應用氯化合物消毒錠（Sodium dichloroisocyanurate, NaDCC tablets）稀釋溶液進行加護病房環境消毒之成效

Application of Standardized and Use of Sodium Dichloroisocyanurate Tablets for Environmental Disinfection

10.6530/YYN.201811_12(3).0005

邱春榕(Chun-Jung Chiu)；呂宗憲(Tsung-Chieng Lu)；謝秉軒(Ping-Hsuan Hsieh)；蔣立琦(Li-Chi Chiang)；王甯祺(Ning-Chi Wang)；高啟雯(Chi-Wen Kao)

醫療環境及設備消毒 ； 二氯異氰尿酸鈉消毒錠 ； 感染控制 ； disinfection ； Sodium dichloroisocyanurate ； troclosenetablets ； Infection control

源遠護理

12卷3期（2018 / 11 / 01）

35 - 44

繁體中文

背景：氯化合物NaDCC消毒錠稀釋溶液，其保存時限及殺菌力皆優於漂白水。擬探討NaDCC消毒錠稀釋溶液取代漂白水是否為有效消毒並降低醫療照護相關感染密度之方法。方法：遴選一篇臨床指引採用AGREE進行評讀。另搜尋結果為中英文文獻資料庫共42篇，排除並刪除文獻後，共評讀4篇文獻，本文以文獻回顧之方式，搜尋Cochrane、EBSCOHOST、PubMed及CEPS資料庫，年限至2016年5月搜尋到42篇文獻，刪除不相關文章，採用2013年版的CASP作為個案對照研究的評讀工具。自104年1月1日至104年6月30日及104年10月至105年3月選擇北部某醫學中心之9個成人加護病房，介入期間以NaDCC替代漂白水進行環境消毒。結果：經pair-t檢定後，NaDCC組之醫療照護相關感染密度低於常規漂白水組t = -4.53（p ＜ .001）；NaDCC組之醫療照護相關感染人次低於常規漂白水組t = -4.61（p ＜ .001）。結論：經由NaDCC環境清潔措施介入後，有效減少發生醫療照護相關感染發生密度，結果可供各醫療機構於環境消毒之參考，以提昇醫療照。

Background: NaDCC tablet solution has more bactericidal persistence, longer preservation time and stronger bactericidal than sodium hypochlorite. This paper explores whether NaDCC tablet solution is more effective in disinfection and reduction in the density of medical care-related infections. Methods: The Critical Appraisal Skills Programme AGREE was used to appraise the quality of the Guideline. Literature search used Cochrane, EBSCO HOST, PubMed and CEPS databases for relevant articles that were published before May, 2016. Forty two studies were identified and four evidence-based references were selected for follow-up assessment. The Critical Appraisal Skills Programme (CASP, 2013) was used to appraise the quality of the reviewed studies. A prospective study design was conducted in the 9 adult intensive care units of a medical center in northern Taiwan from Jan 1 to May 30, 2015 and from October 2015 to March 2016. During the intervention, NaDCC tablet solution was used to replace sodium hypochlorite for environmental disinfection. Result: The paired t-test was used. The infection rate of the Healthcare-associated infection in the NaDCC group was lower than that in the conventional bleach group t = -4.53 (P ＜.001); the medical care-related infection in the NaDCC group was lower than that in the conventional bleach group t = -4.61 (P ＜.001). Conclusions: Use of NaDCC for environmental disinfection has a positive effect on reducing healthcare-associated infection rate. The results may be used as a reference to enhance patient safety and quality of healthcare.

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