摘要
目的 探讨消毒供应中心(central sterile supply department, CSSD)医疗器械管理中采取基于约束理论(theory of constraints, TOC)的精细化管理对医院感染的防控效果及对CSSD人员管理能力的影响。方法 选择2020年1月-2022年12月北京友谊医院CSSD 2 782件医疗器械作为研究对象。常规管理为对照组,实施期间为2020年1月-2021年5月1 158件;基于TOC的精细化管理为改进组,实施期间为2021年6月-2022年12月1 624件,并将32名于CSSD工作的消毒人员作为进行器械管理培训的对象,另纳入27个使用医疗器械的科室进行相关指标评价。比较对照组和改进组的医疗器械科室使用满意度评分、医疗器械清洗后消毒质量与医疗器械质量评分、医疗器械相关医院感染发生率、质量缺陷控制情况,比较CSSD人员管理能力各项评分及对器械相关的理论和操作考核成绩。结果 相较于对照组,改进组的医疗器械使用科室满意度(包括服务态度、物品质量、物品交接、器械配送、信息追溯)评分均更高,差异有统计学意义(P<0.05);相较于对照组,改进组的医疗器械消毒质量、医疗器械质量评分均更高,差异有统计学意义(P<0.05);相较于对照组,改进组的医疗器械相关医院感染总发生率和消毒后手污染、器械与记录不符、标签不吻合、回收器械件数不准确、存储位置不当比率均更低,差异有统计学意义(P<0.05);相较于对照组,CSSD人员在改进组的环境管理能力、管理器械能力、风险防范意识、风险识别能力、灭菌包装、理论知识、清洗消毒、处理流程评分均更高,差异有统计学意义(P<0.05)。结论 基于TOC的精细化管理应用于CSSD的医疗器械中可提升医疗器械科室使用满意度,改善消毒质量与医疗器械质量,提高CSSD人员的管理能力和对于器械相关的理论、操作能力,有效降低医疗器械相关医院感染发生率和质量缺陷,临床有一定的应用�
Objective To explore the effect of adopting refined management based on the theory of constraints(TOC)in the administration of medical devices in the central sterile supply department(CSSD)on nosocomial infection prevention and control and its impact on the management ability of CSSD personnel.Methods A total of 2,782 medical devices from CSSD of Beijing Friendship Hospital from January 2020 to December 2022 were selected as the study subjects.The routine management group served as the control group,and the implementation period was from January 2020 to May 2021,with 1,158 pieces.The fine management group based on TOC was considered as the improvement group,with the implementation period from June 2021 to December 2022 and 1,624 pieces.32 disinfection staff members working at CSSD served as the subjects receiving the training for device management,and 27 departments using medical devices were enrolled into the evaluation on relevant indicators.We compared the scores of satisfaction with the use of medical devices in the departments,the scores of disinfection quality and medical device quality before and after cleaning medical devices,the incidence rate of nosocomial infection related to medical devices,the control status of quality defects,the score of each item concerning management ability in the CSSD staff members,and the assessment performance of theory and operation associated with medical devices between the control group and the improvement group.Results The satisfaction scores of departments using medical devices(including service attitude,product quality,product handover,device delivery,and information traceability)were higher in the improvement group than in the control group,with statistically significant differences(P<0.05).The scores of medical device disinfection quality and medical device quality were higher in the improvement group than in the control group,with statistically significant differences(P<0.05).The total incidence rate of nosocomial infection related to medical devices,and the ratios
作者
许媛媛
袁宜
文高静
许娜
XU Yuanyuan;YUAN Yi;WEN Gaojing;XU Na(Disinfection Supply Center,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 101100,China)
出处
《实用预防医学》
CAS
2023年第7期889-893,共5页
Practical Preventive Medicine
基金
北京市属医院科研培育计划项目(PG2020003)。
关键词
消毒供应中心
精细化管理
感染防控
医疗器械
管理能力
central sterile supply department
refined management
infection prevention and control
medical device
management ability
