Latest Issue
      Vol. 3 ， Issue 2 ， 2024

        MONOGRAPHIC STUDY

      • Lili Guo,Jingyi Lv,Ying Huang
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.01
        Abstract：ObjectiveThe purpose of this study is to understand the working habits of healthcare workers and the contamination of ultrasound instrument surfaces in the ultrasound clinic of infectious disease hospitals, and to explore the effect of disposable medical disinfectant wipes on disinfecting the surface of ultrasound instruments, so as to provide reference for the infection control in the department of medical ultrasound.MethodsA questionnaire survey was conducted on the working habits of 24 staff in the ultrasound department. According to the Hygienic Standard for Hospital Disinfection (2012-GB15982), the surfaces (probes, wires, and keyboards) of 16 ultrasound diagnostic instruments currently in use were examined for colony sampling and cleanness. Disposable medical disinfectant wipes containing compound double-chain quaternary ammonium salt were used to wipe and disinfect the probe, and the samples were sampled and tested again after disinfection. A total of 256 samples were effectively detected. The number of colonies and cleanness of each tested site before and after disinfection were compared and analyzed.ResultsThe frequency of work clothes replacement, hand hygiene implementation, frequency of ultrasound probe cleaning and disinfection in the clinic exceeding standard were lower than those in the clinic non-exceeding standard. The cleanliness of 256 samples after cleaning and disinfection did not exceed the standard, and the number of colonies exceeding the standard was significantly reduced after disinfection (P<0.001). The contamination of the probe, instrument keyboard surface, and wire using disposable medical disinfectant wipes after cleaning and disinfection was significantly improved compared to the contamination before cleaning and disinfection. There was a statistically significant difference between the ultrasound probes before and after cleaning and disinfection (P<0.05).ConclusionBad working habits of medical staff lead to serious pollution of instrument surfaces. The surface of the medical ultrasonic diagnostic instruments, especially the surface of the ultrasound probe, is seriously polluted. The disinfectant wipe containing compound double-chain quaternary ammonium salt has a good disinfection effect on ultrasound probes.  
        Keywords：Ultrasound probe;Compound double-chain quaternary ammonium salt;Disinfection effect;Habits of medical staff   
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        Published：2024-12-19
      • Xiaojia Li,Mingchun Yang,Jianrui Yang,Yanjuan Shi,Xiaorui Wei
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.02
        Abstract：ObjectiveThe present study aims to detect the inner wall cleanliness of spinal luminal instruments with visual track viewer, and to analyze the difficulties of spinal surgical instruments cleaning, so as to improve and perfect the cleaning quality.Methods226 luminal spinal instruments were selected. The luminal cleaning quality of instruments after mechanical cleaning and manual cleaning plus mechanical cleaning were examined by visual track viewer, and the results were statistically analyzed.ResultsIn the control group, 113 instruments were cleaned by mechanical cleaning. The clearance rate was 90.26% for bloodstain, 78.76% for stain, 72.57% for foreign body, and 85.84% for tissue residue. In the experimental group after manual cleaning and mechanical cleaning, the clearance rate of bloodstain was 100%, stain was 96.46%, foreign body was 92.03%, tissue residue was 100%. The pollutant clearance rate of experimental group was significantly higher than that of control group (P<0.05).ConclusionThe structure of spinal surgical instruments is complex, and they are difficult to clean. The use of visual track viewer can clearly detect the inner wall of the lumen, find out the cleaning difficulties, check the cleaning quality, and effectively ensure the safety of surgical instruments.  
        Keywords：Luminal instruments;Visual track viewer;Cleaning quality testing   
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        Published：2024-12-19
      • Yuhua Zhu,Haiyan Gu,Xiyan Ren,Yun Wang,Yunjuan Qian
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.03
        Abstract：ObjectiveThe present study investigates the application and effectiveness of an automated guided vehicle (AGV) and a sterilization monitoring report in the disinfection and sterilization process.MethodsThe AGV is applied for auto loading and unloading in the disinfection and sterilization process and for route planning. A reusable instrument transportation management mode and AGV instruction system are constructed. Following the requirements of the Central sterile supply department (CSSD) - Part 3: Surveillance standard for cleaning, disinfection and sterilization (WS 310.3—2016) for recording critical factors affecting the sterilization process and results, this study used the information tracking system in the central sterile supply department (CSSD) to automatically capture all critical points in time, temperature, and temperature from the equipment monitoring system. In addition, the actual value and the reference value items in the process flow sheet were set up using the clinical chemical examination report template to automatically determine whether the parameters comply with the requirements; parameter abnormalities are displayed with red arrows. The results of chemical and biological monitoring of sterilized items were recorded using a scanner to form a sterilization monitoring report.ResultsIn comparison between before and after the application of AGV, the daily manual transportation and time consuming were reduced from an average of 5 minutes to an average of 1 minute, with a statistically significant difference (P<0.01). In comparison between the sterilization monitoring report before and after the application, the recording time of parameters and monitoring identification was reduced from an average of 3.5 minutes to an average of 1 minute, with a statistically significant difference (P<0.01). A satisfaction survey was conducted from the dimensions of environment, occupational exposure, simplicity of operation, physical exertion, time consuming, and pleasure. The satisfaction rate increased from 75% to 98.4%.ConclusionAGV is an intelligent logistics system that replaces repetitive and unitary manual labor and significantly improves the work efficiency of sterilization operators. It is closely connected with the Internet of Things (IOT), intelligent devices, and information tracking system to realize the intelligent construction of CSSD by reducing occupational injuries such as lowering physical exertion and simplifying operations, and to improve the satisfaction of sterilization operators. The combined application of sterilization monitoring report can not only improve the work efficiency, but also reduce the misidentification of the process flow sheet to reduce the occurrence of adverse events and improve the quality of work.  
        Keywords：Automated guided vehicle;Sterilization monitoring report;Disinfection and sterilization process   
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        Published：2024-12-19
      • Aiqin Li,Congmin Wang,Na Li,Haitao Li,Qian Kang
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.04
        Abstract：ObjectiveThe present study investigates the application of three cleaning quality detection methods in the cleaning effect of endoscope.MethodsFrom June to December 2023, 840 lumens from the postoperative endoscopes in the operating room of the Seventh Medical Center of the PLA General Hospital were selected and randomly divided into groups A, B, and C, with 280 in each group. The cleaning quality was detected before pretreatment, after pretreatment, and after cleaning and disinfection. Group A carried out in-situ protein fluorescence detection, group B carried out visual inspection + the visual trail viewer detection, and Group C carried out a combination of the three detection methods.ResultsThe pollution status of the three groups A, B, and C were not statistically significant before pretreatment (χ2=0.474, P=0.789). After pretreatment, the cleaning status of groups A, B, and C was not statistically significant (χ2=0.204, P=0.903). However, after cleaning and disinfection, there was a statistical difference in the qualified rate of cleaning among groups A, B, and C (χ2=15.777, P<0.001). Further comparison between the two groups revealed that there is no statistically significant difference in the cleaning qualification rate between group A and group B (χ2=0.207, P=0.649), while statistically significant differences were found between group A and group C (χ2=11.293, P=0.001), and between group B and group C (χ2=8.723, P=0.003).ConclusionA combination of visual inspection, visual trail viewer detection, and in-situ protein fluorescence detection effectively improves the cleaning effect of endoscope tubes.  
        Keywords：Endoscope;Lumen instrument;cleaning;Trail inspection system;In-situ protein fluorescence detection   
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        Published：2024-12-19
      • Lijun Cai,Tingting Lin,Chufen Zhuang,Yu Zhang,Xingling Deng
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.05
        Abstract：ObjectiveThe present study intends to observe the cleaning effect of different detection methods in cleaning silicone tubes used in phacoemulsification.MethodsA total of 100 silicone tubes were selected randomly after surgery. The silicone tubes were retained for ≤2 hours after surgery, and then washed with a high-pressure water gun at a flow rate of 12~14 ml/s. Adenosine Triphosphate (ATP) detection and quantitation of residual protein were performed on the samples before cleaning and after washing for 30 s, 40 s, and 50 s, respectively, including the sample surface and the water after cleaning.ResultsAccording to the results before and after cleaning the silicone tube, there are significant differences in three methods of quantitation of residual protein, ATP detection in water sample, and ATP detection in sample surface (c2=8.6, P<0.05), while having no difference between the three methods after washing for 30 s, 40 s and 50 s, respectively (c2=4.918 and 5.571, P>0.05). A comparison of the means of ATP detection in water samples showed significant differences between rinses 30 s/40 s and 30 s/50 s. (Z=-7.45 and -0.08, P<0.05); pairwise contrast of ATP detection in sample surface for rinsing 30 s/40 s, 40 s/50 s, and 30 s/50 s showed significant differences (Z=3.64, 14.92, and 25.86, P<0.05). The quantitation of residual protein in silicone tubes showed pass rates of 84%, 100%, and 100% for 30 s, 40 s, and 50 s, respectively.ConclusionQuantitation of residual protein, ATP detection in water sample, and ATP detection in sample surface are available for monitoring the cleaning quality of silicone tube. The tube should be cleaned at a 12~14 ml/s flow rate and a washing time of ≥50 s.  
        Keywords：silicone tube;ATP;Quantitation of residual protein;cataract   
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        Published：2024-12-19
      • Xiaoying Lai,Zhijuan Xu,Wei Zheng
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.06
        Abstract：ObjectiveThe present study intends to compare four aluminum foil placement modes in testing the cavitation effect of an ultrasonic cleaning machine so as to provide a reference for the operation in the central sterile supply department (CSSD).MethodsThe experiments were divided into Group A, Group B, Group C, and Group D according to the aluminum foil placement modes recommended by different national guides. Each group conducted 20 experiments before and after the failure of the simulated ultrasonic cleaning machine. The four groups' operation time, false positive rate, and fault detection ability were compared.ResultsThe operation time was Group A>Group B>Group C>Group D. The false positive rate of Group C was higher than that of Group A and Group D (all P<0.008). The fault detection ability of Group A and Group C was higher than that of Group B and Group D (all P<0.008).ConclusionThe aluminum foil placement mode of Group A, i.e., one aluminum foil placed along the diagonal perpendicular to the bottom of the sink, has the shortest operation time and most reliable results, which is worth popularizing in CSSD.  
        Keywords：Ultrasonic cleaning;Cavitation effect;Aluminum foil corrosion method;Central sterile supply department   
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        Published：2024-12-19

        TECHNOLOGICAL INNOVATION

      • Yuanlian Zhao,Jie Yang,Anchan Zhou,Yue Xie
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.07
        Abstract：ObjectiveThe present study scientifically and reasonably designs a water treatment system for the central sterile supply department (CSSD) to achieve standardized water use, ensure the safety of instrument treatment, and reduce water resource waste.MethodsFollowing the principle of using water in the CSSD, the design concept of the water treatment system is sorted out, and the implementation plan of the water treatment system is scientifically designed. Two sets of water treatment systems are connected in parallel to ensure an uninterrupted water supply in case of equipment failure. At the same time, the concentrated water produced during the production of pure water and the hot and soft water for sterilization cooling is recycled and reused, and the relevant operation of the water treatment system is monitored.ResultsPure water and soft water were sampled from the sampling ports of the water treatment system. The conductivity monitoring of pure water was qualified. The hardness of the soft water was once found to be unqualified, but after replacing the failed resin, the hardness test passed. About 10 tons of concentrated water as well as about 30 tons of hot and soft water were recycled and reused daily.ConclusionWhen designing a water treatment system, it is necessary to fully understand instrument processing capacity and the usage of softened and purified water in the hospital, configure equipment according to peak usage, and recycle concentrated water and water for sterilization to achieve the goal of energy conservation and consumption reduction.  
        Keywords：Central sterile supply department;Water treatment system;Operation;Energy Saving   
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        Published：2024-12-19
      • Jianli Fan,Yajuan Wang,Chunfeng He,Yeyuan Chu,Mingxia Gu
        Vol. 3, Issue 2, (2024) DOI: 10.11910/j.issn.2791-2043.2024.2.08
        Abstract：ObjectiveThe present study aimed to explore the application effect of business process management (BPM) in processing external medical devices and implants.MethodsThe convenience sampling method was applied to select 150 sets of external medical devices and implants used in the Sir Run Run Shaw Hospital affiliated with the Zhejiang University School of Medicine from October to December 2022 as the control group, and 150 sets from January to March 2023 as the experimental group. The traditional manual method of processing information flow was performed in the control group, while BPM was applied in the experimental group. The premium processing rate, the acceptance rate of timely delivery, the closed-loop traceability system of nosocomial infection information, the missed delivery rate, the handover time, and the medical personnel satisfaction with suppliers were compared for same label from same supplier.ResultsThe effective acceptance rate, the closed-loop traceability rate, and the satisfaction were higher than those before the application of BPM, and the difference was statistically significant (P<0.05). However, the handover time, the delivery time, the premium processing rate, and the missed delivery rate were lower than those before the application (P<0.05). The satisfaction was 98.7%.ConclusionBPM contributes to the standardization of quality surveillance on external medical devices and implants in the hospital, improves the quality control of the whole process, enhances work efficiency and staff satisfaction, and reduces the occurrence of potential safety risks.  
        Keywords：External medical devices;Implant;Business process management (BPM);Hospital;Application effect   
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        Published：2024-12-19
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