2017 APSIC亞太感染管制學會供應中心之醫療器材清潔消毒滅菌作業介紹

Introduction of the Asia Pacific Societyof infection control guideline 2017 forcleaning, disinfection and sterilization ofmedical equipment in the Central SterileSupply Department (CSSD)

鑑於病人安全，醫院器械使用及管理愈趨重要，歐美先進國家均已建立實證依據的措施及指引；而根據近年來我國疾病管制署醫院感染管制查核作業結果發現，在器械之清潔與消毒滅菌作業，仍有許多值得改善之處。我們知道醫療品質即使在有限資源下仍要提供最佳照護，而醫院醫療器材清潔消毒滅菌作業品質更是改善醫療品質與病人安全之根本之一。本內容主要引用 2017 年亞太供應中心醫療器材清潔消毒滅菌作業指引，對於器械再處理流程與監控、定期及新品滅菌品質確效、滅菌物品儲存、儀器設備及執行等內容進行介紹，如供應中心規格設計規範、病房使用後醫材送至供應中心的處理、收集、運送、污物接收區的清潔和去污、清潔區器械的檢查、準備和包裝、滅菌區的滅菌品質監測和測試、無菌物品儲存區的無菌儲存、發送和產品回收、文件記錄保存、供應中心人員資格和持續教育課程、健康管理等，期藉此以提昇醫療機構之醫療品質。

The 2017 Asia Pacific Society of Infection Control guidelines for cleaning,disinfection, and sterilization of medical equipment in the central sterile supplydepartment (CSSD) of a hospital. To protect the safety of patients, the proper management and use of hospitalequipment must be observed. Similar guidelines and standardization of procedureshave been carried out in developed countries such as Europe and the US. Therecent inspection results provided by hospitals under the Disease and InfectionControl Center revealed that the process of cleansing, disinfection, and sterilizationof instruments needs further improvement. We understand that hospitals shouldprovide the highest quality of care, even with limited resources. The standard ofsterilization and infection control of medical instruments constructs the key topatients’ safety. To execute central sterile supply department (CSSD) infectioncontrol policies and procedures, we mainly cite the 2017 Asia Pacific Society ofInfection Control guidelines for cleaning, disinfection, and sterilization of medicalequipment in the CSSD, including 1) facility design; 2) handling, collection, andtransport of contaminated instruments; 3) cleaning and decontamination processes;4) instrument inspection, preparation, and packaging; 5) sterilization, monitoring,and testing; 6) sterile storage and distribution and product recalls; 7) documentationfor each mechanical washer and sterilizer, and 8) personnel considerations. Underthese measures, we will have a clearer understanding of the current issues to proposecorresponding solutions and evaluate the effectiveness of intervention measures,thereby improving the performance of medical organizations.