First, the disinfection supply room work system

1. The disinfection supply room is responsible for the cleaning, disinfection, sterilization and preparation and supply of medical equipment in the hospital. According to the needs of each subject, configure various items, and adjust the base according to the use situation to ensure clinical use and reduce invalid reserves.

2. Strictly divide the three areas (contaminated area, clean area, aseptic area). Staff should strictly abide by the work procedures and operating procedures of each district.

3, all kinds of sterile items should indicate the name of the product, sterilization period, expiration date and packager number, and be kept in special shelves, counters, special personnel to ensure the quality of sterile items. If it exceeds the validity period, the visual inspection is unqualified or suspected to be contaminated, it should be re-treated and distributed after sterilization.

4. Regularly carry out various monitoring of the room, do a good job in monitoring the infection in the hospital to ensure the quality of work. All kinds of equipment and dressings should meet the standard requirements.

5, the establishment of the accounts of various departments and items, and the system of requesting, disbursing, and reporting damages, regular inventory, trade-in, to match the accounts, to prevent the loss of waste; for the various items issued should be dedicated to the use of special items, can not be used for other purposes.

6. Receive and deliver on time to ensure the supply of sterile items.

7. Regularly use the department to solicit opinions and improve the work in a timely manner.

8. Establish emergency plans for power outages, water cuts, sterilizer failures, and disposal procedures for accidents.

Second, disinfection and isolation system

1, working hours staff must be clean and tidy, no jewelry.

2. Wear gloves when collecting dirt and wash your hands before and after handling.

3. Under the lower collection, the “dirty” and “clean” marks are obvious. After the work is finished, wipe it with disinfectant.

4. All operations should be carried out strictly according to the divided areas to keep the room clean and tidy.

5. No personal items may be stored in the workplace, and all equipment in the supply room shall not be diverted to private use.

6, the staff must check the body once a year, suffering from infectious diseases, skin diseases, etc. should be transferred.

7. Air, floor and surface disinfection (recycling room, roughing room, finishing room, packaging room, disinfection room, monitoring room, sterile room) are carried out daily in each working room. Learn the standards and keep the information.

8. Medical supplies used by infected patients are subject to special treatment.

Third, equipment and equipment maintenance system

1. Large and valuable instruments must be managed by special personnel and account registration.

2, each instrument should have strict operating procedures, precautions and routine maintenance measures, and strictly enforce.

3. Equipment and equipment should be cleaned and maintained before and after work every day.

4. Check and register the instrument in charge every week.

5. According to the regulations of the National Bureau of Safety, the safety valve, pressure gauge and temperature gauge of the pressure sterilizer are validated and recorded every six months. Before the new equipment is installed and the old equipment is repaired, it must have a performance appraisal record.

6. If the instrument fails, the head nurse should immediately notify the equipment department for maintenance.

7. After the repair, the equipment needs to pass the performance test and pass the inspection before it can be delivered, and the date of repair, the damaged parts, the repair results and the maintenance personnel and the inspection personnel are registered.

Fourth, the warehouse material management system

1. Special person management, responsible for planning, requesting all kinds of equipment, dressings, disinfection and monitoring supplies necessary for the supply room.

2. Strictly implement the item storage system, the packaging is intact, no rust, mildew and damage.

3. The manager regularly checks the appearance quality of various types of equipment, checks the validity period of products and small and medium-sized packaging, disinfectant and monitoring items, and plans to use them to prevent artificial waste.

4, the warehouse must be clean, dry, cool, well ventilated, no rodents.

5. The stored items are placed in an orderly manner. The shelf is not less than 20cm from the ground and not less than 5cm from the wall.

6. There is a record of the issuance of the item, the signature of the issuer and the owner, and the account is consistent.

7. The warehouse must not store personal belongings.

8. Strengthen the safety management of the warehouse, and routinely conduct safety inspections before work to eliminate safety hazards.

V. Safety management system

1. Under the leadership of the General Care Department, set up a departmental safety quality control team.

2. Regularly organize indoor staff to carry out legal regulations, fire protection knowledge and safety education, and establish safety awareness.

3, fire equipment has a special person to regularly check and manage, and to ensure that the performance of fire equipment is intact.

4. Strengthen the safety inspection of each studio. Before going to work every day, you should carefully check the hydropower facilities and other safety facilities of each studio to prevent fire, burglary, waterproof and explosion.

5, do a good job before the holiday security check, found that the problem should be resolved in a timely manner.

6. Strictly implement various technical operation procedures to ensure 100% pass rate of conventional equipment sterilization and prevent accidents.

Six, sterile room work system

1, aseptic management, adhere to the post, courteous service, work clothes, shoes, non-workers are not allowed to enter.

2. Wipe the table top and the floor with disinfectant every day to keep the environment clean and disinfect the air twice a day.

3. Sterile items are placed in an orderly manner. The date of issuance is short-term and long-term. The period from May 1st to September 30th is one week, and the period from October 1st to April 30th is two weeks.

4. For the distribution of sterile articles, the check-up system and the handover system shall be strictly implemented, and expired, wet, damaged packages shall not be issued, and the borrowed items must be registered.

5, monthly air culture, animal culture, heat source monitoring, in line with hygiene standards.

6, do a good job of inventory and handover work.

Seven, disinfection room work system

1. The disinfection room is managed by a person, and the disinfector is responsible for the disinfection and sterilization of medical items in the hospital.

2, the disinfector must be trained and certified to work.

3. During the disinfection period, strictly follow the operating procedures and stick to the job.

4. Regularly monitor the use efficiency of the sterilization pot to ensure safe use, and the sterilization rate of the items is 100%.

5. Items that have been “sterilized” and “not sterilized” are clearly marked and placed separately.

6. Seriously monitor the sterilization effect and record it.

7. Regularly carry out the maintenance of the sterilization pot and the indoor sanitation cleaning work. The daily air disinfection is once, and there are records.

8. Strictly carry out the standard inspection work on the “to be eliminated”, so that the delivery package is registered.

Eight, check the packaging room work system

1. The staff's clothes are neat and tidy, and they are prohibited from wearing jewelry and wearing slippers.

2. Strictly carry out the fine washing work procedures and equipment maintenance and packaging of the articles after the initial washing.

3, indoor items placed in order, wash hands before and after work, use disinfectant to wipe the desktop, the ground, daily UV disinfection, and make a record.

4. Check the card carefully before packing, check the performance of all kinds of equipment, clean cloth, no damage, cross dressing, and indicate the name, sterilization date, expiration date, work responsibility code.

5, a variety of medical treatment packages need to be sterilized by another person.

6, a variety of medical treatment packages, need to be re-processed and then packaged and sterilized.

7, daily registration, statistical work.

IX. Monitoring room work system and heat source response tracking system

1. Set up a full-time or part-time staff to be responsible for the monitoring of the room.

2. Disposable items, heat source detection for each batch of samples, and make a record.

3. Anyone who has a positive heat source monitoring will be forbidden to issue, and those who pass the retest will be given a return.

4. The heat source reaction occurs. The supply room should follow up the investigation, leave the sample in time, send it to the drug inspection department for testing, record it according to the regulations, and report it to the relevant department at a higher level.

5. Sterilize the quality of all sterilized items in the supply room to prevent unqualified items from flowing into the clinical department.

6. Strict quality monitoring to prevent unqualified products from entering the supply room.

Ten, handover system

1. The supply room is equipped with a weekly duty shift system. The duty personnel should strictly carry out the procedures for handing over the goods when they take over. When the shift is over, the problem is found to be responsible for the shift. The problems found after the succession are responsible for the successor.

2, a certain number of sterile items fixed, marked clearly, regular inspection of sterile items with or without expired, mildew and other phenomena, timely treatment. Ensure the supply of sterile items.

3. Invent the name, quantity and quality of the recovered items and register them. Borrowing items must be registered for borrowing.

4. Check whether the performance of the standing facilities in each studio is good, and report the problem to the head nurse in time.

XI, check the system

1. All kinds of medical treatment packages must be checked by the two persons before the packaging, the type, quantity, performance and quality of the equipment. After passing the test, the package can be sent to the sterilization room for sterilization.

2. When dispensing sterile items, carefully check the divisions, item names, quantities, sterilization dates, and expiration dates registered on the distribution form.

3. When retrieving items, check the name of the product, the type, quantity and performance of the equipment. The boxes, covers and objects are in conformity. The instruments used have been initially disinfected.

4. When the acid and alkali solution is configured, it needs to be checked by two people before it can be configured and used.

Twelve, head nurse duties

1. Under the direct leadership of the Nursing Department, the head nurse of the supply room is responsible for organizing the unified management and administrative management of the medical equipment, dressing vegetation, disinfection and sterilization work.

2. Supervise and urge the undergraduate personnel to conscientiously implement various rules and regulations and technical operating procedures to prevent accidents.

3. Regularly check the performance of the disinfection sterilizer and the concentration of various disinfectants. Frequently identify the disinfection and sterilization effects of equipment and dressings, find abnormalities, and immediately take response measures.

4. Organize personnel to strengthen safety awareness education and training and teaching of new recruits.

5. Responsible for the planning and requesting work of undergraduate medical equipment, dressings and disinfectants.

6. Organize undergraduate personnel to receive and send, and use the department to solicit opinions and improve work.

7. Organize undergraduate personnel to carry out professional theoretical knowledge and technical operation training. Actively develop new business and new technologies.

Thirteen, supply room nurse duties

1. Work under the leadership of the head nurse, responsible for the cleaning, production, packaging, storage, disinfection, registration, distribution and recycling of medical equipment and dressings.

2, often check the quality of medical equipment, if there is damage, timely repair registration, and report to the head nurse for processing.

3, assist the head nurse to ask for a variety of spare parts, often understand the opinions and suggestions of the clinical department, and constantly improve the work.

4. Seriously implement various rules and regulations and technical operation procedures, actively carry out technological innovations, and continuously improve the quality of supply room work.

5. Strictly implement the principle of aseptic operation and disinfection and isolation system, enhance the concept of sterility, do a good job in monitoring and recording the supply room, and prevent accidents.

6. Instruct the caregiver (disinfector) and the hygienist to carry out the preparation and disinfection of medical equipment and dressings.

7, participate in the supply room on duty, and do a good job in the department of indoor cleaning.

XIV. Responsibilities of the staff of the recycling and preliminary washrooms

1. Responsible for the classification and processing of recycled items.

2. Keep the room clean, regularly ventilate and ventilate. Wipe the table top and the floor with disinfectant before and after daily work. Disinfect the UV once a day.

3. When the staff recycles and cleans the items, they must wear gloves and cannot wear slippers.

4. Soak and disinfect the various types of items recovered, according to the initial washing work process (washing, heat removal). Test the concentration of the chlorine-containing disinfectant before each use of the disinfectant and record it.

5, all kinds of cloth and treatment towels have a special washing machine to clean, cloth with a wash, special cloth to be disinfected.

6, indoor items placed in an orderly, positioning management, and strengthen self-protection awareness.

7. Instruments used for special infections and infectious diseases must be treated strictly according to special infections.

Fifteen, fine washing, packaging staff duties

1. Responsible for the finishing of the items after the initial washing and the maintenance and packaging of the equipment.

2. The indoor items are placed in an orderly manner, wash hands before and after work, and wipe the table top and the ground with disinfectant. Daily UV disinfection, there are records.

3, before the packaging, carefully check the card, check the performance of all kinds of equipment, clean cloth, no damage; cross dressing or tape sealing a lot of 3 - 5cm, and indicate the responsibility code and sterilization date and expiration date.

4. Calculate daily workload and record.

XVI, disinfectant job duties

1. Under the leadership of the head nurse, work as a disinfector.

2. Do not leave the post without authorization during autoclaving. Strictly control the sterilization procedure, pressure and time according to the nature of the item to ensure the sterilization effect.

3. Check whether the items are damaged before sterilization, whether they are clean, and whether the packaging is tight; after sterilization, pay attention to safety when taking objects and prevent pollution.

4. Strengthen the concept of sterility, strictly control the methods of disinfection and sterilization, and implement technical operation procedures. Sterilization is strictly distinguished from unsterilized items and placed in a fixed position with obvious signs.

5, regularly check the effectiveness of the sterilizer, and do a good job of maintenance, repair, cleaning.

Seventeen, supply room quality control management system

1. Strictly implement various rules and regulations and operational specifications.

2. According to the requirements, carefully monitor the sterilization quality and steam sterilization effect, and according to different types of sterilizers and disinfection items, achieve the steam pressure, sterilization temperature and sterilization time required for the product.

3. When placing the items properly, all the sterilization bags should be placed vertically, layered, and there is a gap between the bag and the bag. The loading of the sterilized articles shall not exceed 80% of the capacity of the cabinet, and the loading capacity of the pre-vacuum sterilizer shall not exceed 90% of the capacity of the cabinet.

4. Pulsating vacuum pressure steam sterilizer should perform a BD test before and after maintenance to detect the air removal effect. Each package must use chemical indicator tape and chemical indicator card as required.

5, sterile packaging should have an obvious sterilization mark, indicating the name of the item, sterilization date, expiration date, responsibility code, inspector code. Specialized room, counter storage, use within the validity period.

6. Carry out bacterial culture every month in the sterile room, the packaging room, the fine washing room, the recycling rough washing room and the office. The surface of the indoor object and the hands of the staff are disinfected and monitored every month.

7. UV lamp disinfection effect test: The UV intensity is measured by the full-time monitoring personnel of the hospital every six months. The intensity of the UV lamp in use should be ≥70uw/cm2.

8. Keep the room clean, use the disinfectant to mop the floor every day, wipe the table top and the table top once, and disinfect the UV air for 2 hours. The UV lamp is wiped once a week with 95% alcohol and is cleaned once a week.

18, supply room sterilization quality monitoring

Supply room sterilization quality monitoring includes process monitoring, instrument monitoring, chemical monitoring and biological monitoring.

1. Process monitoring:

(1) Meet the necessary sterilization parameters: According to different types of sterilizers, the disinfection dose, steam pressure, sterilization temperature and sterilization time required for the product are achieved.

(2) Correct packaging: The packaging material has good air permeability, and can be made of absorbent cotton cloth, special wrapping paper and utensils with vent holes; the volume of the sterilization package should not exceed 30*30*25cm, the sterilization package volume of the pre-vacuum sterilizer Must not be greater than 30*30*50.

(3) Reasonable placement, all sterilization bags should be placed vertically, leaving voids between the package and the package. The volume of the sterilized articles should not exceed 80% of the volume of the cabinet, and the pre-steaming sterilizer should not exceed 90%.

(4) There is no technical obstacle in the sterilization equipment: the intake and exhaust system is unobstructed, the temperature and time of the instrument are normal, and the steam saturation is good.

2. Instrument monitoring:

(1) All instruments of the sterilizer are regularly monitored. Every half year, the equipment department validates and records the safety valve, pressure gauge and temperature gauge of the pressure sterilizer. Before the new equipment is installed and the old equipment is repaired, it must have a performance appraisal record.

(2) Ultraviolet lamp intensity monitoring, monitoring of the full-time monitoring personnel of the hospital every six months. The strength of the lamp in use shall not be less than 70uw/cm2.

3, chemical monitoring: commonly used methods are: chemical indicator tape, pressure steam chemical indicator card, pressure steam chemical indicator test paper, B-D experimental indicator map, disinfectant concentration test paper. When using the sterilization package, you should first observe the discoloration of the chemical indicator card. When receiving the sterile package, you should first check the discoloration of the indicator tape.

(1) Chemical indicator tape and chemical indicator card are used for daily monitoring, and each package must be used. The 121°C pressure steam chemical indicator card is dedicated to the monitoring of the lower exhaust pressure steam sterilization effect; the 132°C pressure steam chemical indicator card is dedicated to the monitoring of the pre-vacuum or pulsating pressure steam sterilization effect.

(2) B-D test paper is used for monitoring the pre-vacuum pressure steam sterilizer, which is a method for judging whether the cold air in the sterilizer is completely exhausted. After the installation and commissioning of the new sterilizer, the sterilizer is repaired. After the daily sterilizer is used. How to use: Prepare the standard test kit - use a cotton wool to form a 25*25*30cm dressing bag with a weight of 4~5kg. Place the B-D test paper in the middle layer of the bag, and put it in the bottom of the bottom of the sterilizer. After sterilization, the B-D test strips changed evenly, indicating that the exhaust function was good.

(3) The chemical indicator card must be placed in the center of the sterilization package to avoid direct contact with metal and glass to avoid being wetted by the condensed water and affecting discoloration.

(4) The chemical indicating tape is attached to the outside of the bag and can be used as a mark for sterilization.

4. Biological monitoring: Biological monitoring refers to the use of dried bacteria tablets made of bacterial spores of international standard resistance or by indicator tubes composed of bacteria tablets and culture medium, ie biological indicators (pressure steam sterilization morning indicator is thermophilic Bacillus). Biological monitoring is a direct indicator of the effectiveness of sterilization.

(1) Method of operation: The bacteria pieces are placed in a kraft paper bag and placed in the center of the standard test package. After sterilization, the bacteria pieces are inoculated into the bromocresol purple culture solution, and cultured at 56 ° C for 72 hours (24 hours view preliminary result). The biological indicator tube can be taken out on site or in a laboratory, and the glass tube is squeezed to allow the culture solution to be immersed in the bacteria piece, and cultured at 56 ° C for 48 hours to observe the result.

(2) Judgment: The bromocresol purple culture solution is still purple negative, indicating aseptic growth. If the color turns yellow, it is positive, indicating bacterial growth.

19. Pyrogen monitoring method

1. Pyrogen detection is used for syringe washing quality monitoring to prevent and prevent heat source reactions.

2, 鲎 experimental monitoring: method to extract 5ml of pyrogen-free sterilized water, inject the pre-inspection syringe, put it in the incubator, keep it at a temperature of about 500 ° C for 1 minute, (rotate the syringe 2 times), take out the syringe, 0.1 ml was taken and the pyrogen was examined by the 鲎 experimental method.

3, no pyrogen sterilization water consumption: closed infusion device 2.5ml20ml syringe 2ml10ml syringe 1ml4, inspection method:

(1) Take 0.1ml of the test product and add 0.1ml of sputum reagent, mix it in the tube, place it in constant temperature water of about 370C for 1 hour, take out the test tube, and put it in a stable place for 2~3 minutes to see the result.

(2) Set positive control for Yin: 0.1 ml of E. coli endotoxin was added to the positive control tube; 0.1 ml of non-pyrogenic sterilization water was added to the negative control tube.

5. Determination of results:

(1) Gently pick up the test tube and slowly tilt it back to 1800 to see if the liquid is flowing. It is positive when it is gelatinized; it is clear, transparent or turbid with flocculation, but the flow can be negative.

(2) The positive control is negative, which may be due to the low concentration of E. coli toxin or the decrease in the sensitivity of the sputum reagent.

(3) The negative control showed positive, indicating that the experiment was not established, and it was necessary to find the reason and re-experiment.

6, the infusion set, syringe pyrogen test positive is unqualified products, can not be issued.

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