消毒供应中心PDCA管理对外来医疗器械清洗质量的影响  

Impact of PDCA management in sterile supply centres on the quality of external medical device cleaning

作　　者：郭秋艳 刘佳丽 GUO Qiuyan(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院消毒供应二部,河南省郑州市450052

出　　处：《护理实践与研究》2023年第9期1406-1410,共5页Nursing Practice and Research

基　　金：河南省科技攻关计划(社发领域)项目(编号:162102310355)。

摘　　要：目的探索消毒供应中心外来医疗器械清洗质量的影响因素及PDCA循环管理的干预效果。方法收集2020年2月—2022年4月医院消毒供应中心968套外来医疗器械,实施常规管理,其中关节镜手术器械68套,股骨头置换(髋关节置换器械)168套,其他上下肢工具732套。随后对该968套外来医疗器械实施PDCA管理,作为实验组。分析外来医疗器械清洗质量的影响因素及PDCA循环管理的效果。结果清洗设备选用不合适、未遵守清洗操作流程、预处理不规范、操作人员认知欠缺是影响外来医疗器械清洗质量不合格的因素(P<0.05)。经PDCA管理后,器械有效交接率96.90%、清洗合格97.93%、包装合格98.66%、器械完整性98.24%,均高于管理前,差异有统计学意义(P<0.05);且管理后通过目测法合格率98.94%、放大镜法合格率93.98%、ATP生物荧光法的器械检测合格率93.98%,也高于管理前,差异有统计学意义(P<0.05)。结论不规范预处理、操作人员认知欠缺、清洗设备选用不合适、未遵守清洗操作流程是影响外来医疗器械清洗质量不合格的独立因素,针对以上风险因素进行PDCA循环管理,可提高器械清洗合格率。Objective To explore the factors influencing the cleaning quality of external medical devices in disinfection supply center and the intervention effect of PDCA cycle management.Methods From February 2020 to April 2022,968 sets of external medical instruments were collected from the hospital disinfection and supply center for routine management,including 68 sets of arthroscopic surgical instruments,168 sets of femoral head replacement(hip replacement instruments)and 732 sets of other tools for upper and lower limbs.Then,the 968 sets of external medical devices were managed by PDCA as the experimental group.The factors influencing the cleaning quality of external medical devices and the effect of PDCA cycle management were analyzed.Results Improper selection of cleaning equipment,non-compliance with the cleaning operation process,non-standard pretreatment and lack of cognition of operators were the factors affecting the unqualified cleaning quality of foreign medical instruments(P<0.05).After PDCA management,effective handover rate of 96.90%,qualified cleaning 97.93%,qualified packaging 98.66%,and instrument integrity 98.24%were all higher than before management,the difference was statistically significant(P<0.05).After management,the qualified rate of ocular method,magnifying glass method and ATP bioluminescence method were 98.94%,93.98%and 93.98%respectively,which were also higher than before management,the difference was statistically significant(P<0.05).Conclusion Non-standard pretreatment,lack of cognition of operators,improper selection of cleaning equipment and non-compliance with cleaning operation process were the independent factors affecting unqualified cleaning quality of external medical devices.PDCA cycle management based on the above risk factors can improve the qualified rate of device cleaning.

关 键 词：消毒供应中心 外来器械 清洗质量 影响因素 PDCA循环管理 

分 类 号：R47[医药卫生—护理学]