Hospital-acquired infections are a major obstacle to the quality of healthcare, and an important indicator for evaluating the quality of healthcare and the level of management. With the increasing number of interventional diagnosis and treatment in hospitals, the number of contaminated instruments recovered to the disinfection and supply center continues to increase, and the supply room is an important section of the hospital to supply a variety of sterile equipment and dressings, in order to do a good job of cleaning, disinfection and sterilization of contaminated instruments, at the same time, to do a good job of monitoring and management of sterile goods is to ensure that the quality of sterile goods and the safe use of clinical an important part of the link.
1. The general requirements of the supply room building and layout
Mainly: ① location close to the clinical departments, the surrounding environment is clean, no source of pollution. ② The room needs to form an independent region. ③ internal division of the contaminated area, clean area, sterile area, goods processing in order to move forward, not retrograde. ④ The room is well ventilated, clean and dust-free to avoid recontamination of disinfecting and sterilizing equipment. ⑤ The walls and ceilings are free of gaps, the floor is smooth, and there is a drainage channel for easy cleaning and sterilization. ⑥ The supply and quality of pressure steam for sterilization should be guaranteed. (vii) There shall be a recovery room, washing room, dressing making room, drying place for articles, cleaning and assembling room, sterilizing room, aseptic storage room, issuing room and dressing room, and so on. Conditions, there can also be a pyrogen monitoring room, office and restroom.
2. General requirements for the construction and layout of the supply room aseptic room
The aseptic area bears the task of storing sterile items. There are stainless steel storage shelves and stainless steel glass cabinets to store sterilized items. Aseptic articles storage room and ethylene oxide sterilization room and the next send car parking room are open double door transfer window, transfer window from the ground height of 90 cm, the size of the window for the 80 cm × 80 . Area of no water, no vapor original. In order to ensure the environmental quality of sterile goods storage area, in the clean area and sterile area installed 10,000 air laminar flow of the clean room,  the purpose is to use the air pressure is different, to prevent the nearby rooms of the contaminated air into the aseptic room; air through the primary, medium and high efficiency filters to remove dust and bacteria to achieve the purpose of dilution of dust and bacteria indoors; control the temperature, humidity and ventilation, to provide a comfortable The environment is comfortable.
3. Strict implementation of the operating procedures
3.1 Recovered contaminated instruments and items in the contaminated area for classification, disinfection, cleaning, and then enter the clean area.
3.2 In the cleaning area to put a good washing quality of the items. In the cleaning area to do a good job on the items to remove dirt, remove heat, remove detergent, and fine washing four links.
3.2 Good packaging quality. The items are packed to achieve the right degree of tightness. After the items are packed, mark them clearly. And will indicate the disinfection time and expiration time of the 3m indicator tape affixed to the seal of the items to ensure that the effect of sterilization items and the effective use of time.
3.3 Adopt the correct sterilization method and strictly control the quality of sterilization.
The sterilizer should be operated in accordance with the "Sterilization Technical Specification", the sterilization process adhere to the workstation, correctly grasp the operating procedures of the sterilizer and the means of detection, focusing on the three major elements of sterilization: sterilization temperature, time, saturated steam. Routine inspection and hygiene cleaning of the sterilizer before daily sterilization, and the condensate in the pipeline is discharged (≥ 10 min) before the sterilization process. Adhere to each pot with four-ring 121 ℃ pressure steam sterilization chemical indication card and standard package to monitor the sterilization effect of the sterilizer. After sterilization items feel dry, moisture ≤ 3%, sterilization pass rate should reach 100%.
3.4 Strictly good storage of sterile items. Sterilized items into the aseptic room should be placed in categories, and according to the recent sterilized in the back, far sterilized in the order of the previous placement, managed by a special person, a special person to issue, and then to do a daily inventory to check whether there is no expiration date of the items, the issue of the check, in order to prevent the wrong issue.
3.5 Strictly monitor the quality of sterile items. In order to prevent contamination of sterilized sterile items, we insist on wet mopping the floor of the sterile room twice a day with disinfectant. Air disinfection with high-intensity circulating wind ultraviolet dynamic disinfector, circulating wind disinfector has a good bactericidal effect, the natural bacteria of indoor air can meet the disinfection requirements. Regularly monitor the effect of ultraviolet disinfection. According to the 2002 version of the "Disinfection Technical Specification" standard, the air in the supply room sterile room (clean area) is class II environment indoor air, the total number of bacteria in the air ≤ 200 cfu/m3. to achieve the above standard is up to standard. The air sterilization effect of the sterile room directly affects the quality of sterile goods, the incidence of hospital infections and the quality of medical care has a greater impact.
4. Strictly grasp the quality of disposable sterile articles
4.1 Check when entering the warehouse of disposable sterile medical articles
Carefully check each batch of number of inspection certificate, sterilization date, date of shipment, expiration date, whether the outer packaging is intact, and so on, qualified before going through the procedures of warehousing.
4.2 Strict storage of disposable medical supplies
4.2.1 Environmental requirements for storage of disposable medical supplies Requirements for the storage of disposable medical supplies in a cool, dry, clean and well-ventilated warehouse. Air conditioners, dehumidifiers and air sterilization equipment are installed in the room. The bacterial content of the air should be ≤500cfu/m3, the temperature should be 18℃～22℃, and the relative humidity should be maintained at 50%～60%. The storage cabinet is on the storage mat 20cm from the ground, 50cm from the ceiling and 5cm from the wall.
4.2.2 Specialized management Specialized management of disposable sterile medical supplies, regular inventory of items and records. Do send and receive the same, found unqualified products immediately stop the issuance and use, and notify the relevant departments to track the recall.
4.3 Strictly grasp the distribution of sterile goods
4.3.1 Strictly implement the distribution system Follow the principle of first-in-first-out when distributing, and carefully check the validity of disposable sterile goods, the integrity of the packaging, etc., and do not distribute unqualified products such as broken packaging, failure, etc. to the clinic.
4.3.2 Issuance of complete records, traceability should be recorded as the date of discharge of disposable sterile medical articles, name, specifications, quantity, manufacturer, production batch number, sterile date, expiration date and use of the department, etc., in order to establish a quality traceability system, and to find problems in a timely manner to investigate and improve.
5. Strictly grasp the sterile goods and disposable sterile goods distribution environment
In order to avoid contamination of sterile goods in the distribution of the monthly distribution of sterile goods to do the environment of the air culture and the distribution of personnel hand culture, air bacterial content of ≤ 200cfu / m3 [1], the hand of the bacterial content of ≤ 5cfu/m3. At the same time the distribution of the car sent down to the end of the end of the car with 500-1000mg / L effective chlorine immediately after the end. -1000mg/L effective chlorine disinfectant solution wipe, rinse, dry, spare, to avoid contamination caused by the delivery link. Strictly differentiate between sterile and contaminated items when receiving and sending down to avoid contamination of sterile items.
Doing a good job of monitoring and management of sterile goods in the supply room and grasping the quality of sterile goods can effectively prevent and control the occurrence of nosocomial infections, and play a positive role in improving the level of diagnosis and treatment, the quality of nursing care, and work efficiency.