集中式管理对消毒供应中心护理服务质量与工作效率的影响研究

A Study on the Influence of Centralized Management on the Quality of Nursing Service and Work Efficiency of Disinfection Supply Center

目的探讨集中式管理对消毒供应中心护理服务质量及工作效率的影响。方法选取该院消毒供应室(2016年1月—2017年1月)500份实施分散式管理的临床资料为对照组,另选取该院消毒供应室(2018年1月—2019年1月)500份实施集中式管理的临床资料为观察组。对比两组器械及包装清洁灭菌合格率、投入器械消毒时间及各科室满意度以及两组工作人员技能水平和每小时消毒灭菌包数。结果观察组医院感染、器械、包装灭菌质量、包装清洗质量、器械清洗质量分别为1(0.20%)、500(100.00%)、497(99.40%)、498(99.60%),对照组分别为28(5.60%)、471(94.20%)、453(90.60%)、464(92.80%),两组器械及包装清洁灭菌合格率对比差异有统计学意义(χ2=5.178、5.973、4.365、6.324,P<0.05)。观察组机械清洗、人工清洁、消毒隔离、器械洗涤、器械回收、平均得分分别为(87.63±5.70)分、(87.36±6.02)分、(88.49±5.52)分、(87.89±6.42)分、(86.73±5.01)分、(87.58±6.09)分,两组工作人员技能水平对比差异有统计学意义(t=10.193、7.614、10.790、8.190、10.088、8.443,P<0.05)。观察组回收、去污、消毒、包装、灭菌、储存、运送每小时消毒灭菌包数分别为(9.65±0.15)、(9.74±0.06)、(9.78±0.18)、(9.93±0.18)、(9.88±0.38)、(9.88±0.48)、(9.96±0.33)包,对照组分别为(8.86±0.21)、(8.46±0.20)、(8.66±0.27)、(8.75±0.24)、(9.12±0.32)、(9.13±0.42)、(8.97±0.31)包,两组工作人员每小时消毒灭菌包数对比差异有统计学意义(t=19.361、38.770、21.829、24.877、9.675、7.437、13.829,P<0.05)。观察组投入器械消毒时间、临床科室满意度、手术室满意度分别为(0.39±0.11)h、(88.73±5.17)分、(89.23±6.42)分,对照组分别为(2.85±0.54)h、(78.45±4.20)分、(80.75±5.84)分,两组投入器械消毒时间及各科室满意度对比差异有统计学意义(t=99.815、34.510、21.848,P<0.05)。结论集中式管理可提高器械及包装清洁灭菌合格率,提高消毒供应中心工作效率和质量,并且降低临床护士间接护理时数,对消毒供应中心护理服务质量及工作效率具有积极影响。

Objective To explore the impact of centralized management on the quality and efficiency of nursing services in a disinfection supply center.Methods Select 500 clinical data of decentralized supply room in our hospital(January 2016~January 2017)for decentralized management as the control group,and select the disinfection supply room in our hospital(January 2018~January 2019)500 clinical materials with centralized management are the observation group.Comparing the qualification rate of cleaning and sterilization of instruments and packaging of two groups,the sterilization time of equipment and satisfaction of various departments,the skill level of the two groups of staff and the number of disinfection and sterilization packages per hour.Results The hospital infection,equipment,packaging sterilization quality,packaging cleaning quality,and equipment cleaning quality of the observation group were 1(0.20%),500(100.00%),497(99.40%),and 498(99.60%),respectively,and the control group was 28(5.60%),471(94.20%),453(90.60%),464(92.80%),the difference between the two groups of equipment and packaging cleaning and sterilization pass rate was statistically significant different(χ2=5.178,5.973,4.365,6.324,P<0.05).Observation group of mechanical cleaning,manual cleaning,disinfection and isolation,equipment washing,equipment recovery,average scores were(87.63±5.70)points,(87.36±6.02)points,(88.49±5.52)points,(87.89±6.42)points,(86.73±5.01)points,(87.58±6.09)points,the skills of the two groups of staff,the difference in level contrast was statistically significant(t=10.193,7.614,10.790,8.190,10.088,8.443,P<0.05).The number of disinfection and sterilization packages per hour for the observation group for recovery,decontamination,disinfection,packaging,sterilization,storage,and transportation were(9.65±0.15),(9.74±0.06),(9.78±0.18),(9.93±0.18),(9.88±0.38),(9.88±0.48),(9.96±0.33)pack,the control group were(8.86±0.21),(8.46±0.20),(8.66±0.27),(8.75±0.24),(9.12±0.32),(9.13±0.42),(8.97±0.31)pack,the difference in the number of sterilization packages per hour between the two groups of staff was obvious(t=19.361,38.770,21.829,24.877,9.675,7.437,13.829,P<0.05).The disinfection time,satisfaction of clinical departments and operating room of the observation group were(0.39±0.11)h,(88.73±5.17)points,(89.23±6.42)points,and the control group were(2.85±0.54)h,(78.45±4.20)points,(80.75±5.84)points,the difference in the disinfection time of the two groups of input devices and the satisfaction of each department was significant(t=99.815,34.510,21.848,P<0.05).Conclusion Centralized management can improve the qualified rate of cleaning and sterilization of equipment and packaging,improve the efficiency and quality of the disinfection supply center,and reduce the indirect nursing hours of clinical nurses,which has a positive impact on the quality and efficiency of nursing services in the disinfection supply center.