手术室器械隔夜清洗的管理研究

Management of overnight cleaning of instruments in operating rooms

目的通过采取有针对性的措施,改进器械清洗流程及方案,提高器械清洗质量,保证手术器械合格率,减少医院感染的发生。方法运用PDCA管理循环的理论,分析影响手术室隔夜器械清洗质量的因素,将手术室隔夜器械包内的止血钳随机分为A组(228把)和B组(230把),两组器械均使用1∶500STERIS碱性清洗剂预浸泡5min,A组止血钳浸泡后放入清洗消毒机内按器械程序清洗;B组止血钳浸泡后采用超声清洗,然后装载放入清洗消毒机内按器械程序清洗,检测数据采用SPSS软件进行统计分析。结果清洗合格率A组99.6%,高于B组的86.5%,差异有统计学意义(P<0.01)。结论 PDCA管理循环运用于消毒供应中心的集中管理,持续改进清洗质量,是进行质量过程控制管理的有效手段,使消毒供应中心的工作更加科学化、制度化、规范化。

OBJECTIVE To take targeted measures to improve the process and program of cleaning of instruments and raise the cleaning quality so as to ensure the qualified rate of surgical instruments and reduce the incidence of nosocomial infections. METHODS By means of PDCA management cycle theory, the influencing factors for over- night cleaning quality of the instruments were analyzed, the hemostatic forceps in the overnight instrument bags were randomly divided into the group A （ n= 228） and the group B （n= 230）, then the instruments in both groups were soaked in the 1： 500 STERIS alkaline cleaning agent for 5 min, the soaked instrument in the group A were placed in cleaning and disinfection machine for cleaning, the soaked instruments in the group B were treated with ultrasound cleaning and then were placed in cleaning and disinfection machine for cleaning, and the obtained data for test were statistically analyzed with the use of SPSS software. RESULTS The qualified rate of cleaning of the group A was 99.6%, higher than 86.5% of the group B, the difference was significant （P〈0.05）. CONCLUSION The application of PDCA in centralized management of central sterile supply department and continuous improve- ment of cleaning quality is an effective way to perform the management and control of quality process and makes the management of central sterile suoolv deoartment scientific, institutionalized, and standardized.