麻醉机临床使用安全管理初探

Safety management of anesthesia machine in clinical use

目的探讨麻醉机临床使用安全管理措施。方法2018年开始采用PDCA理论指导麻醉机临床使用安全管理工作,由医生、护士、工程师成立的安全管理小组,从人、机、环境3个方面对麻醉机临床使用风险进行分析,制定安全管理计划,安全小组分工负责,对操作者进行麻醉机临床使用安全知识培训,完善安全管理制度,对设备实施三级预防性维护和计量检测;三级维护计划:一级维护主要是外观及报警功能检查、清洁消毒、存放管理等;二级维护主要是除水除尘、润滑紧固、功能检查及性能检测,重点关注旧设备潮气量校准;三级维护主要是年度维护,更换易损部件,计量及性能检测等。结果近3年设备有关不良事件发生率为0;2020年计量检测潮气量(VT)、呼吸频率(RR)、气道峰压(Ppeak)和呼气末正压(PEEP)4个参数首检达标率100%。结论PDCA理论指导麻醉机临床使用安全管理工作取得实际效果。

Objective To explore the safety management measures of anesthesia machines in clinical use.Methods Since 2018,PDCA theory has been used to guide the safety management of anesthesia machines in clinical use.A safety management team includes doctors,nurses and engineers.The risk of clinical use of anesthesia machines is analyzed from three aspects,human,machines and the environment.Meanwhile the plan of safety management is formulated.Considering the division of labor,the work of the safety team can be divided into three parts,which includes the improvement of the safety management system,three-level maintenance of machines and the inspection of the equipment.As for three-level maintenance,the first level maintenance mainly includes the inspection of appearance and alarm function,cleaning and disinfection as well as storage management;the second level maintenance mainly includes water and dust removal,lubrication of fastening screws,functional inspection and performance testing,focusing on the tidal volume(VT)of old equipment;the third level maintenance mainly includes annual maintenance,replacement of vulnerable parts,and metrological testing.Results The incidence of equipment related adverse events in recent 3 years is 0.In 2020,the test index include VT,respiratory rate(RR),peak airway pressure(Ppeak)and positive end expiratory pressure(PEEP),all of which are 100%qualified.Conclusions It has achieved practical effect in the safety management of anesthesia machine in clinical use with the guidance of PDCA theory.