| Nowadays, the relatively widespread problem in medical institutions is that the endoscopic cleaning and disinfection is not carried out by standard procedure. This study shows the situation of endoscopic cleaning and disinfection in medical institutions of Zhejiang Province in 2008 and 2009, analyzing the existing circumstancesand problems, and evaluating the current supervision system. The study also shows the effectiveness of key intervention conducted in Yinzhou District of Ningbo City.ObjectiveTo understand the current situation of endoscope usage, its cleaning and disinfection, evaluate its effectiveness after intervention, and provide basic evidence for administrative decision. Materials and MethodsQuestionnaire investigation on endoscope cleaning and disinfection is applied to native medical institutions of Zhejiang Province, according to "The Technical Operation Criterion of Cleaning and Disinfection for Endoscope" (2004 Edition).425 medical institutions providing with endoscope in Zhejiang Province were investigated in 2008. 451 medical institutions providing with endoscope in Zhejiang Province were investigated in 2009.A pilot point to point intervention of endoscope cleaning and disinfection was carried out and evaluated in 14 medical institutions in Yinzhou District of Ningbo City.ResultsThe number of medical institutions providing with endoscope increased by the rate of 6.1% from 2008 to 2009. There existed differences in distribution of medical institutions providing with endoscope between different areas with different economical level,49.2% of which were in developed areas such as Hangzhou, Ningbo and Wenzhou, and 11.7% were in developing area such as Lishui, Quzhou and Zhoushan. The eligible rate of the cleaning and disinfecting to endoscope and its clinic environment in 2009 (80.5%) was a little higher than that in 2008(78.1%) with no significant difference. The eligible rate of endoscopic equipment to demand treatment in 2009 (89.8%) was little higher than that in 2008 (89.1%). The eligible rate of daily monitoring of endoscopic cleaning and disinfection decreased from 79.8% in 2009 to 83.5% in 2008 with no significant difference. The eligible rates of the operating procedure of endoscopic cleaning and disinfection, disinfectant, and the overall laboratory testing results in 2009 (92%,99.5%and 91.8%) were higher than those in 2008 (86.1%,93.6%and 82.8%) with statistical significant difference(X2= 7.88, P=0.005; x2=23-87,=0.0001;X2=1.413, P=0.006, respectively). After pilot point to point intervention, the eligible rate of endoscopic hardware equipment, quality control and laboratory testing results in Yinzhou District reached 100%, which were higher than 浙江大学硕士学位论文摘要those on 2009's level (80.5%,79.8%and 91.8%, respectively). However, the eligible rate of the operating procedure of endoscopic cleaning and disinfection was a little higher than that on 2009's level (92.8%Vs.92.1%), and that of endoscope equipment was lower (64.3%Vs.89.8%).ConclusionThe comprehensive evaluation shows that the current supervision system in Zhejiang Province is effective, and it can improve the normalization of endoscope usage. The eligible rate of investigation index during the key intervention in trial area is promoted highly than that by daily supervision on overall provincial level. However, the results suggest that the practical implementation of endoscope cleaning and disinfection criterion vary among different medical institutions in the degree and intensity. The supervision and inspection, the ability of self-management and rectification are also different. The existing major problems are:(1) Endoscopic equipment is not very sufficient. (2) Hardware equipment is hard to update and improve because of funds shortage. (3) Professional training was insufficient with lack of staid technicians and operators. (4) The governmental supervision should be strengthened and perfect. |
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