文獻
紅柚醫療
2019-05-22


Recommendations by the Quality Task Group (106)

德國無菌供應協會質量工作組指南(106)

便盆清洗消毒器不能用于腎形盤或洗手盆的再處理

No reprocessing of kidney bowls or wash bowls in?bedpan washer-disinfectors


Author 作者:

B. Amann, M. Bertram, P. Brocheler, D. Diedrich, C. Fassbender, K. Gehrmann,T. Gerasch,A. Jones, S. Krüger, I. Mock, P. Sauer, K. Wiese, U. Zimmermann


以下文章翻譯經《Central Service》出版方許可。


■Introduction

引言


The washer-disinfectors regulated by standard EN ISO 15883-3 [1] are also known?colloquially as?BEDPAN WASHER-DISINFECTORS. The terms automatic bedpan?washers or faecal washers are also occasionally used. These washer-disinfectors?(WDs) are primarily designed and intended for disposal of faeces together with?reprocessing of the associated containers such as urine bottles, bedpans and toilet?commode buckets.

依照EN ISO 15883-3標準[1]設計的清洗消毒器通俗地被稱為便盆清洗消毒器。自動便盆清洗器或糞便清洗器這兩個詞有時也會用到。這類清洗消毒器(WDs)最初的設計目的是對與糞便接觸相關容器的再處理,例如尿瓶、便盆和便桶。


However, it can be noted time and again in everyday practice that other?items are also reprocessed in these washer-disinfectors. Contrary to the manual?reprocessing method formerly used for wash bowls, the standard practice now?in many healthcare institutions and homes for the elderly is to reprocess in such?washer-disinfectors also kidney bowls, including those used for oral hygiene,as well as the wash bowls used for basic personal hygiene or partial medicinal?baths.

然而,在日常工作中也會看到許多其他物品在這類清洗消毒器中進行再處理。以前洗手盆采用手工再處理的方法,而現在許多醫療機構和養老院的標準處理方法是采用上述清洗消毒器進行處理,同時現在采用清洗消毒器處理的還包括用于口腔衛生、個人衛生或局部藥浴的各類容器。


The technical features of these washer-disinfectors are virtually unable to?demonstrate the required proof of validated processes, and certainly do not assure?the safety expected of modern WDs in a Reprocessing Unit for Medical Devices?(RUMED). THE A0 VALUE REQUIRED FOR SAFE DISINFECTION exceeds the?capacity and technical facilities of the majority of the (older) washer-disinfectors?currently in operation.

這類清洗消毒器的技術性能實際上不能滿足驗證過程所需的要求,因此無法達到醫療器械再處理部門(RUMED)中現代化清洗消毒器預期的安全水平。大多數在運行的(舊的)這類清洗消毒器,其能力和技術條件無法達到安全消毒所需的A0值。


In an age of multi-drug resistant organisms there is a particularly high risk of?their transmission when disposing of faeces.

在多重耐藥微生物普遍存在的背景下,在處理各類與糞便接觸相關容器時其傳播風險特別高。


Historical background

歷史背景


The development of these washer machines dates back to the 1930s [2]. Connected?to the cold-water pipeline (drinking water), the most they could do was to rinse?off the utensils, while their main purpose was to improve the removal of faeces.Hence, manual pre-and, possibly, post-cleaning could not be avoided.

這種類型的清洗機的發展要追溯到上世紀30年代。當時,機器與冷水管(飲用水)相連,主要用于沖洗器具,使糞便類的污物去除地更徹底。因此,手工預清洗處理和可能的手工后清洗處理是不可避免的。


It was not until the 1960s that washer machines also facilitating chemical disinfection?after cleaning were developed. These were operated by staff by activating?the cleaning pushbutton but by no means was such a washer-disinfector equipped?with the programme sequences as we know them today.

直到上世紀60年代,這種類型的清洗機在清洗結束之后加入了化學消毒的功能?;骺捎曬ぷ魅嗽蓖ü醇僮?,但并不是像我們今天所熟知的具有一系列設定程序的清洗消毒器。


A further 30 years would go by before new BEDPAN WASHER-DISINFECTORS?WITH THERMAL DISINFECTION were introduced. Their introduction was expedited?by the knowledge that the majority of central dosing units for chemical disinfectants?were colonized with biofilm.

又經過了30 年的時間,具有熱力消毒功能的便盆清洗消毒器才出現。由于大多數化學消毒劑的中央加液單元都會產生生物膜定植,加速了熱力消毒便盆清洗消毒器的出現。


Normative requirements

規范要求


The bedpan washer-disinfectors regulated by ISO 15883-3, with the unwieldy?title “Washer-disinfectors Part 3: Requirements and tests for washer-disinfectors?employing thermal disinfection for human waste containers” just about?meet the minimum requirements. The term “human waste containers” is somewhat?poorly defined as it also includes, in addition to urine bottles and bedpans,holders for disposable bedpans, hospital utensils, e.g. bowls, as well as similar?items.

便盆清洗消毒器的規范為ISO15883-3,其題目有點冗長,“清洗消毒器第3 部分:對人體廢棄物容器進行濕熱消毒的清洗消毒器要求和試驗”,這個規范規定了最低的要求?!叭頌宸掀鍶萜鰲幣淮實畝ㄒ逵行┠:?,因為它除了尿瓶和便盆之外,還包括一次性便盆的支架,醫用器具,例如碗狀容器,以及類似物品。


However, all these items are primarily intended for human waste. For example,among the terms mentioned in Section 3.3 are excreta and body fluids, including?stools, urine, blood, pus, vomit and mucus.

然而,所有這些物品主要用于盛放人體廢棄物。例如,規范第3.3 節中提到的術語有排泄物和體液,包括糞便、尿液、血液、膿液、嘔吐物和粘液。


Section 4.5 dealing with disinfection specifies a MINIMUM A0 VALUE: “Thermal?disinfection must be deemed complete when all surfaces to be disinfected have?been subjected to a process with an A0 value of at least 60.”

關于消毒的第4.5節規定了最小A0值:“當所有需消毒的表面都暴露在A0值不小于60的條件下處理時,可認為濕熱消毒滿足規定要求?!?/span>


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