全国764所医院外来医疗器械与植入物处理现状调查
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摘要
目的 :调查国内医院消毒供应中心外来医疗器械与植入物的处理现状,为规范外来医疗器械与植入物管理提供参考。方法 :对全国764所医院外来医疗器械与植入物管理的现况进行调查。结果 :全国764所医院中,2.88%的医院未建立外来医疗器械与植入物管理制度;44.37%的医院未设置外来医疗器械处理专门岗位;16.23%、17.15%和50.65%医院择期手术外来医疗器械与植入物提前8小时、12小时和24小时送达医疗机构;7.07%的医院外来医疗器械与植入物手术前处理流程不符合管理规范要求;71.34%医院手术后处理流程不符合管理规范要求;63.61%的医院外来医疗器械与植入物灭菌包有超大超重问题;55.50%的医院厂家未提供外来医疗器械处理说明书。结论 :完善和细化外来医疗器械与植入物管理制度、设置外来医疗器械处理专门岗位、进一步提高外来医疗器械与植入物的厂家说明书获得比例,提高工作人员遵循厂家说明书操作的依从性,是保障外来医疗器械的安全使用,降低医院感染风险,提高医疗护理质量的有效途径。
Objective: To investigate the current situation of processing loaner instrument and implants in Central Sterile Supply Department in domestic hospitals, in order to provide reference for the development of relevant regulations. Methods: A survey of loaner instrument and implants management was conducted in 764 hospitals. Results: Totally, 2.88% of the hospitals did not have certain regulations of loaner instrument and implants management. In terms of post-duty settings, 44.37% of the hospitals did not set post for personnel of processing loaner instrument and implants, and 16.23%, 17.15% and 50.65% respectively of the hospitals could get loaner instruments and implants for elective surgeries 8 hours, 12 hours or 24 hours before the surgeries. Nearly 71.34% of the hospitals did not meet the requirements of reprocessing loaner instruments and implants after the surgeries, and 63.61% of the hospitals claimed that they had overweight packages of loaner instrument and implant, while 55.50% of the hospitals indicated that they could not obtain the Instruction For Users(IFUs) of loaner instrument and implants from manufacturers. Conclusion: Developing and refining the regulations for the management and setting up specialized post for processing loaner instrument and implants, increasing the proportion of hospitals that have IFUs of loaner instrument and implants, and enhance their compliance to follow manufacturer's instructions are necessary to ensure safety, reduce the risk of hospital infection, in order to improve the quality of medical care.
Objective: To investigate the current situation of processing loaner instrument and implants in Central Sterile Supply Department in domestic hospitals, in order to provide reference for the development of relevant regulations. Methods: A survey of loaner instrument and implants management was conducted in 764 hospitals. Results: Totally, 2.88% of the hospitals did not have certain regulations of loaner instrument and implants management. In terms of post-duty settings, 44.37% of the hospitals did not set post for personnel of processing loaner instrument and implants, and 16.23%, 17.15% and 50.65% respectively of the hospitals could get loaner instruments and implants for elective surgeries 8 hours, 12 hours or 24 hours before the surgeries. Nearly 71.34% of the hospitals did not meet the requirements of reprocessing loaner instruments and implants after the surgeries, and 63.61% of the hospitals claimed that they had overweight packages of loaner instrument and implant, while 55.50% of the hospitals indicated that they could not obtain the Instruction For Users(IFUs) of loaner instrument and implants from manufacturers. Conclusion: Developing and refining the regulations for the management and setting up specialized post for processing loaner instrument and implants, increasing the proportion of hospitals that have IFUs of loaner instrument and implants, and enhance their compliance to follow manufacturer's instructions are necessary to ensure safety, reduce the risk of hospital infection, in order to improve the quality of medical care.
引文
[1]卫生部.医院消毒供应中心第1部分:管理规范.中国护理管理,2009,9(5):8-10.Ministry of Health.Central sterile supply department(CSSD)-Part 1:management standard.Chinese Nursing Management,2009,9(5):8-10.
[2]Winthrop TG,Sion BA,Gaines C.Loaner instrumentation:processing the unknown.Aorn Journal,2007,85(3):566-573.
[3]Neoh KG,Hu XF,Zheng D,et al.Balancing osteoblast functions and bacterial adhesion on functionalized titanium surfaces.Biomaterials,2012,33(10):2813.
[4]姜华,张静,冯秀兰.外来医疗器械管理调查及对策.中华医院感染学杂志,2013,23(11):2629.Jiang H,Zhang J,Feng XL.External medical instruments management investigation and countermeasures.Chinese Journal of Nosocomiology,2013,23(11):2629.
[5]冯秀兰.消毒供应中心三项标准修订内容解读及其对护理管理的启示.中国护理管理,2017,17(6):725-729.Feng XL.Interpretation and inspiration of the revised standard WS 310-2016 in the management of the central sterile supply department.Chinese Nursing Management,2017,17(6):725-729.
[6]国家卫生和计划生育委员会.医院消毒供应中心第2部分:清洗消毒及灭菌技术操作规范WS 310.1-2016.北京,2016.National Health Commission of the People's Republic of China.Central sterile supply department(CSSD)-Part 2:standard for operating procedure of cleaning,disinfection and sterilization WS 310.1-2016.Beijing,2016.
[7]国家卫生和计划生育委员会.医院消毒供应中心第3部分:清洗消毒及灭菌效果监测标准WS 310.1-2016.北京,2016.National Health Commission of the People's Republic of China.Central sterile supply department(CSSD)-Part 3:surveillance standard for cleaning,disinfection and sterilization WS310.1-2016.Beijing,2016.
[8]张宇,冯秀兰,任伍爱,等.医院消毒供应中心落实三项标准的调查.中国感染控制杂志,2014,13(4):193-197.Zhang Y,Feng XL,Ren WA,et al.Investigation on implementation of three standards by central sterile supply departments.Chinese Journal of Nosocomiology,2014,13(4):193-197.
[9]周彬,巩玉秀,张宇.医院植入物与外来医疗器械管理和处置现况研究.中国医院建筑与装备,2015(10):98-101.Zhou B,Gong YX,Zhang Y.Hospital implants and foreign medical equipment management and disposal status study.Chinese Hospital Architecture&Equipment,2015(10):98-101.
[10]林萍,马玉兰.消毒供应中心外来医疗器械灭菌湿包现象分析与改进.护理实践与研究,2016,13(5):131-132.Lin P,Ma YL.Analysis and improvements to avoid wet packs of loaner instrument in CSSD.Nurse Practices and Studies,2016,13(5):131-132.
[11]郝淑芹,杜合英,刘丛.不同硬质容器盒装载密度对骨科器械发生湿包的影响.现代临床护理,2017,16(6):26-29.Hao SQ,Du HY,Liu C.Influence of different loading density of orthopedics instruments with rigid containers on the rate of wet packs.Modern Clinical Nursing,2017,16(6):26-29.
[12]Williamson JE.Tackling loaner instrumentation challenges head-on.Healthcare purchasing news.(2009-06-01).https://www.highbeam.com/doc/1G1-201441157.html.
[2]Winthrop TG,Sion BA,Gaines C.Loaner instrumentation:processing the unknown.Aorn Journal,2007,85(3):566-573.
[3]Neoh KG,Hu XF,Zheng D,et al.Balancing osteoblast functions and bacterial adhesion on functionalized titanium surfaces.Biomaterials,2012,33(10):2813.
[4]姜华,张静,冯秀兰.外来医疗器械管理调查及对策.中华医院感染学杂志,2013,23(11):2629.Jiang H,Zhang J,Feng XL.External medical instruments management investigation and countermeasures.Chinese Journal of Nosocomiology,2013,23(11):2629.
[5]冯秀兰.消毒供应中心三项标准修订内容解读及其对护理管理的启示.中国护理管理,2017,17(6):725-729.Feng XL.Interpretation and inspiration of the revised standard WS 310-2016 in the management of the central sterile supply department.Chinese Nursing Management,2017,17(6):725-729.
[6]国家卫生和计划生育委员会.医院消毒供应中心第2部分:清洗消毒及灭菌技术操作规范WS 310.1-2016.北京,2016.National Health Commission of the People's Republic of China.Central sterile supply department(CSSD)-Part 2:standard for operating procedure of cleaning,disinfection and sterilization WS 310.1-2016.Beijing,2016.
[7]国家卫生和计划生育委员会.医院消毒供应中心第3部分:清洗消毒及灭菌效果监测标准WS 310.1-2016.北京,2016.National Health Commission of the People's Republic of China.Central sterile supply department(CSSD)-Part 3:surveillance standard for cleaning,disinfection and sterilization WS310.1-2016.Beijing,2016.
[8]张宇,冯秀兰,任伍爱,等.医院消毒供应中心落实三项标准的调查.中国感染控制杂志,2014,13(4):193-197.Zhang Y,Feng XL,Ren WA,et al.Investigation on implementation of three standards by central sterile supply departments.Chinese Journal of Nosocomiology,2014,13(4):193-197.
[9]周彬,巩玉秀,张宇.医院植入物与外来医疗器械管理和处置现况研究.中国医院建筑与装备,2015(10):98-101.Zhou B,Gong YX,Zhang Y.Hospital implants and foreign medical equipment management and disposal status study.Chinese Hospital Architecture&Equipment,2015(10):98-101.
[10]林萍,马玉兰.消毒供应中心外来医疗器械灭菌湿包现象分析与改进.护理实践与研究,2016,13(5):131-132.Lin P,Ma YL.Analysis and improvements to avoid wet packs of loaner instrument in CSSD.Nurse Practices and Studies,2016,13(5):131-132.
[11]郝淑芹,杜合英,刘丛.不同硬质容器盒装载密度对骨科器械发生湿包的影响.现代临床护理,2017,16(6):26-29.Hao SQ,Du HY,Liu C.Influence of different loading density of orthopedics instruments with rigid containers on the rate of wet packs.Modern Clinical Nursing,2017,16(6):26-29.
[12]Williamson JE.Tackling loaner instrumentation challenges head-on.Healthcare purchasing news.(2009-06-01).https://www.highbeam.com/doc/1G1-201441157.html.