10 06 newyork 08 45 01 gantumur -...
TRANSCRIPT
Reprocessing medical devices in Mongolia
TSAGAAN GANTUMUR
‒ Location: Northern Asia, between China and Russia (landlocked)
‒ Climate: strongly continental
‒ Area: 1,564,116 sq km
‒ Population: 3,2 million , in Ulaanbaatar 1,5 million people
Mongolia
– Culture: nomadic life style
– Religion: Buddhism, Shamanism
– Economy: herding (61 million livestock), agriculture and mining
– GDP 11,16 billions $, ranking 129 of 195 countries
– Health expenditure : 4.7 % of GDP
‒ Healthcare system:
3500 healthcare facilities
70 thousand newborn every year
‒ Emerging infectious diseases:
Tuberculosis
HBV, HCV 10%- 22%
Sexual transmitting disease
‒ Healthcare associated Infections:
5.7% and 19.1%
Some determinants for HAI
‒ Poor knowledge and application of basic infection control measures
‒ Insufficient guide for hygiene procedure
‒ Lack of hygiene products and equipment
‒ Poor hand disinfection in hospitals
‒ Poor recording and response to HAI
‒ International hospital hygiene and IPC projects:
WHO, ADB, Meshhp
Many many trainings on IPC …
Some achievements in reprocessing of medical devices
Reprocessing Old pattern New challenges …
Step 1: Cleaning Washing powder + H2O2
Detergents
Step 2: Disinfection Mixed chemicals Disinfectants listed by the Association for Applied Hygiene (VAH)
Step 3: Inspection Almost never Removing rust, lubricating etc.
Step 4: Packaging Old cotton material Reels, pouch and non woven wrapping materials
Step 5: Sterilization Only steam autoclaves
Steam, H2O2, EO, Formaldehyde
Step 6: Sterilization quality assurance
Only chemical tape indicator
Chemical indicators, Bowie Dick test, biological indicator
Sterilization quality assurance in some hospitals
‒ Used bioindicators: BAG-BioCheck Steam
BAG-BioCheck EO
BAG-BioCheck H2O2
gke Steri-Record FO
G.stearothermophilus‒ Monitored sterilizers:
105 steam 3 EO 1 FO 1 H2O2
‒In study included 77 hospitals of Ulaanbaatar:
44 dental clinics, 26 state and private hospitals3 centers for reprocessing of medical instruments 3 maternity hospitals 1 medical waste disposal facility
Most used models of autoclaves and sterilizers
Steam-SHINVA/China
Plasma-LAOKEN/China
EO-From different Countries
Steam-BK75/Russia
FO-MMM/Germany
In monitoring involved steam autoclaves
Imported from Number (%)
China 46 (43,8%)
Russia 25 (23,8%)
Korea 19 (18,1%)
Germany 5 (4,8%)
Japan 6 (5,7%)
USA 1 (1,0% )
Taiwan 3 (2,9%)
Total 105 (100%)
Commissioning period Number
1980-1990 7
1991-2000 10
2001-2010 46
2011-2016 40
No information 2
Total 105
Steam autoclaves
Bio indicators Number
No growth 101
With growth ‒ 4 (3,8%)
Total 105
Some autoclaves did not sterilize …
EO sterilizer
Bio indicators Number
No growth 1
With growth ‒ 2
Total 3
H2O2 FO
Future challenges ….
More attention on IPC at the governance level
Transfer IPC knowledge
Establishing routine controls for sterilization
Improvement technical service and maintenance for sterilization equipment …
Thank you for your attention and welcome to Mongolia !