持续质量改进对手术器械供应及时性与准确性的影响
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摘要
目的研究在消毒供应室实施持续质量改进管理模式对手术器械供应及时性与准确性的影响。方法于2015年1—12月间该院消毒供应科室实施传统管理模式,按照科室原有排班制度完成日常工作,所有班次均轮流使用高压灭菌炉负责手术器械消毒灭菌工作,同时选取此阶段科室工作者17名。于2016年1—12月间该院消毒供应科室实施持续质量改进管理模式,此阶段科室合理排班,间隔时间使用6台高压灭菌炉完成手术器械消毒灭菌工作,同时选取工作者17名,评价两年度科室应急手术器械灭菌等待时间、总耗时、器械准备准确率;科室工作者对护理管理质量评价。结果第一年度,此阶段科室器械经低温等离子灭菌第一炉结束时间为9:55 am;第二年度,灭菌第一炉结束时间为8:20 am;应急灭菌等待时间:第一年度等待时间平均时间为(18.23±3.41)min,第二年度平均为(10.53±2.10)min。急用器械自回收-等离子灭菌完毕耗时:第一年度平均用时为(100.53±10.54)min,第二年度平均用时为(85.12±11.40)min。第二年度平均耗时为(111.53±10.40)min,第二年度急用手术器械自回收至高压灭菌耗时低于第一年度。第一年度,器械准备准确率为76 234件(92.81%);第二年度器械准备准确率为81 542件(98.98%)(χ~2=4.835,P=0.028)。第一年度,科室工作者对科室提供的管理流程细化、手术器械灭菌知识培训、质量监督、合理陪伴、院内感染知识培训等指标评分均较低,第二年度科室工作者对上述质量指标评分均较高(P<0.05)。结论消毒供应科室通过实施持续质量改进管理模式,可有效提高手术器械供应及时性与准确性。
Objective This paper tries to study the effect of continuous quality improvement management mode on the timeliness and accuracy of surgical equipment supply in disinfection and supply department.Methods From January 2015 to December 2015,the hospital disinfection and supply department adopted the traditional management mode,according to the original scheduling system to complete the daily work,all flights in turn used the autoclave for disinfection and sterilization of surgical instruments,and 17 workers were chosen from this department.From January 2016 to December 2016,the hospital disinfection and supply department adopted continuous quality improvement management mode,reasonable scheduling was arranged during this stage,in the interval six autoclaves were used to complete the disinfection and sterilization of surgical instruments,and 17 workers were selected.The waiting time and the total time-consuming of emergency surgical equipment sterilization,equipment preparation accuracy,department workers' evaluation on the quality of nursing management of these two years were evaluated.Results In the first year,the end time of the first furnace in the first stage was 9:55am by the low temperature plasma sterilization.In the second year,the end time of the first furnace was 8:20 am;the waiting time of emergency surgical equipment sterilization:the average waiting time of the first year was(18.23 ± 3.41)min,and that of the second year was(10.53±2.10)min.Time-consuming of emergency equipment recycling-gas plasma sterilization:the average time consuming of the first year was(100.53±10.54)min and that of the second year was(85.12±11.40) min,more than that of the first year.The average time consuming for the second year was(111.53±10.40)min.The accuracy rate of equipment preparation in the first year was namely 76,234 pieces of equipment(92.81%),and that of the second year was namely 81,542 pieces of equipment(98.98%)(χ~2=4.835,P=0.028).The index scores of the management process refinement,the surgical equipment sterilization knowledge training,the quality supervision,the reasonable companion,the hospital infection knowledge training and so on by department staff were lower,while those of the second year were higher(P<0.05).Conclusion The implementation of the continuous quality improvement management mode in the disinfection and supply department can effectively improve the timeliness and accuracy of the supply of surgical equipments.
Objective This paper tries to study the effect of continuous quality improvement management mode on the timeliness and accuracy of surgical equipment supply in disinfection and supply department.Methods From January 2015 to December 2015,the hospital disinfection and supply department adopted the traditional management mode,according to the original scheduling system to complete the daily work,all flights in turn used the autoclave for disinfection and sterilization of surgical instruments,and 17 workers were chosen from this department.From January 2016 to December 2016,the hospital disinfection and supply department adopted continuous quality improvement management mode,reasonable scheduling was arranged during this stage,in the interval six autoclaves were used to complete the disinfection and sterilization of surgical instruments,and 17 workers were selected.The waiting time and the total time-consuming of emergency surgical equipment sterilization,equipment preparation accuracy,department workers' evaluation on the quality of nursing management of these two years were evaluated.Results In the first year,the end time of the first furnace in the first stage was 9:55am by the low temperature plasma sterilization.In the second year,the end time of the first furnace was 8:20 am;the waiting time of emergency surgical equipment sterilization:the average waiting time of the first year was(18.23 ± 3.41)min,and that of the second year was(10.53±2.10)min.Time-consuming of emergency equipment recycling-gas plasma sterilization:the average time consuming of the first year was(100.53±10.54)min and that of the second year was(85.12±11.40) min,more than that of the first year.The average time consuming for the second year was(111.53±10.40)min.The accuracy rate of equipment preparation in the first year was namely 76,234 pieces of equipment(92.81%),and that of the second year was namely 81,542 pieces of equipment(98.98%)(χ~2=4.835,P=0.028).The index scores of the management process refinement,the surgical equipment sterilization knowledge training,the quality supervision,the reasonable companion,the hospital infection knowledge training and so on by department staff were lower,while those of the second year were higher(P<0.05).Conclusion The implementation of the continuous quality improvement management mode in the disinfection and supply department can effectively improve the timeliness and accuracy of the supply of surgical equipments.
引文
[1]朱宏颖,柯雅娟,吴多志,等.复用手术器械清洗消毒后存放时效的研究[J].海南医学,2017,28(4):674-675.
[2]胥树平,周璞,陈芳芳,等.重庆部分基层医院的手术器械消毒现状调查[J].中华医院感染学杂志,2016,26(16):3832-3834.
[3]Schneider David,Schober Florian,Grohmann Philipp,et al.Invitro evaluation of the tolerance of surgical instruments in templates for computer-assisted guided implantology produced by 3-D printing[J].Clinical oral implants research,2015,26(3):320-325.
[4]中国医师协会眼科医师分会,中华预防医学会医院感染专业委员会,中华预防医学会消毒分会,等.我国眼科手术管理、感染控制、消毒灭菌指南(一)[J].中华眼科杂志,2016,52(3):167-173.
[5]申瑶,宋向凤.嗜热脂肪杆菌芽孢极速生物监测在手术器械管理中的应用[J].中华现代护理杂志,2017,23(4):531-534.
[6]巩晓丽.消毒供应室对手术器械的清洗消毒工作实施一体化管理的效果分析[J].中国卫生产业,2017,14(3):11-12.
[7]张金凤,吴湘玉,蔡云霞,等.硬式内镜器械自动化清洗消毒保养流程优化[J].中国消毒学杂志,2015,32(5):481-483.
[8]杨淑华.开展持续质量改善小组降低手术器械返消毒[J].岭南急诊医学杂志,2015,20(6):527-528.
[9]Alonso Araujo Sergio Eduardo,Silveira Mendes Carlos Ramon,Carvalho Gustavo Lopes,et al.Surgeons'perceptions of transanal endoscopic microsurgery using minilaparoscopic instruments in a simulator:the thinner the better[J].Surgical Endoscopy,2015,29(8):2331-2338.
[10]杨凤明.手术器械集中消毒供应管理办法的应用效果[J].中国民康医学,2016,28(10):106-107,114.
[11]王君,刘淑菊.手工预处理在复用手术器械清洗中的应用[J].中国消毒学杂志,2016,33(6):599-600.
[12]张裕,袁玉林.三种不同清洗流程对手术器械清洗的效果评价[J].湖北科技学院学报:医学版,2016,30(1):82-83.
[13]Lamprell L,Ahluwalia S.Who has been hiding in your tonsillectomy tray Eponymous instruments in tonsillectomy surgery[J].The Journal of Laryngology and Otology,2015,129(4):307-313.
[14]邱亚玮.消毒供应中心对外来手术器械灭菌质量管理分析[J].临床医药文献电子杂志,2015,2(31):6541,6543.
[15]张纯英,王俊亭,王珂,等.不同预清洗方法对手术器械的清洗效果观察[J].泰山医学院学报,2016,37(12):1370-1372.
[16]李宇生,周平乐,王卫,等.消毒供应中心质量及效率管理工具应用综述[J].中西医结合护理:中英文,2017,3(3):157-160.
[17]Jelinek Filip,Gerboni Giada,Henselmans Paul W.J,et al.Attaining high bending stiffness by full actuation in steerable minimally invasive surgical instruments[J].Minimally invasive therapy and allied technologies:MITAT:official journal of the Society for Minimally Invasive Therapy,2015,24(1/2):77-85.
[18]俞诗娃,李淑妮,黄钦松,等.硬式内镜手术器械清洗架的研制及应用[J].中国消毒学杂志,2016,33(10):1036-1036.
[19]张裕娴.护理安全管理模式在消毒供应室管理中的应用[J].齐鲁护理杂志,2016,22(3):112-114.
[20]Evangelista Sintia de Souza,dos Santos Simone Gonalves,de Resende Stoianoff Maria Aparecida,et al.Analysis of microbial load on surgical instruments after clinical use and following manual and automated cleaning[J].American Journal of Infection Control,2015,43(5):522-527.
[2]胥树平,周璞,陈芳芳,等.重庆部分基层医院的手术器械消毒现状调查[J].中华医院感染学杂志,2016,26(16):3832-3834.
[3]Schneider David,Schober Florian,Grohmann Philipp,et al.Invitro evaluation of the tolerance of surgical instruments in templates for computer-assisted guided implantology produced by 3-D printing[J].Clinical oral implants research,2015,26(3):320-325.
[4]中国医师协会眼科医师分会,中华预防医学会医院感染专业委员会,中华预防医学会消毒分会,等.我国眼科手术管理、感染控制、消毒灭菌指南(一)[J].中华眼科杂志,2016,52(3):167-173.
[5]申瑶,宋向凤.嗜热脂肪杆菌芽孢极速生物监测在手术器械管理中的应用[J].中华现代护理杂志,2017,23(4):531-534.
[6]巩晓丽.消毒供应室对手术器械的清洗消毒工作实施一体化管理的效果分析[J].中国卫生产业,2017,14(3):11-12.
[7]张金凤,吴湘玉,蔡云霞,等.硬式内镜器械自动化清洗消毒保养流程优化[J].中国消毒学杂志,2015,32(5):481-483.
[8]杨淑华.开展持续质量改善小组降低手术器械返消毒[J].岭南急诊医学杂志,2015,20(6):527-528.
[9]Alonso Araujo Sergio Eduardo,Silveira Mendes Carlos Ramon,Carvalho Gustavo Lopes,et al.Surgeons'perceptions of transanal endoscopic microsurgery using minilaparoscopic instruments in a simulator:the thinner the better[J].Surgical Endoscopy,2015,29(8):2331-2338.
[10]杨凤明.手术器械集中消毒供应管理办法的应用效果[J].中国民康医学,2016,28(10):106-107,114.
[11]王君,刘淑菊.手工预处理在复用手术器械清洗中的应用[J].中国消毒学杂志,2016,33(6):599-600.
[12]张裕,袁玉林.三种不同清洗流程对手术器械清洗的效果评价[J].湖北科技学院学报:医学版,2016,30(1):82-83.
[13]Lamprell L,Ahluwalia S.Who has been hiding in your tonsillectomy tray Eponymous instruments in tonsillectomy surgery[J].The Journal of Laryngology and Otology,2015,129(4):307-313.
[14]邱亚玮.消毒供应中心对外来手术器械灭菌质量管理分析[J].临床医药文献电子杂志,2015,2(31):6541,6543.
[15]张纯英,王俊亭,王珂,等.不同预清洗方法对手术器械的清洗效果观察[J].泰山医学院学报,2016,37(12):1370-1372.
[16]李宇生,周平乐,王卫,等.消毒供应中心质量及效率管理工具应用综述[J].中西医结合护理:中英文,2017,3(3):157-160.
[17]Jelinek Filip,Gerboni Giada,Henselmans Paul W.J,et al.Attaining high bending stiffness by full actuation in steerable minimally invasive surgical instruments[J].Minimally invasive therapy and allied technologies:MITAT:official journal of the Society for Minimally Invasive Therapy,2015,24(1/2):77-85.
[18]俞诗娃,李淑妮,黄钦松,等.硬式内镜手术器械清洗架的研制及应用[J].中国消毒学杂志,2016,33(10):1036-1036.
[19]张裕娴.护理安全管理模式在消毒供应室管理中的应用[J].齐鲁护理杂志,2016,22(3):112-114.
[20]Evangelista Sintia de Souza,dos Santos Simone Gonalves,de Resende Stoianoff Maria Aparecida,et al.Analysis of microbial load on surgical instruments after clinical use and following manual and automated cleaning[J].American Journal of Infection Control,2015,43(5):522-527.