Risk assessment on disinfection management in primary medical institutions in Jiangmen City

Abstract:

ObjectiveTo understand current situation of disinfection management in primary medical institutions, and provide scientific basis for strengthening the prevention and control system of healthcareassociated infection(HAI) in primary medical institutions.MethodsA stratified sampling method was used to select 70 primary medical institutions in Pengjiang District and Jianghai District of Jiangmen City, these institutions performed intravenous injection and/or oral diagnosis and treatment. From April to September 2016, baseline investigation on HAI management status in these medical institutions were performed field trip and questionnaire survey. From February to December 2016, disinfection efficacy in key departments in 70 primary medical institutions and 11 municipal medical institutions was monitored. Brainstorming and expert evaluation were used for risk assessment, risk assessment matrix method was adopted to get the risk level of each risk factor.Results70 primary medical institutions included 7 countylevel hospitals, 12 community health service centers, 14 township health centers/health stations, and 37 private clinics. Of 70 primary medical institutions, only 17.14% (12/70) had adequate HAI management regulations or procedures. Hand hygiene facilities was insufficient, only 55.71% (39/70) of institutions used alcoholbased hand rub. 84.29% (59/70) of institutions installed ultraviolet light, only 17.14% (12/70) of institutions could monitor the intensity of ultraviolet light irradiation regularly. Only 12.86% (9/70) of institutions installed sewage treatment equipment. 2.86% (2/70) and 11.43% (8/70) of institutions respectively had the ability of selfchecking for medical sewage and disinfection efficacy. A total of 816 specimens were conducted disinfection efficacy detection, overall qualified rate was 96.20% (785/816). The qualified rates of indoor air, inuse disinfectant, medical device, and dialysis water all reached 100%; and the lowest rate was medical sewage (61.54%). The qualified rate of object surface disinfection in primary medical institutions was lower than that of municipal medical institutions, difference was statistically significant (P<0.05). Risk assessment results indicated that sterilizer and dialysis water were very high risk projects, hand hygiene, environmental disinfection, and medical devices were high risk projects.ConclusionThere are a lot of deficiencies in the disinfection management of medical institutions in Jiangmen City, risk assessment method can help center for disease prevention and control find the key points of disinfection management of medical institutions, improve the efficiency of surveillance work.