기본간호학회지 (Journal of Korean Academy of Fundamentals of Nursing)

  • 제21권4호
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  • Pages.392-402
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  • 2014
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  • 1225-9012(pISSN)
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  • 2287-1802(eISSN)
기본간호학회 (Korean Academy of Fundamentals of Nursing)
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국내 의료기관의 소독과 멸균 관리 실태

Actual Disinfection and Sterilization Control in Korean Healthcare Facilities

  • 정선영 (건양대학교 간호학과) ;
  • 최정화 (건국대학교병원 감염관리실) ;
  • 김은경 (차의과학대학교 분당차병원 감염관리팀) ;
  • 김수미 (인하대병원 감염관리실) ;
  • 손희정 (이화여대목동병원 감염관리실) ;
  • 조난형 (강남세브란스병원 감염관리실) ;
  • 최지연 (중앙대병원 감염관리실) ;
  • 박은숙 (세브란스병원 감염관리실) ;
  • 박진희 (우석대학교 간호학과) ;
  • 이지영 (가톨릭대학교 서울성모병원 감염관리실) ;
  • 최순임 (계명대학교 동산병원 감염관리팀) ;
  • 우진하 (건국대학교병원 수술실) ;
  • 김옥선 (상지대학교 간호학과)
  • Jeong, Sun Young (Konyang University, Department of Nursing) ;
  • Choi, Jeong Hwa (Kunkuk University Medical Center, Department of Infection Control) ;
  • Kim, Eun Kyoung (CHA Bundang Medical Center, CHA university, Infection Control Team) ;
  • Kim, Su Mi (Inha University Hospital, Department of Infection Control) ;
  • Son, Hee (Ewha Womans University Mokdong Hospital, Department of Infection Control) ;
  • Cho, Nan Hyoung (Gangnam Severance Hospital Yonsei University Healthcare System, Infection Control Department) ;
  • Choi, Ji Youn (Chung-Ang University Healthcare System, Infection Control Unit) ;
  • Park, Eun Suk (Severance Hospital, Infection Control Department) ;
  • Park, Jin Hee (Woosuk University, Department of Nursing) ;
  • Lee, Ji Young (The Catholic University of Korea, Seoul St. Mary's Hospital, Dept. of Infection Control) ;
  • Choi, Soon Im (Keimyung University Dongsan Medical Center, Infection Control Team) ;
  • Woo, Jin Ha (Kunkuk University Medical Center, Operating Room) ;
  • Kim, Og Son (Sangji University, Department of Nursing Science)
  • 투고 : 2014.09.22
  • 심사 : 2014.11.12
  • 발행 : 2014.11.30
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초록

Purpose: This study was done to investigate the status of disinfection and sterilization in healthcare facilities. Method: A survey of 193 Korean healthcare facilities was conducted from February 8 to March 7, 2013. Data were analyzed using descriptive statistics, ${\chi}^2$ test, Fisher's exact test, one-way ANOVA, Scheffe with SPSS WIN 18.0. Results: Of the healthcare facilities 93.2% had specific guidelines for disinfection/sterilization, but only 47.9% had a committee on disinfection/sterilization for decision-making, less than half (42.7%) conducted regular monitoring of actual practices, while 83.9% had established procedures for recovery in case of problems with the disinfection process and 89.0% kept records and archives of disinfection practices. Cleaning process, selection of chemical disinfectants and process of disinfection and sterilization were found to be inadequate in some healthcare facilities. Perception score for adequacy of medical instruments was 8.10, environmental disinfection was 7.20, and sterilizer management was 8.45 out of a possible 10. Conclusion: Compared to larger institutions, smaller healthcare facilities had less effective disinfection and sterilization management systems, while some facilities showed inadequate practices for medical equipment and general sterilization. Better academic and state-level support is recommended for smaller facilities in order to establish a better system-wide management system.

키워드

참고문헌

  1. Seoane-Vazquez E, Rodriguez-Monguio R, Visaria J, Carlson A. Exogenous endoscopy-related infections, pseudo-infections, and toxic reactions: Clinical and economic burden. Current Medical Research and Opinion. 2006;22(10):2007-2021. http://dx.doi.org/10.1185/030079906X121048
  2. Yoon YK, Sim HS, Kim JY, Park DW, Sohn JW, Roh KH, et al. Epidemiology and control of an outbreak of vancomycin-resistant enterococci in the intensive care units. Yonsei Medical Journal. 2009;50(5):637-643. http://dx.doi.org/10.3349/ymj.2009.50.5.637
  3. Rutala WA, Weber DJ. Disinfection and sterilization: An overview. American Journal of Infection Control. 2013;41(5):S2-S5. http://dx.doi.org/10.1016/j.ajic.2012.11.005
  4. Baxter RL, Baxter HC, Campbell GA, Grant K, Jones A, Richardson P, et al. Quantitative analysis of residual protein contamination on reprocessed surgical instruments. Journal of Hospital Infection. 2006;63(4):439-444. https://doi.org/10.1016/j.jhin.2006.03.011
  5. Dancer SJ, Stewart M, Coulombe C, Gregori A, Virdi M. Surgical site infections linked to contaminated surgical instruments. Journal of Hospital Infection. 2012;81(4):231-238. http://dx.doi.org/10.1016/j.jhin.2012.04.023
  6. Tosh PK, Disbot M, Duffy JM, Boom ML, Heseltine G, Srinivasan A, et al. Outbreak of Pseudomonas aeruginosa surgical site infections after arthroscopic procedures: Texas, 2009. Infection Control and Hospital Epidemiology. 2011;32(12):1179-1186. https://doi.org/10.1086/662712
  7. Kovaleva J, Peters FTM, van der Mei HC, Degener JE. Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy. Clinical Microbiology Reviews. 2013;26(2):231-254. http://dx.doi.org/10.1128/CMR.00085-12
  8. Kim KM. Descriptive study on the current usage of disinfectants in Korea. Paper presented at: 14th Korean Association of Infection Control Nurses Summer Conference; 2009 August 28-29; Spacastle. Ducksan.
  9. Park ES, Kim OS, Kim KM, Kim YS, Jeong SY, Yoon SW. Descriptive study for status of usage of disinfectants in Korea. Korean Journal of Nosocomial Infection Control. 2001;6(1):17-32.
  10. Park ES, Jeong JS, Kim KM, Kim OS, Jeong SY, Jang SY, et al. Descriptive study on the current usage of disinfectants in Korea. Korean Journal of Nosocomial Infection Control. 2006;11(1):42-49.
  11. Woo JH, Seo YK, Kim MS, Kim HS, Park SS, Park SA, et al. A survey for the standardization of sterilization management on operation room. Sterilization Evaluation Report. Seoul: Korean Association of Operating Room Nurses; 2010, June.
  12. Oh, YH. National Health Medicine Survey in 2011. Health Evaluation Report. Seoul: Korea Institute for Health and Social Affairs; 2011 December. Report No.: 11-1352000-000524-13.
  13. Maltby J. Introduction to statistics for nurse. Tack YR, Kang KA, Kim JW, Kim TK, Kim HO, Song JH, et al., translator. Seoul: Fornurse; 2009.
  14. Park ES. Disinfection and sterilization. In: Jeong SY, Choi JY, Kim KM, Kim OS, Kim EK, Park ES, et al., editors. Text of infection control. Seoul: Hyunmoonsa; 2012. p.135-161.
  15. Park ES. Disinfection and sterilization. In: Kim EJ, Kim HB, Kim SI, Kim OS, Eom JS, Yoo SY, et al., editors. Infection control in healthcare facilities. 4th ed. Seoul: Hanmibook; 2011. p63-94.
  16. Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee. Guideline for disinfection and sterilization in healthcare facilities, 2008 [Internet]. Atlanta: Centers for Disease Control and Prevention; 2009 [cited 2014 July 30]. Available from: http://www.cdc.gov/hicpac/ Disinfection_Sterilization/acknowledg.html.
  17. Korean Association of Central Supply Department Nurses. Korean sterilization assurance standard [Internet]. Seoul: Korean Association of Central Supply Department Nurses; 2000 [cited 2014 July 30]. Available from: http://www.a-lahm.com/3m/standard1.pdf.
  18. Korea Institute for Healthcare Accreditation. Healthcare accreditation survey guide [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2007 [cited 2014 July 30]. Available from: http://www.koiha.or.kr/home/data/data/doList.act?boardtype=05.
  19. Chang CL, Su LH, Lu CM, Tai FT, Huang YC, Chang KK. Outbreak of ertapenem-resistant Enterobacter cloacae urinary tract infections due to a contaminated ureteroscope. Journal of Hospital Infection. 2013;85(2):118-124. http://dx.doi.org/10.1016/j.jhin.2013.06.010
  20. Brullet E, Ramirez-Armengol JA, Campo R, Board of the Spanish Association for Digestive Endoscopy. Cleaning and disinfection practices in digestive endoscopy in Spain: Results of a national survey. Endoscopy. 2001;33(10): 864-868. https://doi.org/10.1055/s-2001-17330
  21. Fratila O, Tantau M. Cleaning and disinfection in gastrointestinal endoscopy: Current status in Romania. Journal of Gastrointestinal and Liver Diseases. 2006;15(1):89-93.
  22. Korea Society of Gastrointestinal Endoscopy Disinfection Committee. Cleaning and disinfection guide of gastrointestinal endoscope. Seoul: Medbook; 2012.
  23. Centers for Disease Control and Prevention. Guideline for environmental infection control in health-care facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Mortality Morbidity Weekly Report. 2003;52(No. RR-10):1-42.
  24. Hong KB, Oh HS, Song JS, Lim JH, Kang DK, Son IS, et al. Investigation and control of an outbreak of imipenem-resistant Acinetobacter baumannii infection in a pediatric intensive care unit. Pediatric Infectious Disease Journal. 2012;31(7):685-690. http://dx.doi.org/10.1097/INF.0b013e318256f3e6
  25. Squeri R, Grillo OC, La Fauci V. Surveillance and evidence of contamination in hospital environment from methicillin and vancomycin-resistant microbial agents. Journal of Preventive Medicine and Hygiene. 2012;53(3):143-145.

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