题名

氯化合物消毒錠應用於加護中心及新冠肺炎專責病房環境及設備消毒探討

并列篇名

Application of Sodium Dichloroisocyanurate in Disinfection of the Environments of Intensive Care Units and COVID-19 Special Wards

DOI

10.6530/YYN.202211_16(3).0005

作者

邱春榕(Chun-Jung Chiu);呂宗憲(Tsung-Chieng Lu);鍾凱吉(Kai-Chi Chung);商弘昇(Hung-Sheng Shang);張瓈方(Li-Fang Chang)

关键词

醫療環境及設備消毒 ; 二氯異氰尿酸鈉消毒錠 ; 新型冠狀病毒 ; 感染控制 ; medical environment and equipment disinfection ; sodium dichloroisocyanurate tablets ; severe acute respiratory syndrome coronavirus 2 ; infection control

期刊名称

源遠護理

卷期/出版年月

16卷3期(2022 / 11 / 01)

页次

31 - 39

内容语文

繁體中文;英文

中文摘要

目的: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,故比較兩種消毒溶液使用於醫療環境消毒時ATP變化之差異,並應用於新型冠狀病毒之環境消毒。方法:使用不同消毒溶液(NaDCC組與NaCIO組)之拋棄式抹布在進行常規環境清潔時比較ATP變化之差異,分別於清潔前及清潔後0.5小時、2小時、4小時、24小時分別比較之。使用NaDCC溶液於新型冠狀病毒病人之病室環境消毒,進行SARS-CoV-2 PCR採檢。結果:NaDCC溶液從清潔後2小時到4小時在ATP的下降幅度顯著優於漂白水組,顯示NaDCC溶液消毒後維持效果優於漂白水(P.003),且NaDCC溶液應用於新型冠狀病毒病人之環境消毒後,檢驗SARS-CoV-2 PCR均為陰性。結論:使用NaDCC於醫療環境消毒,其消毒效力之持續時間優於漂白水之外,其人力及時間亦均較節省。且將其應用於新型冠狀病毒環境消毒除便利性高,亦可有效避免病毒傳播,本研究結果可提供各醫療機構於環境消毒上之參考。

英文摘要

Objectives: When using bleach, its dilution ratio has to be calculated and it can only be used for 24 hours after dilution. Moreover, it is instable, has strong alkaline corrosion, and leaves a residue after use. Therefore, it is difficult to appropriately and adequately implement its use by the cleaning staff and difficult to master its disinfection effect. Diluted solution of sodium dichloroisocyanurate (NaDCC) tablets has a longer storage life and stronger bactericidal effect than bleach. Our institution has been using NaDCC to disinfect environments with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have shared our experience. Methods: The differences in ATP changes when using a disposable cleaning cloth with different disinfection solutions (the NaCIO group and NaDCC group) to perform routine environment cleaning were investigated by comparing the ATP values before cleaning and at 0.5, 2, 4, and 24 hours after cleaning. The two solutions were also applied during environmental disinfection in institutions admitting and treating patients with SARS-CoV-2 infection and environment disinfection of nursing stations. Results: Although the t-test did not reveal any significant difference in ATP at the different time points, the rising trend of the NaDCC group was continuously lower than that of the NaCIO group, which still was within the reference range. The decline in ATP from 2 hours to 4 hours after cleaning with NaDCC disinfection solution was better than that in the bleach group, indicating that the disinfection effect of the NaDCC disinfection solution was better than that of bleach (P = 0.003). In addition, the allocated working hours of the NaDCC group were significantly lower than those of the NaCIO group. After application in disinfecting environments contacted by patients with SARS-CoV-2 infection, it was confirmed that there was no viral residue in the environments. Conclusions and Suggestions: When applied in environment disinfection, NaDCC not only had a longer duration of disinfection effect than bleach but also had lower storage of disinfection solution, labor, and time costs. In addition, its practicality and degree of satisfaction were significantly higher among staff. The results of this study can provide references for medical institutions in environment disinfection and infection control.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 邱春榕,呂宗憲,謝秉軒,蔣立琦,王甯祺,高啟雯(2018)。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。源遠護理,12(3),35-44。
    連結:
  2. Centers for Disease Control and Prevention. (2020). Cleaning and Disinfection for Community Facilities. 28 March 2020, Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection.html
  3. Friedman, N. D.,Walton, A. L.,Boyd, S.,Tremonti, C.,Low, J.,Styles, K.,Harris, O.,Alfredson, D.,Athan, E.(2013).The effectiveness of a single-stage versus traditional three-staged protocol of hospital disinfection at eradicating vancomycin-resistant Enterococci from frequently touched surfaces.American Journal of Infection Control,41(3),227-231.
  4. Gharpure, R.,Hunter, C. M.,Schnall, A. H.,Barrett, C. E.,Kirby, A. E.,Kunz, J.,Berling, K.,Mercante, J. W.,Murphy, J. L.,Garcia-Williams, A. G.(2020).Knowledge and practices regarding safe household cleaning and disinfection for COVID-19 prevention-United States, May 2020.MMWR,69(23),705-709.
  5. Heling, I.,Rotstein, I,Dinur, T.,Szwec-Levine, Y.,Steinberg, D.(2001).Bactericidal and cytotoxic effects of sodium hypochlorite and sodium dichloroisocyanurate solutions in vitro.Journal of Endodontics,27(4),278-280.
  6. Kurian, J.,Bolla, N.,Damaraju, B.(2012).Comparative evaluation of effectiveness of sodium dichloroisocyanurate and calcium hydroxide against Candida albicans.The Journal of Contemporary Dental Practice,13(5),665-670.
  7. Liang, K. Y.,Zeger, S. L.(1986).Longitudinal data analysis using generalized linear models.Biometrika,73(1),13-22.
  8. Ong, S. W. X.,Tan, Y. K.,Chia, P. Y.,Lee, T. H.,Ng, O. T.,Wong, M. S. Y.,Marimuthu, K.(2020).Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient.Journal of the American Medical Association,323(16),1610-1612.
  9. Palmore, T. N., & Smith, B. A. (2022). COVID-19: Infection prevention for persons with SARS-CoV-2 infection. Up To Date. Retrieved Oct 20, 2022 from https://www-uptodate-com.autorpa.ndmctsgh.edu.tw/contents/covid-19-infection-control-in-health-care-and-home-settings?sectionName=Environmental%20cleaning%20and%20disinfection&search=covid%2019&topicRef=126981&anchor=H3177901446&source=see_link#H3177901446
  10. Sharafi, S. M.,Ebrahimpour, K.,Nafez, A.(2020).Environmental disinfection against COVID-19 in different areas of health care facilities: A review.Reviews on Environmental Health,36(2),193-198.
  11. Shimabukuro, P. M. S.,Duarte, M. L.,Imoto, A. M.,Atallah, Á. N.,Franco, E. S. B.,Peccin, M. S.,Taminato, M.(2020).Environmental cleaning to prevent COVID-19 infection. A rapid systematic review.Sao Paulo Medical Journal,138(6),505-514.
  12. United States Environmental Protection Agency. (2020). About List N: Disinfectants for coronavirus (COVID-19). Retrieved from https://www.epa.gov/coronavirus/about-list-n-disinfectants-coronavirus-covid-19-0
  13. William, A. R., David, J. W. & the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities. Retrieved from www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf
  14. 高智雄 (2021 年 5 月 26 日).新冠肺炎抗原快篩與 PCR 篩檢原理與結果判讀解析.社團法人台灣醫事檢驗學會.https://www.labmed.org.tw/knowledge_1.asp?mno=120
  15. 郭秀娥,石娟娟,楊曼華(2007)。氯化合物之最新發展趨勢-NaDCC 在消毒劑的定位。感染控制雜誌,17(5),322-330。
  16. 衛生福利部疾病管制署 (2021,6 月 14 日) 醫療機構因應 COVID-19 感染管制措施指引.取自https://www.cdc.gov.tw/Category/MPage/I92jtldmxZO_oolFPzP9HQ
  17. 衛生福利部疾病管制署 (2018,9 月 6 日).人口密集機構感染管制措施指引,取自 https://www.cdc.gov.tw/File/Get/PB1NYNPnwOjK2h9owVdTQw