic cleaning, the conventional ultrasonic control cleaning group, and the manual control cleaning group. Each group was in charge of 3 categories of cavity instruments, tooth instruments and smooth instruments. Three methods were used to detect the instrument after cleaning: subjective visual method, occult blood test, endotoxin test, and HBsAg quantitative detection. Results The pass rate of endotoxin removal on the 3 groups of cleaned instruments was slightly higher than that of the 2 control groups; the pass rate of the 3 groups of cleaned instruments was higher than that of the 2 control groups, especially the experimental group of lumen instruments was higher than that of the simple ultrasonic cleaning group; the HBsAg test of the 3 groups of cleaned instruments, dental instruments and smooth instruments were negative for HBsAg; however, the positive rate of simple ultrasonic cleaning for lumen instruments was 2.5%, and the other two cleaning methods were negative. Conclusion Ultrasonic cleaning can improve the cleaning quality of medical devices (especially lumen) after multi-enzyme immersion manual brushing, and ultrasonic cleaning alone can not completely replace manual cleaning.

AbstractOBJECTIVE To improve the cleaning quality of surgical instruments and prevent hospital infection. Methods will be divided into surgical instruments3Group cleaningExperiment of ultrasonic cleaning after manual brushing with multi-enzyme immersionCleaning group, conventional ultrasound controlCleaning group, manual control cleaning group. Each group is also in charge of the cavity type of equipment, tooth type of equipment, smooth type of equipment.3Class.3Methods of carrying out instrumentsAfter cleaningDetectionSubjective visual method,occult blood test, endotoxin test,HBsAgQuantitative detection. Results 3Endotoxin removal on the device after group cleaningThe qualified rate of the experimental group is slightly higher2 a controlGroup;3 Determination of instrument occult blood test after group cleaning, the qualified rate of the experimental group was higher2 a control groupIn particular, the experimental group of lumen instruments is higher than that of the simple ultrasonic cleaning group.;3 Equipment after group cleaning HBsAgInspection, dental and smooth instruments3Group cleaning methodHBsAgare all negative ; And tubeThe positive rate of simple ultrasonic cleaning for cavity instruments was2.5% ,The other two cleaning methods were negative. ConclusionUltrasonic cleaning can improve the cleaning quality of medical devices (especially lumen) after multi-enzyme immersion manual brushing, and ultrasonic cleaning alone can not completely replace manual cleaning.

Key words: medical instruments; multi-enzyme immersion; manual cleaning; ultrasonic cleaning; cleaning quality

CLC No: R472.1          Document identification codeB          Article Number:1006-6411(2011)11-0109-02

 

 

The hospital central supply room is responsible for the cleaning and elimination of hospital medical surgical instruments and articles.The quality of disinfection and sterilization is closely related to the occurrence of hospital infection, Directly affect the quality of medical care in hospitals; and the quality of cleaning of surgical instruments directly affects the qualityto the sterilization quality of surgical instruments. With the development of society, hospitals continue to introduce, promote,The use of a variety of high-tech medical equipment, not only increased the work of the disinfection supply room, and simple manual cleaning can not meet the cleaning quality standards. In order to improve the cleaning quality of surgical instruments, reduceHospital infection rate, the hospital since2009The introduction of automatic medical ultrasonic spray cleaning machine, rivalHigh cleanliness and high efficiency cleaning and disinfection of surgical instruments, hard and soft endoscopes and accessories And hot water drying, so that the cleaning effect of surgical instruments and cleaning level has been greatly improved, Reduce the hospital infection caused by unqualified sterile items, thereby improving the quality of medical care. Through the observation in use, it is found that the simple mechanical cleaning has a special effect on the residual organic matter of the instrument.It is not the instrument with dirt in the tube cavity, which can not achieve the ideal cleaning effect, but the use of multi enzyme immersionThe effect of manual brushing of bubble surgical instruments and ultrasonic cleaning machine is better (especiallyLuminal instruments such as various types of straws). However, mechanical cleaning cannot completely replace manual cleaning.

  1. Materials and Methods
    1. Materials KQ-V1800V SYDigital full-automatic ultrasonic spray cleaning and disinfectionmachine,

KHROType water treatment machine1Taiwan, LonsallThe company produces a low-foaming multi-enzyme cleaning agent, surgical instruments for post-operative recovery of contaminated instruments to be treated,OBTest paper for reagent, endotoxinDetection kit and other testing materials.

    1. Test Method

The surgical instruments will be divided3Group cleaning, that is, multi-enzyme immersion manual brushing after ultrasonic cleaning. Washing experimental group, conventional ultrasonic cleaning group, manual cleaning group. Each group also in charge of the cavity type of equipment, Dental instruments, smooth instruments3The weapon class. Number of surgical instruments performed on the experimentSee1 )Table.

Table1 3Number of surgical instruments in the group (pieces)

 

Device Type

experimental group

Manual cleaning group

Simple ultrasonic cleaning group

Dental instruments

200

200

200

Luminal Devices

80

80

80

Smooth class instruments

100

100

100

 

 

 

 

 

Work Unit:333 000 JingdezhenZhang Junying, Supply Room, Second People's Hospital, Jingdezhen City, Jiangxi Province: Female, Junior College, Supervisor Nurse

Date of receipt: 2011-08-05

    1. Cleaning method

Manual cleaning is mainly in the flow of water after full washing 1: 100low bubble moreBrushing in enzyme cleaning agent, shaft joint, lumen, occlusal surface, etc. require repeated brushing, and then flowWater cleaning, oiling, drying. Conventional ultrasonic cleaning group using flowing water after full flushing directlyInto the automatic ultrasonic spray cleaning machine for cleaning(1 : 500,60'C,low-bubble multi-enzyme cleaningAgent flushing,93 'Chot water disinfection). Experimental group under flowing waterChargeAfter flushing ,Put it in first.1:

1001']concentration of enzyme in liquid soak5min,Then use different types and sizes of brushes to manually scrub pipes, gaps, joints, rough surfaces, etc., and then use an ultrasonic machine to clean.

    1. Sampling method

Wipe the lumen, joints and occlusal parts repeatedly with a cotton swab soaked in sterile water for injection.

    1. Detection method

Subjective visual inspection, occult blood test, endotoxin testFixedHB,sAgDetection.

      1. Visual methodJudging by visual observation of the following indicators: the surface of the instrument after cleaningLight,10There is no adhesion to the surface of the instrument under the double magnifying glass. The dirt that can be peeled off by mechanical methods,The surface of the instrument is free of detergent and dirt and dirty film that affect the luster of metal, and the lumen is injected with sterile.

After the cotton swab is soaked with water, the cotton swab is free of dirt, and the above is qualified, otherwise it is unqualified.121.

      1. Determination of occult blood test: occult blood test is the use of iron-containing blood in hemoglobinIt has the function of catalyzing the decomposition of peroxides and can explain the hydrogen peroxide in the catalytic reagent.Put new ecological oxygen, oxidation of the above substances and color. The test paper method of occult blood test with thousands of medical equipment cleaning quality monitoring, high sensitivity. Wipe the wet cotton swab at the sampling point repeatedly.With the test paper, the test paper showed that the negative result was qualified, and the positive result was unqualified.
      2. Determination of endotoxin: gel method. The gel method is a method for qualitative detection or semi-quantitative detection of endotoxin by the principle of agglutination reaction between the agent and endotoxin, and is based on the observation of gel formation. The most advanced and fast gel in the world today is the endotoxin test kit.
      3. HBsAgquantitative detection : Currently Domestic testing methods areEILSA,The main reason is that the base thousand antigen or antibody can be adsorbed to the surface of the solid phase carrier and keep its immune activity, and the enzyme conjugate formed by the antigen or antibody and the enzyme still maintains its immune activity and enzyme catalytic activity.Basic principles.

 

 

 
 
·110· TODAY NURSE,Novemher,2011,No.ll

 

 

1.6   Statistical Methods Collection of inspection dataUsex 2Inspectors method for statistical analysis.

  1. Results
    1. Visual method

Simple ultrasonic cleaning and experimental group brightness similar, manual cleaning brightness second;There is no dirt on the surface of industrial cleaning and experimental cleaning, and dirt is sometimes visible in simple ultrasonic cleaning. Teeth

 

Class instruments are comparable to smooth class instruments in cleanliness; lumen class instruments, the experimental group uses sterile injectionAfter wiping the test tube cavity with a water-wet cotton swab, the cotton swab has no dirt. Manual cleaning is rare and simpleAcoustic cleaning shows obvious dirt. The cleanliness of the experimental group was the best (especially the lumen instruments).

    1. determination of endotoxin

3Group comparison of the qualified rate of endotoxin removal of instruments after cleaning (See Table2).

 

 

Table2 3Results of instrument endotoxin test after group cleaning (pieces)

 

Device Type

Number of detected pieces (per group)

experimental group

Manual cleaning group

Simple ultrasonic cleaning group

x2

p

 

 

Dental instruments

200

92

88

89

1.866

>0.500

 

 

Luminal Devices

80

95

90

75

15.001

<0.001

 

 

Smooth class instruments

100

96

92

93

1.458

>0.500

 

 

Table3 3Results of occult blood test of instruments after group cleaning (pieces)

 

Device Type

Number of detected pieces (per group)

experimental group

Manual cleaning group

Simple ultrasonic cleaning group

X2

p

 

 

Dental instruments

200

92

84

90

7.340

<0.025

 

 

Luminal Devices

80

90

87

75

16.250

<0.001

 

 

Smooth class instruments

100

94

93

88

1.269

>0.750

 

 

 

    1. 3Comparison of occult blood test results between two groups

3The results of residual blood detection on the instrument after cleaning in the group were compared (see Table3 ).

    1. HBsAgDetection

Instrument after cleaning HBsAgInspectionMeasurement, dental and smooth instruments3Group cleaning method

HBsAgAllis negative;While the luminal instruments use simple ultrasonic cleaningHBsAgpositive rateFor2.5%,In addition2Group cleaning method were negative.

  1. Discussion
    1. The Importance of Medical Device Cleaning Quality

The cleaning quality of medical devices is a prerequisite for successful sterilization, because the organic matter and microorganisms attached to the device will form a layer of biofilm on the surface or cavity of the device, which will prevent the penetration of sterilization factors and lead to sterilization failure. At the same time, some components of organic matter can corrode the surface locking layer of the device, causing the device to be rusted. Study found that thorough cleaning can reduceLow contamination of bacteria, reduce equipment damage and extend the service life. Factors affecting cleaning include the number and type of equipment contamination microorganisms, the amount and state of residual organic matter on the equipment, and the complexity of the structure and materials of the equipment itself. Both dental and lumen instruments are more difficult to wash and require a comprehensive approach: such as multi-enzyme immersion, manual brushing and ultrasonic cleaning. The results of this study show that luminal instruments are cleaned by this method.Can achieve the ideal cleaning effect, simple ultrasonic cleaning can not achieve the ideal cleaning effect.

    1. How to improve the cleanliness of cleaning equipment

There are many factors that affect the cleanliness of the equipment, such as the degree of contamination of the equipment, the complexity of the structure, and the lack of timely pretreatment. There are the following methods to improve the cleanliness of equipment cleaning Several kinds.

      1. Timely pretreatment. Whether manual cleaning or mechanical cleaning, pretreatment before cleaning is an indispensable process, mainly including moisturizing the equipment.  Inspection of cleanliness, classification of instruments, disinfection of non-contaminated instruments, etc.
      2. Remove any dirt adhering to the surface of the instrument. Can be disassembled for instruments with complex structuresParts must be disassembled and scrubbed carefully, while pipes, crevices, rough surfaces, joints, etc. Different types and sizes of brushes should be selected for preliminary manual scrubbing to remove large dirt. After that, it is cleaned with a cleaning machine to ensure the cleaning effect;The washing surface is covered; the equipment with dry dirt will increase the difficulty of cleaning and should not be carried out directly.Cleaning, should first use the enzyme liquid soak to loosen or digest the dirt adhered to the instrument.
      3. Rational use of low-vesicular multienzymes. The enzyme solution should be prepared for current use, as it is only a cleaning agent, The effect is not affected by water quality, but the enzyme will be activated after water, so that the biological degradation and failure; should also be based on the number of immersion in a timely manner to replace the enzyme solution to ensure its effective concentration.
      4. Zheng WeishengWait[ 3 Pass over contaminated equipment WashingFangLawofViewCha, recognize ForInHands.Work

In the process of cleaning the equipment, it is emphasized that the wire ball should not be used to scrub the equipment to avoid leaving the surface of the equipment.Under the brush marks, so that dirt or water in the traces of the accumulation of corrosion and pollution.

      1. For contaminated instruments recovered from the clinic, the rusty instruments are first removed by special use.Rust agent for rust removal treatment, and then regular cleaning.
      2. Through research and observation, it is found that simple mechanical cleaning can not achieve the ideal cleaning effect on the instruments with residual organic matter, while the quality of cleaning with ultrasonic cleaning machine after using multi-enzyme liquid immersion manual brushing is better, especially for lumen instruments.

 

References

l Xu Le,Zhang XiaochunExperimental Study on Removal of Bacterial Endotoxin by Bijie Multi-enzyme Cleaning Solution[J].Chinese Journal of Hospital Infection ,2005 ,15(2):167.

  1. Cao L, Li H, Li Aimin, et al. Exploration on Washing Quality of Semi-automatic Surgical Instruments from Jeli EnzymeStandard for cleanliness of washing [J].Chinese Journal of Infectious Medicine ,2005 ,15(8):910.
  2. Zheng Weisheng, Wang Li, Guo Ping. Contaminated medical devicesstudy on washing method[J].China realJournal of Nursing ,2007 ,23(6) :50.

(Editor: Cao Xi)

RELATED INFORMATION

Quickly find what you need to know

All
  • All
  • Product Management
  • News
  • Introduction
  • Enterprise outlets
  • FAQ
  • Enterprise Video
  • Enterprise Atlas