
影響(xiǎng)清洗效(xiào)果的因素
Factors affecting cleaning effectiveness
消毒供應中心是負責醫療器械清洗消毒處理的部門,隨著手術量日益的增長,很多醫療機構消毒供應中心使用全自動清洗消毒機處理醫療器械(xiè)清洗已(yǐ)經成(chéng)為主要(yào)清洗手段。機械清洗分為全(quán)自動、半自動、超聲清洗機、長龍式等多種形式,有的清洗機帶加(jiā)熱係統和幹燥係統。
The disinfection supply center is the department responsible for cleaning and disinfecting medical equipment. With the increasing number of surgeries, many medical institutions' disinfection supply centers use fully automatic cleaning and disinfection machines to clean medical equipment, which has become the main cleaning method. Mechanical cleaning is divided into various forms such as fully automatic, semi-automatic, ultrasonic cleaning machines, and long queue cleaning machines. Some cleaning machines are equipped with heating and drying systems.
目前國內部分醫院采用機械清洗,全自動噴淋式清洗消毒機清洗手術器械前使用多(duō)酶液浸泡器械的方法,可使同一部器械表麵、軸節、咬合麵的清洗質量明顯提高。超聲波自(zì)動清洗機的洗淨作用是極高頻率水的擠壓產生水泡形成真空區而產生拉力,將附在器械上的汙垢(gòu)鬆動吸離,它比人工清洗好的理由是(shì)它可以清除刷子無法觸及的(de)汙物(wù)。
At present, some hospitals in China use mechanical cleaning and fully automatic spray cleaning and disinfection machines to soak surgical instruments in multi enzyme solution before cleaning, which can significantly improve the cleaning quality of the same instrument surface, joint, and occlusal surface. The cleaning function of an ultrasonic automatic cleaning machine is to create a vacuum zone by squeezing water at extremely high frequencies, which generates tension and loosens dirt attached to the instrument. The reason why it is better than manual cleaning is that it can remove dirt that cannot be touched by brushes.
相比於(yú)手工清洗,全自動清(qīng)洗消毒機的機(jī)械清洗過程是一個多因素參與的複雜過程。不同廠家不(bú)同規格型號的全自動清洗消毒機清洗過程不同,清洗效果主要影響因素包括噴淋機械力,器械清洗(xǐ)劑,清洗溫(wēn)度(dù),清洗時間以及清洗用水的水(shuǐ)質等。每(měi)個因素的改變不僅會影響(xiǎng)整體清洗效果(guǒ),也可能會影響到其它因素的作用效果。
Compared to manual cleaning, the mechanical cleaning process of fully automatic cleaning and disinfection machines is a complex process involving multiple factors. The cleaning process of fully automatic cleaning and disinfection machines of different manufacturers and specifications varies, and the main factors affecting the cleaning effect include spray mechanical force, instrument cleaning agents, cleaning temperature, cleaning time, and the quality of cleaning water. The changes in each factor not only affect the overall cleaning effect, but may also affect the effectiveness of other factors.
一、噴淋機械效果
1、 Spray mechanical effect
全自動清洗消毒機的(de)噴淋清洗的出(chū)水口水壓、水量是形(xíng)成噴淋機械力(lì)的主要(yào)因素。噴淋出水口的出水的水壓越大,水量越大(dà),形成的機械清洗(xǐ)力(lì)越強,更容易把醫療器械表麵的汙染物(wù)質(zhì)衝洗幹淨。過大的機械(xiè)力會對器械,尤其是一些精細部位造成損傷,降低器械的使用壽命,合理設置清洗機的水壓和水(shuǐ)量保證(zhèng)既不損傷醫療器(qì)械又能達到良好的清洗效果尤(yóu)為重要。此外,噴淋懸臂的正常運作與否,醫療器械的裝載是否合理等都會影響噴淋的作(zuò)用效(xiào)果。
The water pressure and volume at the outlet of the fully automatic cleaning and disinfection machine's spray cleaning are the main factors that form the mechanical force of the spray. The higher the water pressure and volume of the water from the sprinkler outlet, the stronger the mechanical cleaning force formed, making it easier to wash away the pollutants on the surface of medical devices. Excessive mechanical force can cause damage to medical equipment, especially some delicate parts, reducing the service life of the equipment. It is particularly important to set the water pressure and volume of the cleaning machine reasonably to ensure that it does not damage medical equipment and can achieve good cleaning results. In addition, the normal operation of the spray cantilever and the reasonable loading of medical equipment will affect the effectiveness of the spray.
二、多酶清洗劑
2、 Multi enzyme cleaning agent
研究(jiū)表明,發現單純的機械清洗對殘存有有機物的(de)器械達不到理想的(de)清洗效果(guǒ),而使用多酶液浸泡手工刷洗再清洗機清洗的效果更好。用於醫(yī)療器械清洗的(de)含酶清(qīng)洗劑本身的性質,使用時(shí)的(de)稀釋濃度,稀釋用水的水質都會直接(jiē)影響清洗效果。如果清洗劑(jì)與醫療器械材質不兼容,不僅(jǐn)會(huì)造成汙染物殘留,還會對醫療器械造(zào)成(chéng)損傷;如果清洗劑稀釋使用濃度過低,容易造成(chéng)汙染物質殘留,經(jīng)過後續幹燥過程,汙物在醫療器械表麵(miàn)幹涸,更(gèng)難去除,而如果使(shǐ)用清洗劑的濃度過高,則會成為成本(běn)上的浪費。另外,稀(xī)釋用水的水質(zhì)過硬或(huò)者含有有機物(wù)質,很容易造成清(qīng)洗劑失活。同時,清洗時的水溫溫(wēn)度,清洗劑接觸時間也會影響清(qīng)洗劑(jì)的作用,常規清(qīng)洗(xǐ)劑的時間(jiān)不低(dī)於120秒鍾。
Research has shown that mechanical cleaning alone does not achieve ideal cleaning results for instruments with residual organic matter, while using a multi enzyme solution soaked in manual scrubbing followed by cleaning with a cleaning machine yields better results. The properties of enzyme based cleaning agents used for medical device cleaning, the dilution concentration during use, and the water quality of the dilution water all directly affect the cleaning effect. If the cleaning agent is incompatible with the material of the medical device, it will not only cause residual pollutants, but also damage the medical device; If the dilution concentration of the cleaning agent is too low, it is easy to cause residual pollutants. After the subsequent drying process, the dirt will dry up on the surface of the medical device, making it more difficult to remove. If the concentration of the cleaning agent is too high, it will become a waste of cost. In addition, the water used for dilution is of high quality or contains organic substances, which can easily cause the cleaning agent to become inactive. At the same time, the water temperature during cleaning and the contact time of the cleaning agent can also affect the effectiveness of the cleaning agent. The time for conventional cleaning agents is not less than 120 seconds.
三、清洗溫(wēn)度(dù)
3、 Cleaning temperature
常規清洗劑清洗時水溫的溫度越高,越容易發揮清洗劑(jì)效(xiào)果,清(qīng)洗效果(guǒ)也越好。但是醫療(liáo)器(qì)械清洗溫度的設定應該考慮到汙物(wù)在高溫(wēn)下凝結變性問題,酶清洗(xǐ)劑在過高的溫度下容易失去活性,一般含酶清洗劑要求水溫25℃~55℃之間。
The higher the water temperature during regular cleaning with cleaning agents, the easier it is to achieve the cleaning effect and the better the cleaning effect. However, the setting of the cleaning temperature for medical devices should take into account the problem of dirt condensation and denaturation at high temperatures. Enzyme cleaning agents are prone to lose their activity at excessively high temperatures, and generally require a water temperature between 25 ℃ and 55 ℃ for enzyme containing cleaning agents.
需要特別注意的是清洗劑中表麵活(huó)性劑發揮作用也需要適宜的溫度。
It should be noted that the surfactant in the cleaning agent also requires a suitable temperature to function effectively.
四、清(qīng)洗時間
4、 Cleaning time
清洗時間越長,越有利於清洗徹底。但是(shì)過長的清洗時間不僅(jǐn)造成(chéng)成本上的浪費,也會影響整個醫療器械(xiè)再處理的進度(dù)。清洗時(shí)間設定過短則不利於清洗劑在醫(yī)療器械表麵停留。
The longer the cleaning time, the more conducive it is to thorough cleaning. However, excessive cleaning time not only results in cost waste, but also affects the progress of the entire medical device reprocessing. Setting the cleaning time too short is not conducive to the cleaning agent staying on the surface of medical devices.
影響醫療器械清洗效(xiào)果(guǒ)的因素繁多複雜且互相影(yǐng)響,臨床(chuáng)操作要嚴格按照產品廠(chǎng)家說明書操作和執(zhí)行,每批次監測清洗消毒器的物理參數及運轉情況,記錄並(bìng)歸檔(dàng),對清洗(xǐ)消(xiāo)毒器的效果可每年采用清洗效果指(zhǐ)示物(wù)進行監測,每年檢測清(qīng)洗消毒器的主要性能參數,如時間、溫度、A0值等。清洗消毒器新安裝、更新、大修(xiū)更換清洗劑、改變消(xiāo)毒參數或裝載方法(fǎ)等時(shí),應遵循生產廠家的使用說明或指導手冊進行檢測(cè),清洗消毒質量檢測合格後,清洗消毒器方可使用。
There are numerous and complex factors that affect the cleaning effect of medical devices, and they interact with each other. Clinical operations must strictly follow the product manufacturer's instructions, monitor the physical parameters and operation of each batch of cleaning and disinfection equipment, record and archive them, and monitor the effectiveness of cleaning and disinfection equipment annually using cleaning effect indicators. The main performance parameters of the cleaning and disinfection equipment, such as time, temperature, A0 value, etc., should be tested annually. When installing, updating, repairing, replacing cleaning agents, changing disinfection parameters or loading methods, etc., the cleaning and disinfection equipment should be tested according to the manufacturer's instructions or guidance manual. After passing the quality inspection of cleaning and disinfection, the cleaning and disinfection equipment can be used.
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