中医医疗器具集中清洗与科室自行清洗消毒效果

Comparative effectiveness of centralized versus departmental cleaning and disinfection of traditional Chinese medicine medical instruments

  • 摘要:
    目的 比较集中清洗与科室自行清洗两种模式对重复使用中医医疗器具的消毒效果,为中医医院感控管理提供科学依据。
    方法 随机抽取2024年11月1日-2025年2月1日北京中医药大学深圳医院各科室重复使用的中医医疗器具339件,其中集中清洗器具144件、科室自行清洗器具195件。以菌落总数作为主要判定指标,应用ATP荧光检测法和微生物培养法对两组器具的清洗消毒效果进行检验与比较,卡方检验分析组间差异。
    结果 集中清洗组144件器具菌落均未检出,高水平消毒合格率100.00%。自行清洗组195件中,高水平消毒合格109件(55.90%),中水平消毒合格60件(30.77%),低水平消毒不合格26件(13.33%)。不同类型器具中,罐类自行清洗不合格率最高(18.18%)。两组合格率差异具有统计学意义(P<0.001)。
    结论 集中清洗消毒效果优于科室自行清洗。建议将非贵重罐类等高风险器具纳入集中清洗范围,同时加强管理规范与多部门协作,以降低中医诊疗相关院内感染风险。

     

    Abstract:
    OBJECTIVE To compare the disinfection effectiveness of two cleaning models (centralized cleaning vs. departmental cleaning) for reusable TCM medical devices, and to provide evidence for the management of hospital-associated infection in TCM practice.
    METHODS A total of 339 reusable TCM medical instruments, including centrally cleaned (n=144) and departmentally cleaned (n=195), were randomly sampled from various departments of Shenzhen Hospital, Beijing University of Chinese Medicine, between Nov. 1, 2024, and Feb. 1, 2025. Total bacterial count was used as the primary indicator. ATP bioluminescence and microbial culture methods were employed to evaluate and compare disinfection efficacy between the two groups. Chi-square tests were adopted to analyze intergroup differences.
    RESULTS In the centralized cleaning group (n=144), no bacterial colonies were detected, and the qualified rate of high-level disinfection was 100.00%. In the departmental cleaning group (n=195), 109 instruments achieved high-level disinfection (pass, 55.90%), 60 achieved intermediate-level disinfection (pass, 30.77%) and 26 were classified as low-level disinfection (fail, 13.33%). Among different instrument types, the highest non-compliance rate was observed in cupping instruments (18.18%) within the departmental cleaning group. The difference in pass rates between the two groups was statistically significant (P < 0.001).
    CONCLUSIONS Centralized cleaning demonstrates superior disinfection effectiveness compared to departmental cleaning. It is recommended that high-risk items, such as non-precious cupping instruments, be included in the centralized cleaning protocol. This should be accompanied by strengthened management standards and interdepartmental collaboration to mitigate the risk of hospital-associated infections in TCM practice.

     

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