Investigation and nursing countermeasures on the current situation of oral instrument cleaning，disinfection，and sterilization management in 348 medical institutions in Henan Province

doi:10.3761/j.issn.0254-1769.2025.05.013

Abstract

Abstract:

Objective To investigate the current status of cleaning，disinfection，and sterilization management of dental instruments in medical institutions in Henan Province，analyze potential issues in hospital infection control，and propose targeted nursing strategies. Methods A convenience sampling method was used to survey the cleaning，disinfection，and sterilization management of dental instruments in 352 medical institutions in Henan Province from February to April 2024. A self-made questionnaire was designed，covering aspects such as the handling model and personnel configuration for dental instruments，training for cleaning，disinfection，and sterilization personnel，configuration and maintenance of cleaning and disinfection equipment，use and management of small pressure steam sterilizers，and reprocessing status of dental instruments. Results A total of 352 questionnaires were distributed，with 348 valid responses. Among the 34 primary medical institutions，only 10（29.41%） had a centralized cleaning，disinfection，and sterilization model for dental instruments；13（38.24%） had dedicated personnel for cleaning，disinfection，and sterilization of dental instruments；25（73.53%） were equipped with pressure water guns. Compari-sons among medical institutions of different levels showed statistically significant differences（P<0.001）. In the 348 medical institutions，194（55.75%） arranged pre-job training for nursing personnel；143（41.09%） performed mainte-nance on cleaning and disinfection equipment once a year；52（14.94%） did not perform pre-treatment on contaminated dental instruments after use. Among the 104 institutions using small pressure steam sterilizers，21（20.19%） used Type N small pressure steam sterilizers. Conclusion The centralized management rate of dental instruments and the basic equipment configuration rate in primary medical institutions in Henan Province are relatively low. There are issues such as insufficient personnel training，neglect of equipment maintenance，improper management of small pressure steam sterilizer usage，and incomplete reprocessing procedures in medical institutions at all levels. It is recommended that nursing managers further strengthen the training of nurses in the disinfection supply center，standardize the cleaning，disinfection，and sterilization workflow for dental instruments，in order to prevent and control hospital infections.

Key words: Medical Institutions, Oral Instruments, Cleaning, Disinfection, Sterilization, Hospital Infections, Current Status Investigation, Nursing Administration Research

摘要：

目的调查河南省医疗机构口腔器械清洗消毒灭菌管理现状，分析医院感染防控的潜在问题并提出针对性护理对策。方法采用方便抽样法，于2024年2月—4月对河南省352所医疗机构口腔器械清洗消毒灭菌管理现状进行调查。采用自制问卷，内容包括口腔器械处理模式及人员设置、清洗消毒灭菌人员培训、清洗消毒设备设施配置及维护、小型压力蒸汽灭菌器的使用和管理、口腔器械再处理情况等。结果共发放问卷352份，回收有效问卷348份。其中，34所一级医疗机构中，仅10所（29.41%）口腔器械处理模式为消毒供应中心集中清洗消毒灭菌；13所（38.24%）设有口腔器械专职清洗消毒灭菌人员；25所（73.53%）配备压力水枪，不同等级医疗机构间比较，差异具有统计学意义（P<0.001）。348所医疗机构中，194所（55.75%）组织护士开展岗前培训；143所（41.09%）每年对清洗消毒设备进行1次维护保养；52所（14.94%）未对使用后的口腔器械做预处理。在104所配备小型压力蒸汽灭菌器的医疗机构中，21所（20.19%）使用N型小型压力蒸汽灭菌器。结论河南省一级医疗机构口腔器械集中管理率和基础设备配置率较低，各级医疗机构存在人员培训不到位、设备设施维护保养不重视、小型压力蒸汽灭菌器使用管理不规范、再处理流程不完善等情况。建议护理管理者加强消毒供应中心护士培训，规范口腔器械清洗消毒灭菌工作流程，从而预防与控制医院感染。

关键词: 医疗机构, 口腔器械, 清洗消毒灭菌, 医院感染, 现状调查, 护理管理研究

CUI Yuzhen, YAO Zhuoya, GENG Junhui, LI Manchun, ZHAN Meng, DING Lina, JIANG Enshe. Investigation and nursing countermeasures on the current situation of oral instrument cleaning，disinfection，and sterilization management in 348 medical institutions in Henan Province[J]. Chinese Journal of Nursing, 2025, 60(5): 596-602.

崔钰震, 姚卓娅, 耿军辉, 李漫春, 詹朦, 丁丽娜, 蒋恩社. 河南省348所医疗机构口腔器械清洗消毒灭菌管理现状及护理对策[J]. 中华护理杂志, 2025, 60(5): 596-602.

Figures/Tables 4

Table 1 Training status of personnel for oral instrument cleaning，disinfection，and sterilization[cases（percentage，%）]

Table 2 Configuration and maintenance of facilities for oral instrument cleaning and disinfection [cases（percentage，%）]

Table 3 Use and management status of small pressure steam sterilizers[cases（percentage，%）]

Table 4 Reprocessing of oral instruments[cases（percentage，%）]

References 19

[1]	Yang X, Liu RL, Zhu JK, et al. Evaluating the microbial aerosol generated by dental instruments:addressing new challenges for oral healthcare in the hospital infection[J]. BMC Oral Health, 2023, 23(1):409. DOI PMID
[2]	丁建勇, 叶先智, 郭怡, 等. 门诊口腔疾病患者医院感染的危险因素分析[J]. 中华医院感染学杂志, 2017, 27(21):5026-5029.
	Ding JY, Ye XZ, Guo Y, et al. Risk factors for nosocomial infe-ctions in patients with oral diseases of outpatient departments[J]. Chin J Nosocomiology, 2017, 27(21):5026-5029.
[3]	国家卫生和计划生育委员会. 口腔器械消毒灭菌技术操作规范:WS 506—2016[S]. 北京: 中国标准出版社, 2017.
	National Health and Family Planning Commission of People’s Republic of China. Regulation for disinfection and sterilization technique of dental instruments:WS 506—2016[S]. Beijing: Standards Press of China, 2017.
[4]	王顺彩, 刘玉芹, 王凯, 等. 青海省医疗机构口腔器械清洗消毒现状调查[J]. 中国消毒学杂志, 2022, 39(9):691-693,697.
	Wang SC, Liu YQ, Wang K, et al. Investigation on the current situation of cleaning and disinfection of oral instruments in medical institutions in Qinghai Province[J]. Chin J Disinfect, 2022, 39(9):691-693,697.
[5]	李秀英, 路珊珊, 张虹, 等. 苏州某区口腔诊疗机构可复用器械清洗、消毒及灭菌现况研究[J]. 中国消毒学杂志, 2022, 39(6):461-463,467. DOI
	Li XY, Lu SS, Zhang H, et al. Current status of cleaning,disinfection and sterilization of reusable medical instruments in dental clinics in a district of Suzhou[J]. Chin J Disinfect, 2022, 39(6):461-463,467.
[6]	张小兵, 徐笑, 张宇. 医院消毒供应中心集中管理方式现状调查与分析[J]. 中国护理管理, 2023, 23(8):1126-1129,1121.
	Zhang XB, Xu X, Zhang Y. Investigation and analysis of the centralized management mode in Central Sterile Supply De-partments[J]. Chin Nurs Manag, 2023, 23(8):1126-1129,1121.
[7]	吴艳艳, 杨阳, 何全利, 等. 不同管理模式对医院口腔器械消毒灭菌质量的影响[J]. 中国消毒学杂志, 2020, 37(9):709-711. DOI
	Wu YY, Yang Y, He QL, et al. Influence of different mana-gement modes on disinfection and sterilization quality of dental instruments in hospitals[J]. Chin J Disinfect, 2020, 37(9):709-711.
[8]	钱黎明, 车凤莲, 季侃雯, 等. 我国三级医院消毒供应中心人员配置及岗位设置的现状分析[J]. 中华护理杂志, 2015, 50(9):1125-1127.
	Qian LM, Che FL, Ji KW, et al. The present situation of the human resource management and the post setting at the central sterile supply department of tertiary hospitals in China[J]. Chin J Nurs, 2015, 50(9):1125-1127.
[9]	黄凝, 何正, 安娜, 等. 某三级专科口腔医院护理人员消毒灭菌知识、态度及行为调查分析[J]. 中国消毒学杂志, 2022, 39(8):616-618. DOI
	Huang N, He Z, An N, et al. Investigation and analysis on knowledge,attitude and behavior of disinfection and steri-lization among nurses in a tertiary stomatological hospital[J]. Chin J Disinfect, 2022, 39(8):616-618.
[10]	康洁, 张青, 杨红, 等. 消毒供应中心护士岗位胜任力现状及影响因素分析[J]. 中华护理杂志, 2022, 57(19):2385-2391. DOI URL
	Kang J, Zhang Q, Yang H, et al. The status quo and influen-cing factors of post competency among nurses in central sterile service departments[J]. Chin J Nurs, 2022, 57(19):2385-2391.
[11]	陈沅, 钱蒨健, 孙育红, 等. 1225所医院围手术期植入物使用与管理现状调查[J]. 中华护理杂志, 2021, 56(12):1827-1834. DOI URL
	Chen Y, Qian QJ, Sun YH, et al. Investigation on the use and management of perioperative implants in 1225 hospitals in China[J]. Chin J Nurs, 2021, 56(12):1827-1834. DOI URL
[12]	李漫春, 王梅杰, 姚卓娅, 等. 河南省238所医院消毒供应中心灭菌人员岗位胜任力的调查研究[J]. 中华护理杂志, 2022, 57(3):331-336. DOI URL
	Li MC, Wang MJ, Yao ZY, et al. Investigation on the post competence of sterilization personnel in 238 hospitals in Henan Province[J]. Chin J Nurs, 2022, 57(3):331-336. DOI URL
[13]	Instrument Reprocessing Working Group. Instrument reproces-sing in dental practices how to do it right[M]. 4th anniversa-ry edition,German: Arbeitskreis Instrumenten-Aufbereitung, 2016.
[14]	谢彦昕, 朱渭萍, 王勇, 等. 浦东新区医疗机构口腔科医院感染管理现状调查[J]. 中国消毒学杂志, 2021, 38(4):314-317. DOI
	Xie YX, Zhu WP, Wang Y, et al. Investigation into the current situation of infection management in the dental departments of medical institutions in Pudong New Area[J]. Chin J Disin-fect, 2021, 38(4):314-317.
[15]	张宇, 李六亿, 巩玉秀, 等. 中国医院小型蒸汽灭菌器现状调查[J]. 中华医院感染学杂志, 2020, 30(6):951-954.
	Zhang Y, Li LY, Gong YX, et al. Current status of small steam sterilizers in Chinese hospitals[J]. Chin J Nosocomiology, 2020, 30(6):951-954.
[16]	国家卫生和计划生育委员会. 医院消毒供应中心第2部分:清洗消毒及灭菌技术操作规范WS 310.2-2016[S]. 北京: 中国标准出版社, 2017.
	National Health and Family Planning Commission of People’s Republic of China. Central sterile supply department(CSSD)-Part 2:Standard for operating procedure of cleaning,disin-fection and sterilization WS 310.2-2016[S]. Beijing: Standards Press of China, 2017.
[17]	王雪晖, 龚茹洁, 钱蒨健, 等. 生理盐水致手术器械锈蚀反应的观察研究[J]. 中华护理杂志, 2014, 49(5):606-608.
	Wang XH, Gong RJ, Qian QJ, et al. The corrosive effect of sodium Chloride physiological solution on surgical instruments[J]. Chin J Nurs, 2014, 49(5):606-608.
[18]	刘玲, 甘俊丽, 张世华, 等. 不同预处理方法对隔夜手术器械清洗质量的影响[J]. 护理研究, 2017, 31(10):1249-1251.
	Liu L, Gan JL, Zhang SH, et al. Influence of different pretrea-tment methods on cleaning quality of overnight surgical instruments[J]. Chin Nurs Res, 2017, 31(10):1249-1251.
[19]	鲍文丽, 王宇群, 叶莺. 牙科手机机械清洗后4种干燥方法效果的对比研究[J]. 中华护理杂志, 2018, 53(3):318-320.
	Bao WL, Wang YQ, Ye Y. Effects of four drying methods after mechanical cleaning of dental handpieces[J]. Chin J Nurs, 2018, 53(3):318-320.