МЕХАНИЗИРОВАННАЯ ОЧИСТКА И ДЕЗИНФЕКЦИЯ СЕКЦИОННЫХ ИНСТРУМЕНТОВ С ПОМОЩЬЮ УЛЬТРАЗВУКА КАК ОДИН ИЗ ЭТАПОВ СОВЕРШЕНСТВОВАНИЯ ПРОТИВОЭПИДЕМИЧЕСКИХ МЕРОПРИЯТИЙ В БЮРО СУДЕБНО-МЕДИЦИНСКОЙ ЭКСПЕРТИЗЫ

Abstract

Introduction. An analysis of the most time-consuming and dangerous tasks for medical personnel shows that one of them is the cleaning of medical instruments from contamination. The same applies to sectional instruments used in the operations of the Bureau of Forensic Medicine during autopsy of corpses. To solve this problem, mechanized cleaning through the use of ultrasonic cleaners is increasingly applied in global practice. Aim. The aim of the work was to organize the washing and disinfection of sectional instruments by mechanized method using ultrasonic washers and to evaluate the efficiency and quality of instrument cleaning. Material and methods. We analyzed the experience of the Republican Bureau of Forensic Medicine of the Ministry of Health of the Republic of Tatarstan in the organization ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2021 Том 14, вып. 6 29ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ and provision of washing and disinfection of sectional instruments. We developed basic principles of operation and standard operating procedures for the personnel of thanatology department with regard to mechanized washing and disinfection of sectional instruments in ultrasonic washing. We evaluated the effectiveness of the implemented measures by conducting sanitary and bacteriological examination and by testing the effectiveness of ultrasound treatment of instruments. Results and discussion. Ensuring the safety of personnel working in the expert institution dictates the necessity of mechanization and automation of production processes in the area of cleaning and disinfection of metal instruments. In this regard, standard operating procedures for personnel based on the current regulatory documents were developed and implemented. The effectiveness of the implemented measures was further evaluated. Sanitary and bacteriological studies in the control group (before the implementation of standard operating procedures) revealed E. coli bacteria in 15% of the samples. Staphylococcus aureus was not detected in any of the samples. All samples containing E. coli group bacteria were in the washes taken from the scissors. In the experimental group (after implementation of standard operating procedures), E. coli and Staphylococcus aureus bacteria were not detected in all samples. When evaluating the efficiency of instrument washing in an ultrasonic washer, 98,33% of SteriTEC indicators for instrument cleaning reached the optimal variant. Conclusion. Thus, the introduction of modern, mechanized methods of instrument processing into the activities of medical and preventive treatment institutions, in particular forensic medicine bureaus, can significantly improve the quality of cleaning and disinfection of metal instruments involved in the performance of examinations. Such innovations must be accompanied by a comprehensive approach in solving sanitary and hygienic problems and be supported by clear guidelines and standard operating procedures for personnel.