医院消毒供应中心精密手术器械管理现存问题调查分析

Analysis on existing problems of the management of precise instruments of central sterile supply departments in hospital

目的:调查医院消毒供应中心精密手术器械管理中的现存问题并分析原因。方法:采用自制问卷的调查方法,调查广东省61所不同级别医院消毒供应中心精密器械管理相关信息、精密器械处理设施设备配置情况、精密器械处理流程与方法、精密器械损坏原因以及岗位设置与人员培训5个维度内容,总结常见问题,分析原因。结果:全省61所不同级别医院仅有8.20%的消毒供应中心建立精密器械管理制度,54.10%的消毒供应中心未获取大部分精密器械说明书;仅有8.20%消毒供应中心要求器械商对全部精密器械配置保护筐;19.67%消毒供应中心回收时未使用专用筐妥善固定,44.26%消毒供应中心认为人工清洗是保护精密器械和提高周转效率的方法。精密器械损坏原因前4位的分别是缺乏合适的保护筐或保护工具(占67.74%),认为与手术医生使用不当有关(占64.53%),岗位人员培训不到位(占46.77%),器械运输路程损坏(占37.1%)。此外有59.02%消毒供应中心未设置精密器械清洗检查包装专用岗。结论:医院消毒供应中心精密手术器械的管理需多部门协调,建立完善的相关管理制度,需要有足够的保护工具和设施,利用信息和培训资源,做好对精密手术器械管理。

Objective: To investigate the existing problems in management of precise surgical instruments of central sterile supply departments (CSSDs) in hospital, and discuss and analyze its causes. Methods: A self-designed questionnaire was implemented to investigate CSSDs of 61 hospitals of different grades in Guangdong province from 5 aspects: the relevant information of precise instrument management, the configuration situation of facility and equipment of precise instrument processing, flow and method of precise instrument processing, the damage cause of precise instrument and the post setting and staff training. And through summarized the common problems to analyze the reasons of problems. Results: In the 61 hospitals of different grades in our province, only 8.20% of CSSDs have established management system of precise instrument. And 54.10% of the CSSDs have not obtained specifications of most used precise instrument. And 8.20% of CSSDs asked for instrument supplier to configurate protective basket, and 19.67% of CSSDs didn't use special basket to implement properly fixation in recycle, and 44.26% of CSSDs considered manual washing was a methods of protecting precise instrument and enhancing turnover efficient. The top 4 damage causes of precise instruments were respectively: lacked properly protective basket or protective tool (67.74%), improper use by surgeon (64.53%), insufficient training for staff (46.77%), damage during transportation (37.1%). Besides, 59.02% of those CSSDs of hospitals have not assigned dedicated post for washing, detection and packaging of precise instrument. Conclusion: The management of precise surgical instrument of CSSDs in hospitals requires coordination of multidepartments, and establishes impeccably relevant management system, sufficient protection tools and equipment facility, and applies information and training resources, and dose well the management for precise surgical instrument.