医护人员,你的电脑键盘清洁吗?

2018-02-28 许磊 SIFIC感染官微

护士站,一名护士敲打着键盘,认真的核对医嘱……

护士站,一名护士敲打着键盘,认真的核对医嘱……

家属:护士…护士…15床病人的液体输完了。

护士:好的,您稍等。

护士连忙放下手头的工作,端起治疗盘来到病人床边,核对病人信息无误后,拔针、止血,熟练的操作,一气呵成,伴随着病人的一声谢谢,护士满意的返回护士站继续敲着键盘核对医嘱……



可是妹纸,你的电脑键盘清洁吗?这是一个简单的问题,同时也是一个容易被忽略的问题,更是一个需要我们医务人员重视的问题

电脑的广泛应用让各行各业的工作变得简便,高效和准确,在医院里为病人办理入院、出院,开具医嘱,核对医嘱,执行医嘱,书写病历,护理记录等等都离不开电脑,电脑键盘也成为临床高频接触的物品。

按照《病区医院感染管理规范》的要求,每天要对各类仪器物表进行湿式清洁,保持清洁、干燥,同时在遇到污染时随时清洁。

但实际工作中电脑键盘的清洁消毒常常被我们护士和保洁人员所忽略,是因为我们的键盘不接触病患较少受到污染而不需要每天清洁吗?还是因为它凹凸不平的表面及大量的间隙难以清洁而不愿意清洁呢?

带着这些问题让我们一起来探究一下医院内电脑键盘的污染情况及清洁消毒对策吧。

一、键盘污染来源

多位研究者均发现,未经日常消毒的键盘的细菌污染率几乎为100%,或外观直接观察即污染明显,或看起干净,实际上致病微生物超标。造成键盘污染的主要原因有以下几点:

护士站多为开放性区域,医护人员、患者、家属及探视者人流量较大,空气中病原微生物密度高,随尘埃自然沉降在键盘表面及缝隙内造成污染。

医生或护士在接触病人或物品后未严格落实手卫生就开始使用电脑,通过接触传播的方式污染键盘。

检验科、病理科等医技科室工作人员常习惯于戴PE手套处理样品或标本,而此过程中需要借助电脑上进行操作,易造成键盘的污染。

少数医护人员在使用电脑时进食,导致在键盘缝隙中均藏匿有细小杂物,直接污染键盘的同时也为微生物的繁殖生存提供了适宜的环境。

清洁消毒不彻底,键盘表面凹凸不平,大量间隙,容易藏污纳垢且难易彻底清洁消毒。

护士及保洁人员对键盘污染重视不足,进行日常物表清洁消毒工作时电脑多在使用状态,不便于暂停工作进行清洁消毒或直接忽视掉对键盘的清洁消毒。

二、常见的病原菌种类

多名研究者对医院内电脑键盘进行表面采样培养,菌落计数约在60~360CFU/cm2之间,并检出多种医院感染致病菌,包括凝固酶阴性葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌、醋酸钙不动杆菌、大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、溶血链球菌、枯草杆菌、变形杆菌等细菌。

三、键盘污染的危害

无论对于医生还是护士来说,电脑键盘都是日常工作中接触频次较高的物品,开具医嘱,书写病历,核对医嘱,执行医嘱,护理记录以及办理出入院均需要在电脑上完成,污染后的键盘作为持续的传播源,在医护人员手卫生不规范的情况下通过手将病原体传播给病患、自己或家人。如此一来不仅容易造成医护人员自身及家人的感染,更为严重的是可能造成特定病原菌在医院内的感染暴发。

四、清洁消毒方式及效果

电脑键盘作为低度危险性物品,只需要达到低水平消毒即可,常用的低水平消毒剂有季铵盐类消毒剂和双胍类消毒剂,在合适的浓度和有效的作用时间下即可达到低水平消毒的目的。同时也可采用常用的中高水平消毒剂对键盘进行清洁消毒,如乙醇和含氯消毒剂。

来自不同医疗机构的研究者研究了不同类型的消毒剂对键盘消毒的效果,以消毒后菌落数小于10CFU/cm2为达标,清洁消毒的效果如下表:

表  各类消毒剂消毒效果

由上表可知采用中高低消毒剂均可达到对键盘清洁消毒的目的,但最终的消毒效果与消毒剂的浓度、作用时间及擦拭的过程紧密相关。各机构可根据自身情况选用合适类型的消毒剂对键盘进行清洁消毒。

五、其他建议与方法

认识医院内电脑键盘的污染现状并掌握其清洁消毒的方法对降低医院感染具有重要意义,但单纯的定期对键盘进行消毒是不够的,严格落实使用电脑前后的手卫生对保持键盘清洁亦十分重要。

除此之外还有其他的保持键盘清洁的方法可供参考,例如在键盘上覆盖薄膜,定期对薄膜进行清洁消毒;或选用家用保鲜膜进行覆盖,每日进行更换;有研究者采用一次性床单按照键盘尺寸进行裁剪,每日更换,既经济又方便(纳尼?床单?我不会盲打啊)。

只要积极性不滑坡

办法总比困难多

让我们群策群力

将键盘清洁进行到底

原始出处:

[1]曹岚, 李洁. 综合干预前后ICU床旁笔记本电脑键盘及鼠标细菌学监测[J]. 中国感染控制杂志, 2015,14(12):843-845.

[2]李莉, 林晓红, 谭伊莉, 等. 医院护士站电脑键盘、鼠标细菌污染情况调查分析及对策[J]. 现代临床护理, 2008,7(2):12-14

[3]杨俐. 医院电脑键盘和鼠标细菌污染调查[J]. 职业卫生与病伤, 2008,23(4):225-227.

[4]刘淑梅. 医用电脑键盘、鼠标的污染分析及管理对策[J]. 中国现代药物应用, 2014,8 (18):240-241.

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    2018-03-02 smartxiuxiu

    我知道你们说的都对.可是时间--呃

    0

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    2018-02-28 明月清辉

    谢谢分享.学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=292217, encodeId=ab2629221e16, content=我知道你们说的都对.可是时间--呃, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Fri Mar 02 07:54:16 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278555, encodeId=251812e8555a9, content=<a href='/topic/show?id=d80c343e4fd' target=_blank style='color:#2F92EE;'>#医护人员#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34374, encryptionId=d80c343e4fd, topicName=医护人员)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Thu Mar 01 16:31:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291636, encodeId=a3142916364a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Feb 28 08:19:13 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291614, encodeId=4301291614c9, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Wed Feb 28 07:30:11 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291582, encodeId=2bc029158200, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Feb 28 07:03:05 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291569, encodeId=f863291569bd, content=好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Feb 28 06:57:02 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291545, encodeId=55fe29154524, content=好好好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Wed Feb 28 05:25:31 CST 2018, time=2018-02-28, status=1, ipAttribution=)]
    2018-02-28 sunfeifeiyang

    0

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    2018-02-28 飛歌

    厉害了我的哥

    0

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    2018-02-28 忠诚向上

    好好学习天天向上

    0

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    2018-02-28 yjs木玉

    好好好好好好好好

    0