1, the principles of management countermeasures set In order to strengthen the quality of disinfection technology in our hospital, set management countermeasures is a vital issue. Practical, simple, convenient and effective is the basic principle of setting management countermeasures. In use, only let the user feel that the implementation of the method of practical, will maximize the provisions to do, only brief only in line with the dental clinic nervous and heavy tasks to complete the needs. The most convenient will only realize the most effective medical and nursing work safety.
2, classification of the development of appropriate management countermeasures To ensure the effectiveness of the dental clinic disinfection, we have developed various types of oral medical equipment and items disinfection process management countermeasures; clinic indoor air disinfection management countermeasures; medical waste disposal management countermeasures for the safety of medical waste, etc..
(1) Various types of medical equipment and articles disinfection process management countermeasures Dental instruments to implement a double disinfection system.
Soaking: Soak with Jianzhixin soaking instant disinfectant tablets (the main ingredient is trichloroisocyanuric acid) for more than 30min and then clean:
Cleaning: Due to the process of treatment of oral diseases, handpieces or other instruments inevitably get stained with bacteria-containing materials such as patient's saliva, blood, etc., and some dirt is attached at the same time. Such dirt should be cleaned before formal sterilization. Enzyme-containing cleaning solution can be used, put into the ultrasonic cleaning machine for cleaning, not only can the surface of the phone to wash the dirt, but also the phone inside (such as cell phone core and pipe) to remove the dirt, so as to achieve the inside and outside of the clean.
Oil refueling: connect the lubricating cleaning oil interface to the cell phone oil hole, inject the lubricating oil into the cell phone to the front of the phone until the oil is sprayed out. Through refueling, you can make the inner wall of the cell phone pipe and the bearings in the core of the shaft covered with a layer of oil film, which can avoid oxidation of the cell phone metal in high-pressure steam sterilization, thus extending the service life of the cell phone. In addition to the handset outside the oral instruments on the oil more paraffin oil wipe maintenance.
Sealing: sealing is the use of sealing machine will be added to the oil of the phone or instrument sealed in a sterilized paper bag, and then into the autoclave. The main significance of the seal is: ① can test whether the sterilization to achieve the desired effect; ② can distinguish between oral instruments have been sterilized; ③ can avoid contamination of sterilized instruments and other storage; ④ open that is to be used, easy to operate; ⑤ to prevent evaporation of lubricating oil, the accumulation of a long time caused by the internal contamination of the sterilizer (usually sterilized bags on the disinfection indicator, before and after the sterilization, the color of the paper bag has a change in the color of the bag, through the color change, you can know the bag inside the sterilization equipment, and then put it into the steam autoclave. (Usually there is a sterilization indicator on the sterilization bag, the color of the paper bag changes before and after sterilization.)
Sterilization: There are two commonly used sterilization methods in stomatology, high-temperature instruments such as sealed handpieces, etc. are sealed in disposable plastic bags and put into autoclave according to the operating instructions for sterilization operations. After sterilization, they are put into the sterile containers in the clean area for spare parts. Sterilization temperature 134 ℃, sterilization time 35 ~ 40 min. not resistant to high temperature instruments into 2% glutaraldehyde (molecular formula C5H8O2, molecular weight 100.13) immersion sterilization sterilization.
Precautions: ① 2% glutaraldehyde has a strong corrosive immersion disinfection of instruments need to be rinsed with distilled water, dry with a sterile towel before use. ② 2% glutaraldehyde is irritating to the skin and mucous membranes, contact with glutaraldehyde solution should wear rubber gloves, but also to prevent splashing into the eyes or inhalation. Sterilization time 10h. ③ Glutaraldehyde should be added 0.5% sodium nitrite to prevent rust before use. The container containing glutaraldehyde disinfectant should be covered and placed in a well-ventilated place. (5) Other: clean area supplies such as storage tanks, square trays with lids and other weekly replacement of disinfection and autoclaving once. Dry forceps jar and holding forceps autoclaved every 4h. Part of the open sterile items sterilized every 24h.
(2) indoor air disinfection management countermeasures
Disinfection of health standards for various types of treatment rooms, consultation rooms, dressing rooms should be disinfected to achieve the total number of bacteria in the air ≤ 500cfu / m3. our commonly used air disinfection method is ultraviolet irradiation disinfection method. Some reports show that: diagnosis and treatment room in the room temperature 19 ℃ ~ 20 ℃, relative humidity 48% ~ 59% of the conditions, with ultraviolet radiation 30min, can make the total number of airborne bacteria ≤ 500cfu/m3. ultraviolet irradiation energy is low, weak penetration, can only kill the microorganisms that directly irradiated, so disinfection must be disinfected parts of the full exposure to ultraviolet light. UV disinfection of the appropriate temperature range is 20 ℃ ~ 40 ℃, the temperature is too high or too low will affect the disinfection effect, can be appropriate to extend the disinfection time for air disinfection, disinfection of the environment, the relative humidity is less than 80% is good, otherwise should be appropriate to extend the irradiation time. According to these characteristics of ultraviolet disinfection of my department to use the clinic after the suspension of daily ultraviolet radiation disinfection 2h, and fill in the irradiation after the registration card for monitoring.
(3) Management countermeasures for safe disposal of medical waste
In order to prevent the spread of disease and protect the environment, safe disposal of medical waste is very important. Our hospital's medical waste is collected and disinfected by the medical waste disposal center every day. Medical waste such as bloody dressings and disposable instrument boxes are closed in yellow plastic bags. Sharps are enclosed in sharps boxes. Specialized personnel will collect and transport the medical waste and fill in the registration form, including the date, name, quantity, weight, department of delivery, deliverer and collector, etc., and strictly keep the handover records. Containers for storing medical waste should be disinfected by wiping with chlorine disinfectant in a timely manner every day, and then disinfected with ultraviolet light for 60min.