The Influence of Ventilator System to Environmental Quality in the Hospital and Strategies for Ventilator Disinfection Process

According to the World Health Organization, the occurrence of hospital-acquired infection among hospitalized patients due to acute illness is approximately 5%~10%, and it occurs 14.0/1000 patient-days in adult intensive care unit in Taiwan. The advanced medical technology extends lives, yet it seems carry some issues. The hospital-acquired infection is one of the most concerned issues, as it increases hospitalization days, medical costs, and mortality. The patients admitted in the respiratory care center (RCC) are with weakened immunity due to prolonged hospitalization, and are in the risk of upper airway infection due to prolonged intubation. Hence, the air quality in the RCC should be evaluated. Comparing to closed suction system, the use of open suction system has found with high concentration of bacteria contamination and high incidence of ventilator-associated pneumonia. However, due to the cost of the catheter, the use of open suction system is still favored in Taiwan. With the used of open suction system, the ventilator circuit has to be opened during administration of aerosol therapy; whereas, the risk of contamination of ventilator circuit and to the patient may be arisen. Furthermore, lack of information is on bacteria contamination of ventilator surface during use, neither is on the regulation of ventilator system disinfection process, including on ventilator, circuit, and ventilator surface. Therefore, we propose a three years research project. In the first year we will analyze the air quality of a RCC in a medical center, and explore the the influencing factors. Additionally, the indoor air will be sampled during open suctioning procedure to examine the possibility of medical personals exposure to bioaerosols. In the second year two systems will be used: (1) the conventional reused ventilator system, combined with manually filled heated humidifier, open suction system, and conventional aerosol therapy procedure; (2) the disposable closed ventilator-suction system, combined with auto-filled heated humidifier, closed suction system, and closed aerosol therapy procedure with a valved T-adaptor. Both circuit systems will be routinely used for a week, and then specimens will be collected from the ventilator internal circuit for comparison of bacterial contamination. In the third year we will compared the effectiveness of disinfectants , such as, sodium hypochlorite, alcohol, quaternarym ammonium compounds, and chlorhexidine gluconate on ventilator surface systems.

Project ID:PC10108-0890
External Project ID:NSC101-2314-B182-049