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國家衛生計生委辦(ban)公(gong)廳

關(guan)于(yu)加強醫(yi)療機構(gou)醫(yi)用織物洗滌消毒管理(li)工作(zuo)的通(tong)知

各省、自治區、直轄市衛生計生委，新疆生產建設兵團衛生局：

醫(yi)(yi)用(yong)織(zhi)(zhi)物(wu)(wu)(wu)的(de)(de)洗滌消(xiao)毒工作是預防和控(kong)制醫(yi)(yi)院感(gan)染的(de)(de)環節之一，隨著醫(yi)(yi)療機構后勤工作社會化的(de)(de)逐(zhu)步推進，醫(yi)(yi)用(yong)織(zhi)(zhi)物(wu)(wu)(wu)交由社會化洗滌服(fu)務機構處理(li)存在(zai)環境衛(wei)生、洗滌質量問題。為(wei)加強醫(yi)(yi)療機構醫(yi)(yi)用(yong)織(zhi)(zhi)物(wu)(wu)(wu)管理(li)，保障醫(yi)(yi)療質量與患(huan)者安(an)全，現就有關工作提出如下要求(qiu)：

一、充分認識(shi)加強醫用織物洗滌消毒管理的(de)重要(yao)性，強化責任意(yi)識(shi)

醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)作(zuo)為(wei)特殊的醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)物(wu)品，多(duo)數(shu)將接觸患者(zhe)和(he)醫(yi)(yi)(yi)(yi)(yi)(yi)務人員皮膚(fu)。加強醫(yi)(yi)(yi)(yi)(yi)(yi)療(liao)機(ji)構醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)洗滌(di)消毒(du)管(guan)理(li)(li)，對于提高醫(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)管(guan)理(li)(li)水平、預(yu)防醫(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)感染、改善患者(zhe)就醫(yi)(yi)(yi)(yi)(yi)(yi)體驗(yan)具有重(zhong)要(yao)意義。各級衛(wei)生計(ji)生行(xing)政部門(men)和(he)醫(yi)(yi)(yi)(yi)(yi)(yi)療(liao)機(ji)構應當充分認識(shi)加強醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)洗滌(di)消毒(du)管(guan)理(li)(li)的重(zhong)要(yao)性，堅持“以病人為(wei)中心”的服務理(li)(li)念，將醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)洗滌(di)消毒(du)工(gong)作(zuo)納(na)入醫(yi)(yi)(yi)(yi)(yi)(yi)院(yuan)管(guan)理(li)(li)的重(zhong)要(yao)內容常抓不懈，建立常態化管(guan)理(li)(li)機(ji)制。落實醫(yi)(yi)(yi)(yi)(yi)(yi)療(liao)機(ji)構對本機(ji)構醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)洗滌(di)消毒(du)的主體責任(ren)，強化責任(ren)意識(shi)，依法依規開(kai)展醫(yi)(yi)(yi)(yi)(yi)(yi)用(yong)(yong)織物(wu)洗滌(di)消毒(du)工(gong)作(zuo)，確保洗滌(di)消毒(du)質(zhi)量符合臨床使(shi)用(yong)(yong)要(yao)求。

二、加(jia)強醫用(yong)織物洗滌消(xiao)毒管(guan)理，保障(zhang)洗滌消(xiao)毒質量

（一(yi)）自行(xing)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)的(de)醫療(liao)機構。要(yao)(yao)加(jia)強(qiang)(qiang)內設洗(xi)(xi)(xi)衣(yi)房(fang)管(guan)(guan)(guan)理(li)(li)(li)。一(yi)是完善(shan)組織(zhi)(zhi)(zhi)管(guan)(guan)(guan)理(li)(li)(li)框架。設置(zhi)專門(men)部(bu)門(men)或專（兼）職(zhi)人(ren)(ren)員(yuan)，建(jian)立后勤(qin)、醫務、醫院感染(ran)(ran)、護(hu)理(li)(li)(li)等(deng)相關部(bu)門(men)分(fen)(fen)工合作(zuo)的(de)管(guan)(guan)(guan)理(li)(li)(li)機制(zhi)(zhi)(zhi)，明確(que)管(guan)(guan)(guan)理(li)(li)(li)職(zhi)責，落(luo)實責任到位。二是加(jia)強(qiang)(qiang)制(zhi)(zhi)(zhi)度(du)建(jian)設。建(jian)立完善(shan)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)管(guan)(guan)(guan)理(li)(li)(li)工作(zuo)制(zhi)(zhi)(zhi)度(du)，至少包括(kuo)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)回(hui)收(shou)、洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)、質量管(guan)(guan)(guan)理(li)(li)(li)、定期(qi)更換等(deng)制(zhi)(zhi)(zhi)度(du)，并(bing)(bing)保障制(zhi)(zhi)(zhi)度(du)落(luo)實到位。三(san)是加(jia)強(qiang)(qiang)洗(xi)(xi)(xi)衣(yi)房(fang)環境衛生(sheng)管(guan)(guan)(guan)理(li)(li)(li)。合理(li)(li)(li)規(gui)劃布局，符合環保要(yao)(yao)求。清潔(jie)區(qu)(qu)、半污(wu)染(ran)(ran)區(qu)(qu)和(he)污(wu)染(ran)(ran)區(qu)(qu)分(fen)(fen)區(qu)(qu)明確(que)。設置(zhi)獨(du)立的(de)人(ren)(ren)流和(he)物(wu)(wu)(wu)(wu)(wu)流通道；接(jie)收(shou)污(wu)染(ran)(ran)的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)與(yu)發放洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)后的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)應(ying)當(dang)分(fen)(fen)區(qu)(qu)管(guan)(guan)(guan)理(li)(li)(li)。工作(zuo)流程合理(li)(li)(li)，物(wu)(wu)(wu)(wu)(wu)流由污(wu)染(ran)(ran)區(qu)(qu)到清潔(jie)區(qu)(qu)，不交(jiao)叉、不逆行(xing)。保證環境清潔(jie)衛生(sheng)。四是加(jia)強(qiang)(qiang)環節管(guan)(guan)(guan)理(li)(li)(li)。加(jia)強(qiang)(qiang)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)分(fen)(fen)類(lei)回(hui)收(shou)管(guan)(guan)(guan)理(li)(li)(li)，傳染(ran)(ran)性疾病(bing)科使用(yong)(yong)(yong)(yong)后的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)，以及(ji)被血液、嘔吐物(wu)(wu)(wu)(wu)(wu)和(he)患者其他體(ti)液污(wu)染(ran)(ran)的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)應(ying)當(dang)單獨(du)回(hui)收(shou)并(bing)(bing)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)。嚴格按照洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)標準操作(zuo)規(gui)程，根據醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)的(de)污(wu)染(ran)(ran)性質、程度(du)和(he)使用(yong)(yong)(yong)(yong)對象(xiang)進行(xing)分(fen)(fen)類(lei)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)。對洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)后的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)進行(xing)妥(tuo)善(shan)保存(cun)并(bing)(bing)及(ji)時提供臨(lin)床使用(yong)(yong)(yong)(yong)。嚴格按照《醫療(liao)廢物(wu)(wu)(wu)(wu)(wu)管(guan)(guan)(guan)理(li)(li)(li)條例》等(deng)要(yao)(yao)求，加(jia)強(qiang)(qiang)醫療(liao)廢物(wu)(wu)(wu)(wu)(wu)管(guan)(guan)(guan)理(li)(li)(li)，醫療(liao)廢水(shui)排放應(ying)當(dang)符合環保要(yao)(yao)求。五是加(jia)強(qiang)(qiang)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)質量控制(zhi)(zhi)(zhi)。對洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)后的(de)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)，應(ying)當(dang)有專人(ren)(ren)對其性狀(zhuang)、表面污(wu)漬、破損等(deng)進行(xing)檢查，定期(qi)或不定期(qi)進行(xing)微生(sheng)物(wu)(wu)(wu)(wu)(wu)學(xue)監測。六是加(jia)強(qiang)(qiang)人(ren)(ren)員(yuan)培訓。加(jia)強(qiang)(qiang)洗(xi)(xi)(xi)衣(yi)房(fang)工作(zuo)人(ren)(ren)員(yuan)崗前培訓和(he)能力培訓，熟練掌握(wo)醫用(yong)(yong)(yong)(yong)織(zhi)(zhi)(zhi)物(wu)(wu)(wu)(wu)(wu)洗(xi)(xi)(xi)滌(di)(di)(di)(di)消(xiao)(xiao)毒(du)技能和(he)醫院感染(ran)(ran)防控基本要(yao)(yao)求。

（二）由(you)社會化(hua)洗滌服務機構(gou)承擔洗滌消毒工作的(de)醫療機構(gou)。

 一是(shi)(shi)要認真審核社(she)會(hui)(hui)化洗(xi)(xi)滌(di)(di)服(fu)務機(ji)(ji)構(gou)(gou)資(zi)質(zhi)(zhi)。醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)交(jiao)由社(she)會(hui)(hui)化洗(xi)(xi)滌(di)(di)服(fu)務機(ji)(ji)構(gou)(gou)或(huo)(huo)其(qi)他醫(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)的(de)，醫(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)應當(dang)在(zai)簽定(ding)(ding)合(he)同前對(dui)(dui)(dui)其(qi)資(zi)質(zhi)(zhi)進(jin)(jin)行嚴格審核，必要時(shi)進(jin)(jin)行現場調研；簽訂合(he)作協議(yi)，明確雙方責任(ren)，約(yue)定(ding)(ding)醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)回收(shou)、運輸、分類洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)操作流程，特別是(shi)(shi)洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)應當(dang)達(da)到的(de)質(zhi)(zhi)量要求。二是(shi)(shi)加強對(dui)(dui)(dui)洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)后醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)的(de)質(zhi)(zhi)量驗(yan)收(shou)和(he)反(fan)饋(kui)。建立醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)交(jiao)接(jie)、保管(guan)和(he)分發等相應制(zhi)度。醫(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)應當(dang)設專(zhuan)人接(jie)收(shou)洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)后醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)，并(bing)對(dui)(dui)(dui)其(qi)抽樣進(jin)(jin)行性狀、表(biao)面(mian)污(wu)漬、破損等檢查(cha)。定(ding)(ding)期或(huo)(huo)不定(ding)(ding)期進(jin)(jin)行洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)后醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)微生物(wu)(wu)學監(jian)測。設置潔(jie)污(wu)分開的(de)醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)輪(lun)轉庫。加強與社(she)會(hui)(hui)化洗(xi)(xi)滌(di)(di)服(fu)務機(ji)(ji)構(gou)(gou)等溝通，必要時(shi)進(jin)(jin)行現場查(cha)驗(yan)。建立醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)使(shi)(shi)用(yong)科室(shi)意(yi)見反(fan)饋(kui)制(zhi)度，定(ding)(ding)期收(shou)集使(shi)(shi)用(yong)科室(shi)對(dui)(dui)(dui)醫(yi)(yi)用(yong)織(zhi)物(wu)(wu)洗(xi)(xi)滌(di)(di)消(xiao)(xiao)毒(du)質(zhi)(zhi)量的(de)意(yi)見，針對(dui)(dui)(dui)科室(shi)發的(de)問題查(cha)找原因并(bing)及時(shi)處理。

三、加強對醫用織物(wu)洗滌消毒的監(jian)督管理(li)

各級(ji)衛生(sheng)計(ji)生(sheng)行政部(bu)門應(ying)當加強對醫療現(xian)機構醫用織(zhi)(zhi)物(wu)洗滌消(xiao)毒工作(zuo)的(de)(de)(de)監督管(guan)理，定期開(kai)展綜合(he)性和(he)專(zhuan)項督導檢(jian)查，及時發(fa)現(xian)并糾(jiu)正存在的(de)(de)(de)問題。對與(yu)無資(zi)質或者不符合(he)質量要求(qiu)的(de)(de)(de)社(she)會化(hua)洗滌服(fu)務機構合(he)作(zuo)，存在潛在醫院感染風險的(de)(de)(de)情況，一經查實，應(ying)當立即依法、依規嚴(yan)肅處理，切實維護人(ren)民群眾健康(kang)權益。各級(ji)各類(lei)醫療機構應(ying)當加強內部(bu)管(guan)理，定期開(kai)展醫用織(zhi)(zhi)物(wu)洗滌消(xiao)毒自(zi)查自(zi)糾(jiu)，加強醫用織(zhi)(zhi)物(wu)回收(shou)、運輸(shu)、分(fen)類(lei)洗滌消(xiao)毒、接收(shou)保管(guan)和(he)分(fen)發(fa)等全流程管(guan)理，確保為(wei)臨(lin)床提(ti)供合(he)格的(de)(de)(de)醫用織(zhi)(zhi)物(wu)。

                                               國家衛生計生委辦公(gong)廳

                                                   2015年(nian)8月19日