实施层级管理对消化内镜消毒质量影响的研究  

The Influence of the hierarchical management on the disinfection quality of digestive endoscopy

作　　者：张丽华[1] 宋家武[1] 张江平[2] 杨又春[3] 高敏照[1] 周怀力[1] 赖开兰[4] 

机构地区：[1]中山大学附属第五医院消化内镜中心,广东珠海519000 [2]中山大学附属第五医院呼吸内科,广东珠海519000 [3]中山大学附属第五医院麻醉科,广东珠海519000 [4]中山大学附属第五医院急诊科,广东珠海519000

出　　处：《中华医院感染学杂志》2015年第19期4537-4539,共3页Chinese Journal of Nosocomiology

基　　金：广东省科学技术计划攻关基金资助项目(2006B36030019)

摘　　要：目的探讨层级管理对消化内镜感染控制的作用,以提高患者诊疗安全。方法对实施层级管理前(2006年1月-2009年4月)与管理后(2009年5月-2013年10月)消化内镜消毒流程相关的各项消毒指标进行随机采样抽检,对其合格率采用SPSSl3.0统计软件进行统计分析和比较。结果层级管理实施后,胃镜及肠镜内腔监测合格率分别由实施前的88.46%、78.84%上升至100.00%、97.82%;胃镜、肠镜消毒槽侧壁及使用中2%戊二醛消毒液监测合格率分别由实施前的88.63%、92.85%、91.07%、89.28%,均上升至100.00%;医务人员手卫生合格率由实施前的56.66%上升至91.07%,差异均有统计学意义(P<0.05)。结论层级管理模式的实施对消化内镜的消毒质量控制有显著影响,通过实施并与医院感染管理形成互为交叉、互为补充的无缝隙管理模式,有效控制了医院感染,提高了患者诊疗安全。OBJECTIVE To explore the role of the hierarchical management in controlling the digestive endoscope infections so as to improve the safety when diagnose and treat .METHODS The relevant randomized sampling‐based qualified rates （% ） of digestive endoscope disinfection processes were statistically analyzed and compared before （during Jan .2006 to Apr .2009） and after （during Apr .2009 to Oct .2013） implementing hierarchical manage‐ment .The qualified rate was dealt with SPSS 13 .0 software .RESULTS After implementing hierarchical manage‐ment ,the qualified rates of gastroscope and colonoscopy rose from 88 .46% and 78 .84% to 100% and 97 .82% . And the qualified rate of gastroscope ,colonoscopy ,disinfection sink and 2% glutaral disinfectant raised from 88 .63% ,92 .85% ,91 .07% and 89 .28% to 100 .00% for all .The qualified rate of hand hygiene ascended from 56 .66% to 91 .07% .The differences were significant （P〈0 .05） .CONCLUSION The nursing hierarchical manage‐ment ,as a complementary management pattern for the nosocomial infection control ,has a significant impact on controlling disinfection quality of digestive endoscopes .It can effectively control the endoscope infections and thus is worthy of popularized application .

关 键 词：层级管理 消毒质量 管理研究 

分 类 号：R197.323[医药卫生—卫生事业管理]