TheSterile(无菌的)SupplyCycle无菌供应周期

1、The Sterile（无菌的）Supply Cycle 无菌供应周期Author: Jan HuysImportance of sterilization of medical suppliesMore and more, infectious diseases form a serious threat to peoples health. Adequate sterile supply plays an essential role in the attempt to reduce the spreading of diseases within the health service.

2、In a number of short articles, each step in the cycle of sterile supply as it is performed in most health facilities is explained. This first article describes an overview of the sterile supply cycle. In the year to come, further descriptions of each step are worked out and will be presented by clic

3、king on the topic title or the image of the respective step in the illustration above. Detailed information on each topic can be found in more extensive professional literature and the international standards related to sterilization.医疗用品灭菌的重要性越来越多的传染性疾病严重威胁着人们的健康。充足的无菌供应在医疗卫生服务中对减少疾病的传播起着至关重要的作用。下列

4、短文对卫生机构中的无菌供应周期的每个步骤都做了阐述。第一篇文章概述了无菌供应周期。在未来的一年中,每一步骤将会有更深入的说明,您仅需点击以上插图中的标题或相关的图像就可了解到。每一个主题的详细信息,可以在其他有关专业文献和国际标准中找到。Introduction: The cycle of sterile supplyPeople come to health facilities to be cured from disease and injuries. Many of their diseases are caused by micro-organisms. Therefore heal

5、th facilities are places with a high incidence of disease-causing micro-organisms which are easily spread from patient to patient by the staff and equipment and other materials used for patient care. Moreover many people visiting hospitals are weak and therefore are extra susceptible for acquiring a

6、 disease. It is the task of the health facilities not only to cure diseases of its patients but also to prevent transmission of diseases from one patient to the other. An important measure against spreading of diseases is the requirement that all medical supplies, such as instruments, swabs, drapes

7、etc, which are used on open wounds or will be in touch with the inner fluids of the body, are free of any viable micro-organisms. They have to be sterile. Some of these materials are sterilized at the factory and are designed for single use. However, many instruments and materials used for medical i

8、nterventions are very expensive and are designed such that they can be re-used. A high-quality reprocessing cycle is necessary in which the used materials are treated such, that they can be used safely again. As the reprocessing of sterile goods has developed into a specialism on its own, reprocessi

9、ng should centralized in a single Central Sterile Supply Department (CSSD) serving the whole facility. In mostly older health facilities sterilization is still decentralized. More and more the sterilization activities of these departments are put under the responsibility of a single sterilization pr

10、ofessional in charge of sterile supply of the whole facility. 简介:无菌供应周期人们到卫生机构治病疗伤，而他们的许多疾病都是由微生物引起的。因此卫生机构是病人被致病微生物感染的高发地方，这些致病微生物容易通过工作人员和设备，以及病人护理中的器械和其他物品传播。另外,很多去医院的人抵抗力较弱，因此更容易感染。卫生机构的任务不仅是治愈疾病，也要防止疾病的传播。一个防止疾病传播的重要措施就是要求所有的用于开放性创口或接触到人体内部的医疗用品,如手术器械、棉纱、布帘等,其上没有任何活的微生物。它们必须经过消毒。有些材料是在工厂中消毒,专为一

11、次性使用。然而,许多用于医疗干预的工具和材料是非常昂贵,可重复使用的。因此高质量的的再处理周期是必要的,以使使用过的材料能安全地再使用。无菌物品的再处理已经发展成为一门专业领域，再处理应该由中央消毒供应部门来服务于整个卫生体系。但大多数老年卫生机构中的消毒仍然是分散的。越来越多的这些机构的消毒活动处于一个专业的消毒部门的的监管中，该部门对整个无菌供应负责。Transportation to the sterilization departmentAfter use, for example in the operating theatre or other treatment room, th

12、e soiled materials are collected and transported in suitable containers and trolleys to the location where the reprocessing takes place: the Central Sterile Supply Department. 污染物品的运送使用后,如在手术室或其他治疗室,被污染的材料被收集起来放到适当的容器和手推车，并运送到再处理的地点：中央消毒供应部。CleaningThe instruments and materials are taken to the clea

13、ning section of the sterilization department. In the cleaning section the dirty materials are handled; therefore this area is know as the dirty area of the sterilization department. Cleaning implies the removal all (visible) debris and dirt. The large majority of micro-organisms including any diseas

14、e-causing agents are removed here. Adequate cleaning is considered the most essential step in the reprocessing cycle of sterile goods.清洗这些仪器和材料被送入消毒部门的清洗间。污物在清洗间被处理：因此这个地区也被称为消毒部门的“脏区”。清洗阶段将除掉所有(可见)碎屑和灰尘。绝大多数的致病微生物在这个阶段被除去。充分的清洗被认为是无菌产品后处理周期中最重要的步骤。 FULL ARTICLE Inspection and tray assemblyA missing

15、 or failing instrument while performing a surgical procedure is the annoyance of any surgeon! It can be the cause of great problems, for the patient as well as the staff performing an operation. It is therefore essential that instrument trays for all procedures are complete and that each instrument

16、works correctly. That is why each individual instrument is subjected to a vigorous inspection, and that each tray should be double-checked for completeness.托盘器械的检查在手术中仪器的缺失或破坏是任何一个外科医生的烦恼！它将给病人和手术医务人员带来大麻烦。因此托盘上的用于每个程序的器械的完整和有效性是至关重要的。这也是为什么每个仪器都要受到严格的检验,而每一个托盘上仪器的完整性都要经过二次检查的原因。PackagingBefore they

17、 are used, sterile goods are usually stored until they are needed. In order to prevent recontamination during storage, they have to be packed. This also implies that the load is to be sterilized inside its packaging. Therefore the packaging should allow for the sterilizing agent to reach the actual

18、load. Whereas after sterilization, it should prevent that micro-organisms can reach the items inside; it should act as a microbial barrier. Packaging should guarantee sterility upto the moment a product is used. Poor or damaged packaging makes the all the work of cleaning, packaging and sterilizatio

19、n useless!包装无菌物品在它们使用之前通常都会被储存起来。为了防止储存过程中的再污染，它们必须要包装好。这也意味着在包装内部也要经过杀菌消毒。因此包装过程也应考虑到消毒事宜。消毒后,应能防止微生物入侵内部物品，成为无菌物品的“防火墙”。包装应保证物品在使用之前都是无菌的。不严格或损坏的包装都会导致所有的清洗，包装，和消毒工作都功亏一篑。 FULL ARTICLE SterilizationAfter packaging the load is ready to be sterilized. In a sterilizer the micro-organisms remaining af

20、ter the cleaning process are killed. Their number is reduced to a probability, which is considered safe: the Sterility Assurance Level. A range of methods are in use, all with their specific field of application: moist heat, dry heat, ethylene oxide, formaldehyde, irradiation, and gasplasma. The mos

21、t common and safe method used in health facilities is the sterilization by moist heat using pressurized high-temperature steam. The machines used for sterilization with steam are known as steam sterilizers or autoclaves. Sterilizers should meet the stringent technical standards for performance and s

22、afety (for example the European norm EN 285 for Large Steam Sterilizers). To ensure the safety of the staff and patients, for each sterilizer used for medical supplies, all processes in combination with each type of load in its packaging should be validated. Simply said: You have to prove that your

23、sterilizer sterilizes.灭菌物品包装将进行消毒。在灭菌器清洗过程中残留的微生物将会减少到一个安全水平：即无菌安全水平。在这一过程中一系列在特定领域被应用的方法都会被使用:湿热灭菌、干热灭菌、环氧乙烷、甲醛、辐射、气体等离子。在卫生机构中最常见和安全的方法就是使用密封高温蒸汽。这种用于蒸汽灭菌的机器被称为蒸汽灭菌器或消毒锅。灭菌器应符合严格的安全技术标准(例如大型蒸汽灭菌器的欧洲规范EN 285)。为了确保医务人员和病人的安全，所有用于医疗用品的灭菌器，所有在各种包装过程中的步骤都要经过检验。简单地说:"必须保证用于消毒的工具已消毒。Sterile StorageU

24、pon completion of the sterilization cycle, the goods are taken out of the sterilizer. Based on the registered process data and indicators the cycle is checked and when the required conditions are met, the load is released for storage, transport and use. The sterile goods are stored in a dedicated st

25、orage area, where they are kept until they are taken away for the next use. In a sterile storage there are special requirements for environmental conditions and stock management. A regime of product shelf life or the concept of event related sterility is used to ensure the integrity of each sterile

26、item until its use.无菌储存灭菌周期完成后,物品将被拿出灭菌器。根据注册过程数据和在此周期中的检验指标，当所需的条件得到满足时,物品将被储存、运输和使用。无菌物品在被使用前被存储在一个专门的存储区，对该储存区有特殊的环境条件和库存管理的要求。物品保质期或和无菌相关的概念用来确保无菌物品在使用之前的完整性。Transportation to the userWhen sterile goods are needed they can be requested to be picked up from the sterile storage and are transported

27、 in dedicated closed trolleys or container systems to the locations where they are needed. When materials are to be transported outside the facility, additional measures are to be taken to ensure the integrity of the materials and an adequate protocol is necessary for handing over of the goods to th

28、e end-user.无菌物品的运输当人们需要使用无菌物品时，它们就会被从无菌储存区中取出，并通过密封的手推车或容器运送到所需地点。当物品运送到设备外，需要额外的措施来确保物品的完整性和适当方案使得物品安全交付到最终用户。Use of sterile productsAny sterile product needs to be used correctly to ensure its safe use on a patient. By simply opening the sterile package wrongly, the instruments can be contaminated

29、, just before they are used By considering the concept of aseptic procedures, the chances on recontamination at the moment of using sterile goods is to be reduced to a minimum. The aseptic opening of a sterile pack and the presentation of an instrument to the surgeon are examples of such procedures.无菌产品的使用应正确使用无菌产品,以确保病人的安全。仅是错误地打开无菌包装都可能使器械在使用之前就被污染。严格遵守无菌规程，在使用时就能将无菌物品的再次污染降低到最小限度。例如无菌条件下打开无菌包装，将器械传递给外科医生都是这一规程的具体体现。Quali