| 中文摘要 |
對於無法進食造成營養不良的醫院病人，鼻胃管灌食是很重要的營養供給方式，一旦灌食過程中遭受污染，會使病人病情受到很嚴重的影響；輕者腹痛、腹瀉，重者可能會引起併發症的危險。本研究主要探討HACCP系統在重症患者的灌食前、後之比較其是否可有效改善供應過程的衛生安全。我們檢測病人的灌食食物、灌食容器、灌食袋的殘餘物、灌食管、供應者的手套及食物分裝檯的表面，觀察total plate count (TPC), coliform, E. coli, Salmonella spp. and Staphylococcus aureus之微生物生長。本實驗顯示經由HACCP系統管理，大部份樣本的微生物都可明顯減少，尤其在灌食供應的細管（由灌食容器通到病人鼻胃的管子）TPC, coliform, and E. coli 各別由 6.95, 5.32, and 4.84 log CFU/mL，減少到1.52, 0.24, and 0.24 log CFU/mL。以及Salmonella spp. and S. aureus 從100及61%下降到0 and 16%。我們的研究指出HACCP系統在重症患者的灌食系統中扮演很重要的角色。" |
| 英文摘要 |
Enteral feeding system is one of the important therapeutic tools to prevent malnutrition for hospitalized patients. The microbiological index, including total plate count (TPC), coliform, E. coli, Salmonella spp., and Staphylococcus aureus., of an enteral feeding system at a district hospital in central Taiwan was evaluated. The elements of food, food residues in the feeding containers, feeding containers, luer connectors, feeding operators’ hands, and working area surfaces were evaluated. A hazard analysis and critical control point system (HACCP) was applied. Various critical control points related to the sanitary conditions were selected and the corresponding corrective actions were taken. The microbial counts of the majority of the samples were significantly reduced. The luer connectors were noted in particular. The microbial counts of TPC, coliform, and E. coli of the luer connectors were 6.95, 5.32 and 4.84 log CFU/mL, respectively. After HACCP implementation, the microbial counts were significantly reduced to 1.52, 0.24 and 0.24 log CFU/mL, respectively. The posi-tive detection percentage of Salmonella spp. and S. aureus of the luer connectors was reduced from 100 and 61% to 0 and 16%, respectively. Similar reduction of microbial count could also be observed in other samples. This study implies that proper monitor and corresponding corrective actions could be used to improve the microbial quality of an enteral feeding system in hospitals. |
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