基于质量敏感指标的戴明循环管理模式在口腔复用诊疗器械消毒灭菌管理中的应用效果观察

Observation on the application effect of PDCA cycle management mode based on quality sensitive indicators in the management of disinfection and sterilization of oral reusable medical instruments

目的:探究基于质量敏感指标的戴明循环(PDCA)管理模式在口腔复用诊疗器械消毒灭菌管理中的应用效果。方法:组建PDCA管理小组,确定结构、过程和评价3个一级质量敏感指标以及人力资源、规章制度及不良事件等10项二级质量敏感指标,制定PDCA管理措施与控制目标进行各环节工作的检查与规范,实施基于质量敏感指标的口腔复用诊疗器械消毒灭菌PDCA管理。选取医院临床使用的160个口腔器械包和同期使用该器械包治疗的160例口腔疾病患者,按照诊疗器械管理模式不同将其分为对照组和观察组,每组纳入80个口腔器械包和使用该器械包治疗的80例患者,对照组实施常规管理,观察组实施基于质量敏感指标的PDCA管理模式。采用自制调研问卷调研医护人员对器械消毒的满意度评分和患者满意度,比较两组诊疗器械消毒效果、诊疗器械损伤情况以及院内感染发生率。结果:观察组诊疗器械灭菌合格率为100%(80/80),且高于对照组,差异有统计学意义(x^(2)=4.102,P<0.05)。观察组诊疗器械损坏率为1.25%(1/80),低于对照组,差异有统计学意义(x^(2)=4.736,P<0.05)。医护人员对观察组器械消毒的满意度评分为(95.84±2.31)分,且高于对照组,差异有统计学意义(t=18.657,P<0.05)。观察组院内感染发生率为1.25%(1/80),低于对照组,差异有统计学意义(x^(2)=4.736,P<0.05)。观察组患者总满意度为97.50%(78/80),且高于对照组,差异有统计学意义(x^(2)=3.840,P<0.05)。结论:基于质量敏感指标的PDCA管理模式有利于提高口腔复用诊疗器械各工作环节管理和灭菌质量,减少不良反应发生,提升医护工作满意度。

Objective:To explore the application effect of the Deming Cycle(PDCA)management model based on quality sensitive indicators in the management of disinfection and sterilization of oral reusable medical instruments.Methods:A PDCA management team was establish,three primary nursing quality sensitive indicators of structure,process and evaluation,and 10 secondary nursing quality sensitive indicators including human resources,rules and regulations,and adverse events were determined.The PDCA management measures and control objectives were formulated to inspect and standardize the work of each link,and the PDCA management for disinfection and sterilization of oral reusable diagnostic and therapeutic equipment based on quality sensitive indicators was implemented.A total of 160 oral instrument packs in clinical use and 160 oral patients treated with these instrument packs during the same period were selected and divided into a control group and an observation group according to different management modes,with 80 oral instrument packs and 80 patients treated with these instrument packs in each group.The control group implemented routine nursing management,and the observation group implemented PDCA management mode based on quality sensitive indicators.A self-made survey questionnaire was used to investigate the satisfaction of medical staff on instrument disinfection and the satisfaction of patients on nursing care.The efficacy of instrument disinfection,instrument damage and nosocomial infection rate were compared between the two groups.Results:The sterilization qualification rate of medical instruments in the observation group was 100%(80/80),which was higher than that in the control group,the difference was statistically significant(x^(2)=4.102,P<0.05).The damage rate of diagnostic and treatment instruments in the observation group was 1.25%(1/80),which was lower than that in the control group,the difference was statistically significant(x^(2)=4.736,P<0.05).The satisfaction score of medical staff to the instrument disinfection in the observation group was(95.84±2.31)points,which was higher than that in the control group,the difference was statistically significant(t=18.657,P<0.05).The incidence of nosocomial infection in the observation group was 1.25%(1/80),which was lower than that in the control group,the difference was statistically significant(x^(2)=4.736,P<0.05).The total nursing satisfaction of the observation group was 97.50%(78/80),which was higher than that of the control group,the difference was statistically significant(x^(2)=3.840,P<0.05).Conclusion:The PDCA management model based on quality sensitive indicators is beneficial to improve management and sterilization quality of each work link of oral reusable medical instruments,reduce the occurrence of adverse reactions,and improve the job satisfaction of nurses.