基于质量管理约束的医疗器械消毒供应路径构建联合优化模型研究  

Construction and practice of joint optimization model for medical device disinfection supply path based on quality management constraints

作　　者：曹蓓蕾 陆玲庆[2] 张林[3] 张婷婷 CAO Bei-lei;LU Ling-qing;ZHANG Lin(central Sterile Supply Department,Shanghai Public Health Clinical Center,Shanghai 201508,China;不详)

机构地区：[1]上海市公共卫生临床中心消毒供应中心,上海201508 [2]上海市公共卫生临床中心药物临床试验机构办公室,上海201508 [3]上海市公共卫生临床中心护理部,上海201508 [4]上海市公共卫生临床中心手术室,上海201508

出　　处：《中国医学装备》2022年第12期147-151,共5页China Medical Equipment

基　　金：上海市卫生健康委员会科研课题(202040091)“公共卫生应急批量收治中消毒供应中心管理模式的探索与应用”;上海申康医院发展中心科研课题(SHDC2022CRS024B)“促进市级医院临床技能与临床创新三年行动计划”。

摘　　要：目的:基于质量管理约束理论构建联合优化模型,探讨其在医疗器械消毒供应管理中的应用价值。方法:成本、效率和灭菌3方面制定质量约束指标,构建医疗器械消毒供应路径联合优化模型。选取中心临床在用的5660件可复用医疗器械,按照管理模式不同将其分为对照组(4786件)和观察组(5109件,包含对照组中在用的4235件和新增加的874件),对照组采用传统管理模式;观察组采用联合优化管理模式,从成本、效率及灭菌等方面制定质量约束指标和控制阈值,联合多部门开展优化管理。自制调研问卷,分析临床科室医护人员对消毒供应医疗器械的满意程度,对比两组器械的消毒供应质量。结果:观察组医疗器械消毒供应成本质量、效率质量和灭菌质量约束达成率分别为(70.73±4.75)%、(72.08±4.22)%和(73.46±6.49)%,均高于对照组,差异有统计学意义(t=4.886,t=5.360,t=6.301;P<0.05);观察组医疗器械回收、分类清点、清洗消毒、包装灭菌和储存发放的技术操作规范率分别为(96.51±1.89)%、(96.70±1.97)%、(95.85±4.47)%、(97.21±2.70)%和(94.06±5.91)%,均好于对照组,差异有统计学意义(t=5.989,t=5.592,t=2.541,t=5.156,t=2.187;P<0.05);医护人员对观察组器械的清洗消毒水平、回收下放效率、问题处理效果和信息沟通机制的满意率分别为(88.65±5.37)%、(90.51±4.78)%、(88.29±3.68)%和(89.87±4.02)%,均优于对照组,差异有统计学意义(t=2.290,t=2.719,t=3.516,t=4.474;P<0.05)。结论:联合优化模型能够规范消毒供应人员技术操作,改善消毒供应工作流程,提升医疗器械消毒供应质量和临床服务水平。Objective:To construct a joint optimization model based on quality management constraint theory and explore its application value in the management of medical device disinfection supply.Methods:A total of 5,660reusable medical devices in clinical use were selected and divided into control group(4,786 devices)and observation group(5,109 devices,including 4,235 devices in use in control group and 874 devices newly added)according to different management models.The control group adopted traditional management mode.The observation group adopted the joint optimization management mode,the quality constraint index and control threshold from the aspects of cost,efficiency and sterilization were established,and the optimization management jointly with multiple departments was carried out.A self-made survey questionnaire was used to analyze the satisfaction degree of medical staff in clinical departments with the disinfection supply of medical devices,and the quality of disinfection supply of medical devices between the two groups was compared.Results:The cost quality,efficiency quality and sterilization quality constraint achievement rate of medical device disinfection supply in the observation group were(70.73±4.75)%,(72.08±4.22)%and(73.46±6.49)%,respectively,which were higher than those in the control group,the difference was statistically significant(t=4.886,t=5.360,t=6.301,P<0.05).The technical operation standard rates of the recycling,classification and counting,cleaning and disinfection,packaging and sterilization,storage and distribution of medical devices in the observation group were(96.51±1.89)%,(96.70±1.97)%,(95.85±4.47)%,(97.21±2.70)%and(94.06±5.91)%,respectively,which were better than those in the control group,the difference was statistically significant(t=5.989,t=5.592,t=2.541,t=5.156,t=2.187,P<0.05).The satisfaction rate of medical staff on cleaning and disinfection level,recycling and decentralization efficiency,the effect of addressing problems and information communication mechanism of medical d

关 键 词：质量管理约束 消毒供应 联合优化模型 技术操作 

分 类 号：R197.39[医药卫生—卫生事业管理]