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关键问题一：

输液接头的消毒时间

在临床上，输液接头的种类有很多，包括分隔膜接头，机械阀接头，正压接头，负压接头，那么这么多种输液接头，该如何确定消毒时间呢？

确定输液接头消毒时间最直接的方法是查看说明书，如果工作量繁重未来得及查看，或者说明书上未写明，则需参考2019年由中华护理学会发表的《临床静脉导管维护操作专家共识》给出的明确指出，也就是无针接头应用消毒棉片多方位用力擦拭5-15秒并待干，消毒和待干时间根据无针接头的设计和消毒剂的性质决定。

关键问题二：

输液接头的消毒方法

在消毒时，使用左手的拇指和食指捏住接头的末端，右手拇指与食指拿取消毒工具（含75%的酒精棉片），完全包裹住接头的连接面，用力，反复，多方位擦拭，在接头的连接面顺时针旋转180度再逆时针旋转180度回到原点。

根据我国2014年的《静脉治疗护理技术操作规范》给出的明确指出：经输液接头（或接口）进行输液及推注药液前，应使用消毒剂多方位擦拭各种接头（或接口）的横切面及外径（也就是螺纹口）。

关键问题三：

输液接头的消毒工具

使用碘伏棉签/酒精棉片存在部分接触面（尤其是螺纹口）无法消毒到位。操作中，用荧光剂代替碘伏进行接头消毒，后经荧光灯照射发现，螺纹口荧光剂分布不均。

2019年由中华护理学会发表的《临床静脉导管维护操作专家共识》给出的明确指出，也就是使用含有酒精或异丙醇的消毒帽可以降低中心导管相关血流感染的风险（CLABSI）

Key Issue One:

Disinfection time of the infusion connector

Clinically, there are many types of infusion joints, including split septum connectors, mechanical valve connectors, positive displacement connectors, negative displacement connectors, neutral displacement connectors, etc. How to determine the disinfection time of so many kinds of infusion connectors?

The most direct way to determine the disinfection time of the infusion connector is to check the instruction manual, if the workload is heavy and you don’t have time to check, or the instruction manual is not specified, you need to refer to the "Expert Consensus on Clinical Venous Catheter Maintenance and Operation" published by the Chinese Nursing Association in 2019, that is, the needleless connector should be wiped vigorously for 5-15 seconds with a disinfectant cotton pad in multiple directions and to be dried, and the disinfection and drying time is determined according to the design of the needleless connector and the type of the disinfectant.

Key Issue Two:

Disinfection method of infusion connectors

During disinfection, use the thumb and index finger of the left hand to pinch the end of the joint, and the thumb and index finger of the right hand to take the disinfectant tool (75% alcohol pads), completely wrap the connecting surface of the connector, wipe it forcefully, repeatedly, and in multiple directions, rotate the connecting surface of the joint 180 degrees clockwise and then rotate 180 degrees counterclockwise to return to the original point.

According to China's 2014 "Intravenous Treatment Nursing Technical Operation Specifications" given a clear point: before infusion and injection through the infusion connector (or interface), disinfectant should be used to wipe the cross-section and outer diameter (that is, the threaded port) of various connectors (or interfaces) in multiple directions.

Key Issue Three:

Disinfection tool for infusion connectors

The use of PVP swabs/alcohol pads has some contact surfaces (especially the threaded mouth) that cannot be disinfected thoroughly. During the operation, the joint was disinfected with a fluorescent agent instead of iodine, and then it was found that the fluorescent agent at the thread mouth was unevenly distributed by fluorescent lamp irradiation.

In 2019, the "Expert Consensus on Clinical Intravenous Catheter Maintenance Operation" published by the Chinese Nursing Association clearly pointed out that the use of disinfecting caps containing alcohol or isopropyl alcohol can reduce the risk of central catheter-associated bloodstream infection (CLABSI)