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

1. 为构建居家长期人工呼吸道管理患者的感染控制系统，对38例患者进行感染控制情况调查，并对气管吸痰相关材料进行细菌学检测。不同护理人员对气管吸痰感染控制方法不同，许多病例未遵守清洁程序。聚氯乙烯导管粘附在气管吸引管上的活菌数量明显少于橡胶导管，且大多数分离菌为革兰氏阴性棒菌。提出了开展循证感染控制教育的必要性。2. 为了获得感染控制的证据，对样本进行了形态学和细菌学调查，并概述了指南如下：(1)聚氯乙烯导管指定用于重复使用。(2)经导管吸入无菌蒸馏水后，吸入气道分泌物。(3)用酒精棉擦拭沾在导管外表面的分泌物。(4)用100毫升或更多的自来水冲洗掉导管内的分泌物。(5)导管浸泡在消毒剂中保存。(6)每24小时更换一次导管和消毒剂，将无菌蒸馏水细分成等份供一次性使用。3. 将感染控制指南反馈给从事家庭护理的人员，以及如何提高气管吸引的安全性，例如通过护士进行感染控制教育。

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.