Current status and development of cleaning and disinfection of cuff

Cuff is
  widely used in clinical venous infusion, venous blood sampling and other treatment operations, and is a commonly used diagnostic and treatment product. According to the requirements in the 2016 version of the hospital disinfection supply center management specification, the medical equipment, appliances and articles that contact the intact skin and mucous membranes should be disinfected. The cuff is in direct contact with the patient’s skin, and is easily contaminated by blood. In addition, due to its repeated use and improper handling, it is easy to form a carrier of nosocomial infection. According to the requirements of the specification, all clinical cuffs are put into the disinfection supply room for centralized treatment, but due to the large number of them, the material is not resistant to high temperature, and the long lumen, the treatment time is too long during the cleaning and drying process. This article combines the treatment experience of various domestic hospitals to discuss the current situation and problems in the disinfection of the cuff.
  1 processing status of domestic cuff
  cuff is clinical departments nurses intravenous infusion, venous blood must be used when medical supplies [1]. It is used frequently in clinical work, which makes the cuff contaminated from time to time [2]. According to the hospital’s “one person, one use, one disinfection” requirement, if each department assigns special personnel to disperse the cuffs every day and follow the standardized cleaning and disinfection procedures each time, it will not only waste human resources, but also waste water, enzymes, and disinfectants. Etc. [3]. At present, the clinical cuff is mainly used for centralized treatment in the disinfection supply room. The implementation of centralized cleaning and disinfection of the cuff is conducive to the promotion of high-quality nursing services, freeing clinical department nurses from the tedious tasks of cleaning and disinfection, and reducing The workload of nurses allows nurses in clinical work to have more time and energy to provide high-quality nursing services to patients, and truly “return time to nurses and nurses to patients[4].
  Zhuang Limei [5] used a cuff disinfection plate to disinfect the cuff at the same time with quick manual disinfection. The method is simple, but it is easy to cause incomplete disinfection. Most disinfection supply rooms use standard manual cleaning mode for treating cuffs. According to the rinse-wash-rinse-final rinse mode, first rinse the surface stains with running water, then soak it in 1:270 multi-enzyme solution for 5 minutes, and then Rinse with normal water, then put it in 75% ethanol for disinfection or put it in 500mg/l chlorine disinfectant for 30 minutes or other disinfectant for 30 minutes, then rinse with pure water repeatedly, and put it in the dryer Medium and dry. Laying flat in a dryer is not conducive to drying. Luo Yu et al. [6] hung one end of the self-made S pull hook on the cuff binding place and one end on the shelf of the drying cabinet to dry the cuff, effectively solving incomplete drying and shortening the drying. time. The semi-automatic dehydration machine is used in the drying process of the cuff, which reduces the manual operation time of the staff, at the same time shortens the drying time of the cuff, and reduces high temperature exposure, effectively delays the aging of the cuff, and also increases the use of the cuff Times, saving costs [7].
  However, due to the large number of daily cleanings and the heavy workload, coupled with the materials that are not resistant to high temperatures and the long lumen, further improving the cleaning quality of the cuff and reducing the drying time is an urgent problem in the disinfection supply room. Existing fast-drying brighteners are used in the process of cleaning cuffs. Since the fast-drying brighteners contain <5% anionic surfactants and 5-15% nonionic surfactants, their product characteristics are used for Before the drying step, it can save 30-70% of the drying time, improve work efficiency, and at the same time improve the brightness of the cuff. Its product characteristics can not only enhance the cleaning effect of the cuff, but also reduce the drying time of the cuff.   2 Development trend of cuff treatment:   Standardized treatment methods to ensure the quality of disinfection of the cuff can effectively block iatrogenic infections [2]. The cuff is a low-risk item, and the total number of colonies of low-risk medical devices must be ≤200 cfu/piece in accordance with the requirements of induction control, and no pathogenic microorganisms can be detected to be qualified [8]. In accordance with the requirements of the 2016 Disinfection Supply Center specification, the cleaned instruments, utensils and articles should be disinfected. The first choice is damp heat disinfection, but 75% ethanol, acidic oxidizing potential water or other disinfectants can also be used for disinfection. As for the medical instruments, appliances and articles used directly after disinfection, the temperature of damp heat disinfection should be ≥90℃, the time should be ≥5min, or the A0 value should be ≥3000[9], and the cuff is a rubber product that cannot withstand too high temperature , So you can only choose to soak and disinfect. The residual disinfectant after soaking must be rinsed and dried with pure water for later use. Therefore, the cleaned cuff carries a lot of water. According to the specification, drying equipment is the first choice for drying operation, and the drying temperature of plastics is 65-75℃; the items that are not heat-resistant can be dried with a pressure air gun or 95% ethanol; if there is residual water in the cavity of the luminal equipment It can be dried with a pressure air gun instead of using natural drying methods.   The disinfection, cleaning, and drying treatment of the cuff after use in the disinfection supply room is mainly to choose an appropriate treatment method according to its own conditions and equipment to meet the requirements of clinical departments. Part of the disinfection supply room has limited conditions. The cuff adopts manual high-level disinfection treatment with a chlorine-containing disinfectant after initial washing, and simply uses a pressure air gun to dry, which requires a large workload and a long processing time. Drying with a dryer alone has a long drying time, high temperature for a long time, the cuff is easy to age, and the dryer produces noise for a long time, which easily affects human hearing, so the problem of cleaning and drying the cuff has been difficult to solve.   The cuff is centrally processed, which can make full use of the professional expertise, professionals, professional equipment, professional cleaning agents and perfect professional protection standards of the disinfection supply center, and strictly follow the standards of cleaning, disinfection, drying, inspection packaging, and distribution. Process [10] for processing.   3 Problems in the cleaning and disinfection of the cuff   The clinical department's self-disinfection and drying are not professional, and there are real problems such as irregularities in the implementation of disinfection and drying. Cuffs are centrally processed for cleaning and disinfection. Due to the large quantity, heat-resistant materials, long lumen and other reasons, the workload has increased greatly. In order to process the cuffs, the dryer keeps running and drying, which causes long-term noise pollution. , And it is easy to cause damage to the dryer. At the same time, the drying time is too long, and the cuff is exposed to high temperature for a long time, and it is easy to age. There are many cuffs in the cleaning process, and they are rubbed each other, which may easily cause unclean cleaning.   Existing disposable cuffs are used clinically, but due to their high cost, they have not been widely used. More hospitals are still using reusable cuffs. In order to prevent cross infection, "one person, one use, one disinfection" is implemented. Every time the cuff is used, it is necessary to replace the clean and disinfected cuffs. The disinfection supply center is used to clean and disinfect the cuffs, which comprehensively protects the interests of the majority of patients. Each department uses a large number of cuffs and handles these cuffs. The workload of operators has increased rapidly [11].   4 Summary   cuff hospitals reusable handled by centralized sterile supply room, can make full use of human resources, while ensuring the quality of cleaning and disinfection. However, due to the different conditions in different hospitals, different methods in the treatment process, heavy workload, long noise pollution time, and incomplete cleaning still exist. Therefore, fully explore the methods and how to complete this work with high quality, high efficiency and low cost. It is particularly important to find effective and practical methods for centralized processing in the disinfection supply room, and it is also an issue that every consumer needs to study.