消毒供应中心医院感染管理中实施PDCA的效果评估

Effect Assessment of PDCA Conducted in Central Sterile Supply Department for Nosocomial Infection Management

目的探讨消毒供应中心的管理方法,切实提高其质量。方法 2008年8月-2010年12月应用PDCA循环管理模式,对消毒供应中心实施标准化、规范化、系统化和科学化的管理。结果应用PDCA循环管理模式以来,消毒供应中心的建筑布局及工作流程得以规范;手术器械处置效率、清洗消毒灭菌质量得以提高;手术切口、Ⅰ类手术切口的感染率均得以降低。2009年与2008年、2010年与2008年比较,手术切口感染率均得以降低,差异有统计学意义(χ2=39.95,P<0.05;χ2=27.80,P<0.05);2009年与2010年比较,手术切口感染率差异无统计学意义(χ2=0.02,P>0.05)。2009年与2008年、2010年与2008年、2010年与2009年比较,Ⅰ类手术切口感染率降低,但差异无统计学意义(χ2=2.83,P>0.05;χ2=2.21,P>0.05;χ2=0.05,P>0.05)。结论推行PDCA循环管理模式,促进了消毒供应中心的规范化管理,实现了消毒器械质量控制的前馈控制、过程控制以及反馈控制;拓展了消毒供应专业领域,使医院的现有资源得到了最为高效的利用;使患者安全得到了切实保障。

Objective To investigate advanced management method for central sterile supply department（CSSD）,in order to effectively improve the quality of CSSD.Methods From August 2008 to December 2010,PDCA cycle management model（PDCA cycle） was employed to standardize and systematize CSSD as well as make it more scientific.Result Through the application of PDCA circulation management mode,the architectural layout and work flow of sterilization and supply center was standardized.The quality of cleaning,disinfection and sterilization was improved,and the infection rate of surgical incision and type-I incision were reduced.Compared with the year 2008,the infection rate of surgical incision were significantly reduced in 2009 and 2010（χ^22008-2009=39.95,P〈0.05;χ22008-2010=27.8,P〈0.05）.There was no significant difference in surgical incision infection rate between 2009 and 2010（χ22009-2010=0.02,P〈0.05）.Although the type-I incision infection rate was reduced from 2008 to 2010,there was no significant differences among those three years（χ^22008-2009=2.83,P〈0.05;χ^22008-2010=2.21,P〈0.05;χ^22009-2010=0.05,P〈0.05）.Conclusion Carrying out PDCA circulation management mode can promote standardized management of CSSD,realize feedforward control,process control,and feedback control of the disinfection equipment quality,and increase the using efficiency of the present resources,thus guarantee the interests of the patients.