基于鱼骨图分析法的SHEL模式在内镜清洗消毒质量管控中的应用  

Application of SHEL Model Based on Fishbone Diagram Analysis in the Quality Control of Digestive Endoscope Cleaning and Disinfection

作　　者：吕艳萍 王俊锋 丁丽娜 詹朦 L Yanping;WANG Junfeng;DING Lina;ZHAN Meng(Central Sterile Supply Department,Henan Provincial People’s Hospital,Henan Provincial Medical Key Laboratory for Quality Control of Medical Devices Sterilization,Zhengzhou University People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院消毒供应中心,河南省医疗器械灭菌质控医学重点实验室,郑州大学人民医院,河南郑州450003

出　　处：《河南医学研究》2025年第8期1489-1493,共5页Henan Medical Research

基　　金：2022年河南省医疗器械灭菌质控医学重点实验室开放课题立项项目(MJZK20220004)。

摘　　要：目的 探讨基于鱼骨图分析法的SHEL模式在内镜清洗消毒质量管控中的应用效果。方法 选取河南省人民医院60例清洗消毒人员为研究对象,采用随机数字表法分为观察组、对照组,每组30例清洗消毒人员。对照组实施常规内镜清洗消毒质量管理,观察组实施基于鱼骨图分析法的SHEL模式实施内镜清洗消毒质量管理。比较干预前、后清洗消毒人员内镜清洗消毒知信行评分、内镜清洗消毒质量。结果 观察组的内镜基本结构、常用消毒液使用方法、清洗消毒流程、内镜使用后预处理方法得分及总分均高于对照组(P<0.05);观察组预处理、测漏、清洗、消毒、漂洗、终末漂洗、干燥、储存得分均高于对照组(P<0.05);此外,干预后观察组学习态度、工作态度、循证态度得分也高于对照组,差异有统计学意义(P<0.05);观察组腔道清洗中ATP生物荧光测定法清洗质量合格率高于对照组(97.92%比83.33%),差异有统计学意义(P<0.05)。结论 基于鱼骨图分析法的SHEL模式能够及时发现内镜清洗消毒质量管控中的薄弱环节,有效提高内镜清洗消毒人员的工作质量,值得在临床推广。Objective To explore the application effect of SHEL model based on fishbone diagram analysis in the quality control of digestive endoscopy cleaning and disinfection.Methods Sixty cleaning and disinfection personnel from Henan Provincial People’s Hospital were selected as the research subjects and randomly divided into an observation group and a control group using a random number table method,with 30 cleaning and disinfection personnel in each group.The control group was subjected to routine cleaning and disinfection quality management of digestive endoscopes,while the observation group was subjected to SHEL model based on fishbone diagram analysis.The score of knowledge,practice,quality of cleaning and disinfection of digestive endoscope were compared before and after the intervention.Results The scores and total scores of the basic structure of endoscopes,the use of commonly used disinfectants,the cleaning and disinfection process,and the pre-treatment methods after using endoscopes in the observation group were higher than those in the control group(P<0.05).The scores and total scores of pre-treatment,leak detection,cleaning,disinfection,rinsing,final rinsing,drying,and storage in the observation group were higher than those in the control group(P<0.05).In addition,the scores of learning attitude,work attitude,and scientific research attitude in the observation group after intervention were also higher than those in the control group,and the differences were statistically significant(P<0.05).The qualified rate of cleaning quality in the observation group using ATP bioluminescence assay during cavity cleaning was higher than that in the control group(97.92%vs 83.33%),and the difference was statistically significant(P<0.05).Conclusion The SHEL model based on the fishbone diagram analysis method can promptly identify weak links in the quality control of endoscopic cleaning and disinfection,effectively improving the work quality of endoscopic cleaning and disinfection personnel,and is worthy of clinical promotio

关 键 词：内镜 清洗消毒 SHEL模式 鱼骨图 质量管控 

分 类 号：R197.32[医药卫生—卫生事业管理]