消毒供应室细节问题管理关口前移模式的建立及效果分析

Effects establishment of management-pass antedisplacement model of detail problems in sterilizationsupply department

目的建立消毒供应室发现和改进细节问题的管理关口前移机制，改善质控效果。方法将消毒供应室细节问题的管理模式更加细化和具体化，建立全员参与细节问题管理的关口前移平台，激励全员参与细节问题管理，及时追溯改进效果。结果细节问题管理关口前移后，供应室各区域物品检查合格率提高，去污区、包装检查灭菌区、无菌物品存放区、技能知识比赛、临床满意度得分分别为（96．9±1．7），（97．2±1．6），（98．8±1．7），（97．9±1．5），（98．2±1．8）分，前移前分别为（91．6±1．8），（93．7±2．4），（94．5±1．1），（93．9±1．7），（93．5±1．7）分，前移前后比较差异均有统计学意义（t值分别为-7．22，-4．79，-3．54，-6．26，-7．29；P〈0．01）。结论消毒供应室细节问题管理关口前移可进一步改善质控效果。

Objective To establish the mechanism of management-pass antedisplacement of detail problem and improve the effects of the quality control. Methods Made the former management-model of finding, noting and improving detail problems more fine and more material, established the platform of the management-pass antedisplacement of detail problem, and encouraged all staffs participating in management of detail problems and casting back effects of improving. Results After the implementation of the management- pass antedisplacement model of detail problem, the indexes of working quality were improved significantly. And comprehensive scores in various areas increased significantly such as removing dirt zone [ （ 96.9 ± 1.7 ） vs （91.6 ± 1.8 ） ], packing-check sterilization zone [ （97.2 ± 1.6 ） vs （93.7 ± 2.4 ） ], asepsis-goods storing zone [ （98.8 ± 1.7 ） vs （94.5 ± 1.1 ） ], skill-knowledge competition [ （ 97.9 ± 1.5 ） vs （ 93.9 ± 1.7 ） ], and clinical satisfaction degree [ （98.2 ± 1.8 ） vs （93.5 ± 1.7 ） ] were significantly higher than those before （ t = - 7.22, - 4.79, - 3.54, - 6.26, - 7.29, respectively; P 〈 0. 01 ）. Conclusions The management-pass antedisplacement of detail problem can effectively improve the effects of quality control in sterilization-supply unit.