Reprocessing practice gaps associated with low-temperature hydrogen peroxide gas plasma sterilizers in public hospitals in Sichuan, China: A cross-sectional survey.

BACKGROUND

Low-temperature hydrogen peroxide gas plasma (LTHPGP) sterilizers are increasingly used in public hospitals, but whether deployment is matched by infection prevention and control capacity remains unclear. This study assessed LTHPGP reprocessing practices and infection prevention and control gaps in Sichuan, China.

METHODS

From January to February 2025, Central Sterile Supply Department (CSSD) nurse managers from 165 secondary and tertiary public hospitals completed an online questionnaire covering device configuration, environmental protection, loading, monitoring, residue and leak events, and information system connectivity. Descriptive statistics, χ² tests, and exploratory logistic regression were performed.

RESULTS

The survey covered 360 LTHPGP sterilizers, with a mean of 2.2 devices per hospital and service life of 6.0 years. Hazardous gas alarms were present in 69.1% of hospitals; H₂O₂ leaks were reported by 8.5%; and signs of H₂O₂ residue by 82.4%. Routine loading ratios exceeded 80% in 7.9%, and information system connectivity was 44.8%. More devices were associated with H₂O₂ leak reporting (OR, 2.09; 95% CI, 1.01-4.33).

DISCUSSION: Device expansion was not fully matched by process-control capacity, particularly in environmental protection and traceability.

CONCLUSIONS

Tiered improvements in environmental safety, loading control, monitoring completeness, and electronic traceability are needed to support safer LTHPGP reprocessing.