强化质量控制与持续方法改进在达芬奇机器人手术器械清洗消毒中的应用研究

Application of strengthening quality control and continuous improvement in cleaning and disinfection of Da Vinci surgical system instruments

目的探讨强化质量控制与持续方法改进在达芬奇机器人手术器械清洗消毒中的实施效果和应用价值。方法选取2016年1月-2017年1月期间解放军总医院手术室消毒供应区清洗消毒的机器人手术器械包相关器械,采取系统抽样法分为试验组与对照组,试验组采用改良后的手工结合机械清洗检测法,对照组采用常规的手工清洗法,比较两种清洗消毒方法的器械检测合格率及细菌检出率。结果目、镜测法质控结果中,试验组操作器械合格率为98.7%、其他辅助器械为95.9%与总合格率为96.9%,均高于对照组的96.3%、94.4%与95.5%(P<0.05);生物指示剂检测法质控结果中,试验组操作器械合格率为94.2%、其他辅助器械为92.0%与总合格率93.2%均高于对照组的87.7%、87.6%与88.8%(P<0.05);试验组细菌检出率少于对照组(P<0.05)。结论本研究将强化质量控制与持续方法改进应用于达芬奇机器人手术器械清洗消毒工作中,制定了标准化流程,提升了清洗消毒质量,具有重要价值。

OBJECTIVE To explore the effect of strengthening quality control and continuous improvement on cleaning and disinfection of Da Vinci surgical system instruments and analyze its application value.METHODS The robotic surgical instruments that were cleaned and disinfected in the disinfection and supply area of operating room of PLA General Hospital from Jan 2016 to Jan 2017 were collected and divided into the experimental group and the control group according to systematic sampling method.The experimental group was treated with modified manual combined with mechanical cleaning method,the control group was treated with routine manual cleaning method,and the qualified rate of detection of instruments and isolation rate of bacteria were observed and compared between the two types of cleaning and disinfection methods.RESULTS The quality control results of visual,microscopic examination showed that the qualified rates of operating instruments and auxiliary instruments and total qualified rate of the experimental group were respectively 98.7%,95.9% and 96.9%,higher than 96.3%,94.4%and 95.5% of the control group（P〈0.05）.The quality control results of biological indicators examination indicated that the qualified rates of operating instruments and auxiliary instruments and total qualified rate of the experimental group were respectively 94.2%,92.0% and 93.2%,higher than 87.7%,87.6% and 88.8% of the control group（P〈0.05）.The isolation rate of bacteria of the experimental group was lower than that of the control group（P〈0.05）.CONCLUSIONStrengthening quality control and continuous improvement,as is applied in cleaning and disinfection of the Da Vinci surgical system instruments,has formulated standardized procedures and improved the cleaning and disinfection quality,and it has high application value.