医院消毒供应中心推进信息化质量追溯管理的实践及效果评价

Practice and effectiveness of promoting informationized quality traceability management in hospital central sterile supply department

目的探索全国推进医院消毒供应中心(CSSD)信息化质量追溯管理的情况。方法中华护理学会消毒供应专业委员会依据《医院消毒供应中心第1部分:管理规范》WS 310.1—2016对信息系统的基本要求,采用抽样调查方法对CSSD信息化质量追溯管理情况进行调查,并采取一系列管理措施。基线调查于2018年7月进行;第二次调查于2019年7月进行。比较2018、2019年信息化质量追溯系统实现等情况。结果2018年1972所医院参加调查,其中1633(82.81%)所医院CSSD对集中处理的无菌物品实现质量追溯管理;2019年2728所医院参加调查,其中2606(95.53%)所医院CSSD对集中处理的无菌物品实现质量追溯管理。两年所调查医院采用的质量追溯方法所占比率比较,差异有统计学意义(χ^(2)=43.339,P<0.001),不同级别医院间比较,差异均有统计学意义(均P<0.001)。两年质量追溯功能、管理功能的分布在不同级别医院均存在差异(均P<0.001)。919所实现信息化质量追溯管理医院中572所(62.24%)医院实现全部追溯(所有集中化处理的物品均纳入信息化质量追溯管理),主要以每个灭菌包为追溯粒度的医院有471所(82.34%)。结论国内医院CSSD信息化质量追溯管理尚待完善,合理选择标签技术,开发信息化系统功能并提高追溯粒度,从而借力信息化发展更进一步提高CSSD的工作质量和效率。

Objective To explore the promotion of informationized quality traceability management(QTM)in hospital central sterile supply departments(CSSDs)in China.Methods According to the basic requirements of information system in Central sterile supply department(CSSD)-Part 1:Management standard WS 310.1-2016,informationized QTM of CSSDs was investigated through sampling survey method by Disinfection and Supply Professional Committee of Chinese Nursing Association,a series of management measures were taken.The baseline and the second survey was conducted in July 2018 and July 2019 respectively.Implementation of informationized QTM in 2018 and 2019 was compared.Results In 2018,1972 hospitals participated in the survey,CSSDs in 1633(82.81%)of hospitals implemented QTM for centralized processing of sterile items;in 2019,2728 hospitals participated in the survey,CSSDs in 2606(95.53%)hospitals implemented QTM for centralized processing of sterile items.There was significant difference in the proportion of quality traceability methods used by the investigated hospitals in the past two years(χ^(2)=43.339,P<0.001),difference among different levels of hospitals was significant(all P<0.001).Distribution of quality traceability function and management function in different levels of hospitals during two years was significantly different(all P<0.001).Of the 919 hospitals that implemented informationized QTM,572(62.24%)hospitals all achieved traceability(all centralized processed items were included in informationized QTM),and 471(82.34%)hospitals mainly used each sterilization package as the traceability granularity.Conclusion informationized QTM in domestic hospitals needs to be improved,rational selection of label technology,development of information system function and improvement of traceability granularity can further improve the quality and efficiency of CSSDs with the help of information development.