Construction of an infection control system for patients requiring long-term in-home respiratory management using an artificial respiratory circuit

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1. To construct an infection control system for patients requiring in-home long-term respiratory management using an artificial respiratory circuit, we surveyed the infection control state and performed bacteriological testing of tracheal suctioning-related materials in 38 patients. The infection control method related to tracheal suctioning varied among care-givers, and the cleaning procedure was not complied with in many cases. The number of viable bacteria adhered to tracheal suction catheters was significantly smaller on polyvinyl chloride catheters than on rubber catheters, and most isolates were gram-negative rods. The necessity of evidence-based infection control education was suggested. 2. To obtain evidence of infection control, samples were morphologically and bacteriologically investigated, and the guidelines were outlined as follows: (1) Polyvinyl chloride catheters are specified for repeated use. (2) Airway secretions are sucked after sucking sterile distilled water through the catheter. (3) Secretions adhered to the outer surface of the catheters are wiped off with alcoholic cotton. (4) Secretions in catheters are washed off with 100 ml or more of tap water. (5) Catheters are stored by immersion in disinfectants. (6) The catheter and disinfectant are replaced every 24 hours, and sterile distilled water is subdivided into aliquots for single use. 3. The infection control guidelines were fedback to persons engaged in in-home care, along with ways to improve the safety of tracheal suctioning, such as through infection control education by nurses.