福建省104所医疗机构消化内镜终末漂洗用水管理现状

Current status of water management for terminal rinsing of digestive endoscope in 104 medical institutions in Fujian Province

    摘要
  • 摘要:
    目的 调查福建省医疗机构消化内镜终末漂洗用水管理现状, 为完善区域性质控标准提供参考。
    方法 2024年7-8月通过方便抽样法对福建省9个地级市二级及以上医院进行电子问卷调查, 内容涵盖水处理系统配置、维护及水质监测等。
    结果 共发放问卷108份, 回收有效问卷104份, 有效回收率为96.30%。调查显示：78.85%(82/104)的医院采用科室单独供水, 82.69%以纯化水作为终末漂洗用水；仅19.23%将最后一道滤膜安装于出水口处；66.35%的医院未明确供水管路使用年限, 管路消毒执行率为60.58%, 其中31.75%消毒频次不固定, 消毒剂以含氯消毒剂(50.79%)和过氧乙酸(34.92%)为主；电导率定期监测率为47.12%, 微生物监测覆盖率达90.38%, 监测频率以每季度一次为主(60.64%), 但仅20.21%使用R2A培养基, 12.77%采用滤膜法接种。三级医院在滤膜孔径合格率(87.50% vs. 56.86%)、管路消毒执行率(71.43% vs. 50.91%)及先进检测方法应用方面均优于二级医院(P＜0.05)。
    结论 福建省消化内镜终末漂洗用水管理存在设备维护不规范、监测方法不统一及管理人员认知不足等问题, 建议从优化水处理系统设置、建立标准化监测流程及加强人员专业培训等方面提升管理质量。

     

    Abstract:
    OBJECTIVE To investigate the current status of water management for terminal rinsing of digestive endoscope in medical institutions in Fujian Province, and to provide reference for improving regional quality control standards.
    METHODS An electronic questionnaire survey was conducted from Jul. 2024 to Aug. 2024 through convenient sampling in secondary and above hospitals of 9 prefecture-level cities in Fujian Province. The survey covered topics such as water treatment system configuration, maintenance and water quality monitoring.
    RESULTS A total of 108 questionnaires were distributed and 104 valid questionnaires were collected, with an effective response rate of 96.30%. The survey revealed that 78.85% (82/104) of the hospitals adopted separate water supply for each department, and 82.69% used purified water for terminal rinsing. Only 19.23% installed the final filter membrane at the water outlet. In addition, 66.35% of the hospitals did not specify the service life of the water supply pipeline, and the pipeline disinfection implementation rate was 60.58%, but 31.75% of them had irregular disinfection frequencies, with chlorine-based disinfectants (50.79%) and peracetic acid (34.92%) being the main disinfectants. The regular conductivity monitoring rate was 47.12%, and the microbial monitoring coverage rate reached 90.38%, with the monitoring frequency mainly being once every quarter (60.64%), but only 20.21% used R2A medium, and 12.77% adopted the membrane filtration method for inoculation. Tertiary hospitals were superior to secondary hospitals in terms of film membrane pore size pass rate (87.50% vs. 56.86%), pipeline disinfection implementation rate (71.43% vs. 50.91%) and advanced detection method application (P < 0.05).
    CONCLUSIONS There are issues in the management of water used for terminal rinsing of digestive endoscopes in Fujian Province, including non-standard equipment maintenance, inconsistent monitoring methods and insufficient awareness among management personnel. It is recommended to enhance management quality by optimizing the water treatment system setup, establishing standardized monitoring procedures and strengthening professional training for personnel.

     

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