Discussion on the protection of enzyme cleaning agent in disinfection supply room The staff in disinfection supply room are the high-risk group of hospital infection, and there are various harmful factors in special environment, including the harm of enzyme cleaning agent which is easily overlooked. In order to reduce occupational hazards, this paper analyzes the reasons, summarizes the experience and puts forward protective measures to ensure the safety of employees.

Keywords enzyme cleaning agent; Adverse reactions; protective measure

The staff of disinfection supply room is a special group engaged in special work in special environment, and is responsible for the recovery, classification, cleaning, disinfection, packaging, sterilization and distribution of various instruments and dressing packages used in clinic. In this series of processes, they are faced with many unsafe factors of occupational injuries, which threaten the health of staff [1]. Enzyme cleaning agent for cleaning medical devices has been used for many years at home and abroad. Multi-enzyme cleaning agent is very important for cleaning organic substances in medical devices with complex structure, unsmooth surface and pores, but its precautions and the harm caused by enzyme cleaning agent have not been paid attention to.

1 Function of enzyme cleaning agent

The principle of 1. 1 is to decompose macromolecular fat, protein, sugar and other organic substances into water-soluble small molecular substances, so as to achieve the purpose of cleaning.

1.2 Multi-enzyme cleaning agent mainly contains hydrolases of protein, fat, mucopolysaccharide and carbohydrate, and has a strong ability to dissolve and remove pus, blood and other secretions on articles, especially dry dirt on the surface.

1.3 enzyme cleaning agent can increase the ability to remove microorganisms on the surface of objects during cleaning, and can enter the deep part of the lumen, penetrate all the surfaces of the lumen, decompose organic substances, and reduce the biological load on the surface of objects by 3 ~ 5 logarithmic orders.

2 Classification of enzyme cleaning agents

2. 1 mainly uses microbial fermentation to produce various enzyme preparations. Single enzyme and multiple enzymes [1]: The enzyme cleaning agent used for cleaning contains at least 1 enzyme (single enzyme cleaning agent), and the enzyme cleaning agent used for cleaning medical devices must use multiple enzyme cleaning agents, which must contain at least four enzymes: protease, lipase, cellulase and amylase. Protease: An enzyme that catalyzes the hydrolysis of protein. Amylase: generally acts on α- 1, 4- glucan such as soluble starch, amylose and glycogen to hydrolyze α- 1, 4- glycosidic bond. Cellulase is an enzyme that plays a biocatalytic role in decomposing cellulose. Lipase: catalyzes the hydrolysis of natural substrate oil to produce fatty acids, glycerol and glycerol monoesters or diesters.

2.2 The industrial technical content of enzyme cleaning agents in powdered enzyme and liquid enzyme powder state is low, and most of them are single enzymes, which are easy to remain and have low activity. When diluted, it is easy to cause uneven and incomplete dissolution, and the solubility is difficult to control, and it is easy to splash on human skin and mucosa to cause damage.

3. Side effects of enzyme cleaning agent

3. 1 multi-enzyme cleaning agent is easy to form aerosol in the preparation process, which is irritating to human respiratory tract and skin, and even has symptoms of chemical bronchitis or pneumonia. Soaked and disinfected enzymes, cleaning and long-term contact have adverse effects on human skin, nervous system and gastrointestinal tract [3] 3.2 At present, there are many kinds of medical enzyme cleaning agents, and the quality requirements, enterprise production standards and product specifications are inconsistent. Multi-enzyme cleaning agents generally also contain stabilizers, preservatives and detergents. Stabilizers and preservatives can prevent mutual destruction between enzymes and maintain the stability of enzyme solution; Cleaning agents can remove and prevent the re-accumulation of dirt. Some domestic enzyme cleaning agents use highly toxic ethylene glycol as stabilizer. Ethylene glycol is mainly used as antifreeze and stabilizer. It is colorless, odorless, tasteless, non-volatile and non-corrosive. Inhalation into the human body will cause chronic poisoning, which will have a serious impact on pregnant women and fetuses in the abdomen, and even cause deformed children. Men will reduce the number of sperm and indirectly affect fertility.

4 protective measures

4. 1 Strengthen health education and training, raise awareness of occupational protection, establish occupational exposure protection system, and strengthen the study of occupational safety protection knowledge.

4.2 When using enzyme cleaning agent, the operation should be standardized. First of all, when choosing a multi-enzyme cleaning agent, we should choose a multi-enzyme cleaning agent that is liquid, clear, transparent, bubble-free or less, uniform and impurity-free, has a rinsing function, meets the requirements of the best water temperature and has no restrictions on water quality. Master the correct configuration method, do not spray enzyme cleaning agent, and wear round hat, mask, rubber gloves, protective mask and rubber shoes when touching. At the same time, when using immersion and ultrasonic instruments, they should be sealed, because they are volatile and easy to cause respiratory irritation when exposed to air. If you accidentally splash it into your eyes, wash it with running water immediately.

4.3 Strengthen hand hygiene, take off contaminated gloves as soon as possible after work, and immediately standardize hand washing.

4.4 Regularly open the window for ventilation and turn on the exhaust fan. Thereby reducing the content of harmful gases in the air.

4.5 Carry out health examination every year, strengthen the protection of personnel in disinfection supply center, and establish health records.

4.6 Reasonable shift arrangement, monthly shift adjustment, avoiding long-term contact with enzyme cleaning agents, reducing occupational injuries, and advocating the people-oriented management concept.

4.7 Strengthen physical exercise at ordinary times, have a full rest and enhance physical fitness.

5 experience

The working nature of the disinfection supply room determines that the staff are very likely to have hospital infection during their work. In the whole operation process, there are many occupational exposure factors such as biology, physics and chemistry at any time. We should not only pay attention to the common hazards, but also fully understand the hazards that are usually ignored, such as cleaning agents and disinfectants. For these, occupational protection is particularly important. The occupational protection of supply room staff should start with prevention and strengthen the training of occupational safety technology operation, especially the training of new nurses and nurses; Strictly implement various operating procedures, strengthen safety awareness, create a safe and healthy working environment, and improve necessary protective appliances and equipment.

Take the exam and contribute.

[1] Zhang Chunfei, should. Occupational Hazards and Protection of Staff in Hospital Supply Room [J]. China Disinfection Journal, 2008,25 (6): 687 ~ 688.

Wei. Problems related to enzymatic washing of medical devices [J]. China Journal of Misdiagnosis, 2007, 10 (7): 5726 ~ 5727.

Zheng Zhongli, Guo Kai. Hazard factors and preventive measures of nurses in supply room [J]. The 6th Disinfection Supply Center Development Forum, 20 10, 8: 897 ~ 898.