一体化管理应用于消毒供应室手术器械清洗消毒工作中的价值分析

Value of integrated management on cleaning and disinfection of surgical instruments in disinfection supply room

目的探讨一体化管理对消毒供应室手术器械清洗消毒工作的影响,为实际应用提供参考依据。方法自2018年7月1日起,我院消毒供应室实施一体化管理模式,派遣专人到手术室参与清洗、消毒和包装等工作,要求消毒供应室工作人员全程参与清洗消毒工作。随机抽取实施前(2018年1~6月)、实施后(2018年7~12月)1000件手术医疗器械,比较实施前后6月内包装、器械功能、无菌性、包外标签及放大镜检测等合格率差异,并统计实施前后手术室医护人员满意度、医院感染和Ⅰ类切口感染率。结果实施后,1000件抽样器械中,包装合格率为95.0%、器械功能完好率为98.9%、无菌合格率为100.0%、包外标签合格率99.5%、放大镜检测合格率为99.8%,均高于实施前,差异有统计学意义(χ^2=32.803、63.441、79.098、82.296、78.636,P<0.05)。实施前1000例手术中,合并院内感染率为0.7%、Ⅰ类切口感染率为0.4%,发生率为1.1%,高于实施后的0.1%,差异有统计学意义(χ^2=6.791,P<0.05)。实施后,手术室医护人员非常满意15例,满意率为100.00%,高于实施前的72.73%,差异有统计学意义(χ^2=4.825,P<0.05)。结论一体化管理可有效提升手术器械消毒灭菌质量,有利于减少医院感染发生,对控制医患纠纷、加强院内医护人员合作均有重要意义,值得临床推广应用。

Objective To explore the influence of integrated management on the cleaning and disinfection of surgical instruments in the disinfection supply room,and to provide a reference for practical applications.Methods The integrated management model has been implemented since July 1,2018 in our hospital's disinfection and supply room,in which special personnel have been dispatched to the operation room to participate in cleaning,disinfection and packaging,and the staff of the disinfection and supply room are required to participate in the cleaning and disinfection work throughout the process.The eligibility rates differences in packaging,device function,sterility,outof-package labels and magnifying glass detection of 1,000 surgical medical devices before implementation(January to June 2018)and after implementation(July to December 2018)were compared,and satisfaction of operating room medical staff,hospital infections,and typeⅠincision infections before and after implementation were analyzed.Results After implementation,the packaging qualification rate was 95.0%,the device function intact rate was 98.9%,the aseptic qualification rate was 100.0%,the out-of-package label qualification rate was 99.5%,and the magnifying glass test qualification rate was 99.8%,which were higher than those before implementation,and the differences were statistically significant(χ^2=32.803,63.441,79.098,82.296,78.636,P<0.05).Before implementation,the combined hospital infection rate was 0.7%,the rate of typeⅠincision infection was 0.4%,and the incidence rate was 1.1%,which was higher than 0.1%after implementation,and the difference was statistically significant(χ^2=6.791,P<0.05).After implementation,15(100%)operating room medical staff were very satisfied,which was higher than 72.73%before implementation,and the difference was statistically significant(χ^2=4.825,P<0.05).Conclusion Integrated management can effectively improve the quality of disinfection and sterilization of surgical instruments,and is conducive to reducing the incidence of hospital infections.It is of great significance for controlling doctor-patient disputes and strengthening cooperation in hospital medical staff,and is worthy of clinical promotion and application.