基于循证证据构建提高隔夜硬式内镜器械清洗合格率品管圈实践  

Practice of constructing quality control circle to improve the qualified rate of overnight hard endoscopic instrument cleaning based on evidence-based evidence

作　　者：石敏[1] 高春红[1] 顾则娟[1] 王沁[1] 张海伟[1] 杨宁俐 洪含霞[1] Shi Min;Gao Chunhong;Gu Zejuan;Wang Qin;Zhang Haiwei;Yang Ningli;Hong Hanxia(People's hospital of Jiangsu,Nanjing,Jiangsu,210029,China)

机构地区：[1]江苏省人民医院,江苏南京210029

出　　处：《齐齐哈尔医学院学报》2021年第19期1734-1738,共5页Journal of Qiqihar Medical University

基　　金：江苏省“六大人才高峰”资助项目(2015-WSW-031)。

摘　　要：目的探讨基于循证证据构建品管圈实践在提高隔夜硬式内镜器械清洗合格率的成效。方法选择凌晨00:00—7:00急诊微创手术后,放置时间超过2 h,未能及时处理的硬式内镜器械中抽取难以清洗的三通吸引器、电凝钩、分离钳作为研究对象,按接收的隔夜硬式内镜器械日期不同分为对照组和研究组两组,将2018年12月接收的234件隔夜硬式内镜器械为对照组,2019年3月接收的287件器械为研究组。对照组内镜器械实施常规硬式内镜器械清洗流程;研究组内镜器械开展以“提高隔夜硬式内镜器械清洗合格率”为主题的品管圈活动。比较实施品管圈活动后隔夜硬式内镜器械清洗ATP合格率、手术室满意度、使用后内镜处理方式、岗位胜任力水平,形成标准化四项作业、比较品管圈活动前后无形成果。结果实施品管圈活动后隔夜硬式内镜器械清洗ATP合格率从82.75%提高至95.81%,差异具有统计学意义(P<0.05);实施品管圈活动后手术室满意度、使用后内镜处理方式、岗位胜任力水平均明显提高,差异具有统计学意义(P<0.05)。形成标准化四项作业后成本效益分析器械使用寿命延长,根据消毒供应追溯系统数据显示腔镜器械已循环使用268例次;隔夜硬式内镜器械器械供应效率由4.5 h缩短至2.5 h。开展品管圈活动后的圈员压力指数、痛苦指数、烦恼指数、黒眼圈指数、疲劳指数的感信负性指数降低,问题解决能力、品管手法运用、沟通协调能力、自我成长、圈员参与能力的理性正面指数上升。结论品管圈活动能有效提高隔夜硬式器械清洗合格率,手术室满意度、使用后内镜处理方式、岗位胜任力水平均明显提高,圈员感信负性指数降低,理性正面指数上升。Objective To investigate the effect of building quality control circle based on evidence in improving the pass rate of overnight hard endoscopic instrument cleaning.Methods The hard endoscopic instruments such as three-way aspirator,electrocoagulation hook,and separation forceps,those were used during 00:00 and 07:00am and put over 2 hours and didn't clean timely and were difficult-to clean,were selected as study subjects.The grouping was according to the reception time of the hard endoscopic instruments.234 overnight hard endoscopic instruments received in December 2018 were used as the control group,and 287 instruments received in March 2019 were used as the research group.In the control group,the conventional hard endoscopic instrument cleaning process was implemented.The research group carried out a quality control circle activity with the theme of"improving the pass rate of overnight hard endoscopic instrument cleaning".After the implementation of quality control circle activities,ATP qualification rate of overnight rigid endoscopic instrument cleaning,satisfaction in the operating room,post-use endoscopic treatment methods,and post competence level were compared.Form four standardized operation procedures and compare intangible results before and after quality control circle activities.Results The pass rate of the overnight hard endoscopic instrument cleaning increased from 82.75%to 95.81%after the implementation of the quality control circle activity,and the difference was statistically significant(P<0.05).After the implementation of quality control circle activities,level of satisfaction in operating room,endoscopic treatment method,and post competence were significantly improved,and the differences were statistically significant(P<0.05).The service life of the instruments was extended after the standardization of the four operations in cost-benefit analysis.According to the data of disinfection supply traceability system,the endoscopic instruments had been reused for 268 times;The supply efficiency of ov

关 键 词：循证证据 品管圈 隔夜硬式内镜器械 清洗合格率 

分 类 号：R471[医药卫生—护理学]