口腔专科诊疗环境感染控制评价体系构建及应用效果

Construction and application effect of environmental infection control evaluation system for diagnosis and treatment of stomatology specialty

目的 构建口腔专科诊疗环境感染控制评价体系,观察该体系对持续提高消毒隔离管理工作质量的作用。方法 采用德尔菲专家咨询法构建口腔专科诊疗环境感染控制评价体系。2020年6月-2021年6月,每季度抽取20家深圳市某区正常运营中的开展口腔医疗项目的机构作为研究对象,区域级质控中心根据“评价体系”,组织每季度的消毒隔离管理专项现场评估检查。分析执行“评价体系”后消毒隔离管理质量变化情况。结果 3轮专家咨询问卷回收率为100%。初步构建了环境布局、诊疗过程、清洗消毒、管理制度和医疗废物5个一级指标,17个二级指标,54个三级指标。按照“评价体系”对口腔医疗机构共进行4次现场评估。结果显示,无菌物品管理、无菌操作技术、环境卫生管理、医疗废物管理、手卫生依从性方面合格率逐次增高,四次间比较差异有统计学意义(P<0.05)。结论 构建的评价指标体系可以持续提高护理人员在消毒隔离管理方面的工作质量。

Objective To construct the evaluation system of environmental infection control in the diagnosis and treatment of stomatology specialty and to observe the effect of the system on continuously improving the quality of disinfection and isolation management. Methods Delphi expert consultation method was used to construct the evaluation system of environmental infection control in the diagnosis and treatment of stomatology specialty. From June 2020 to June 2021, 20 institutions carried out oral medical projects in a district of Shenzhen were selected as the research objects. The regional quality control center organized the special on-site evaluation and inspection of disinfection and isolation management every there month according to the "evaluation system". Analyze the changes of disinfection and isolation management quality after the implementation of the "evaluation system".Results The recovery rate of three rounds of expert consultation questionnaire was 100%. 5 first level indicators,17 second level indicators and 54 third level indicators of environmental layout, diagnosis and treatment process,cleaning and disinfection, management system and medical waste have been preliminarily constructed. According to the "evaluation system", 4 times on-site evaluations were conducted for oral medical institutions. The results showed that the qualified rate of sterile article management, sterile operation technology, environmental health management, medical waste management and hand hygiene compliance increased step by step, the comparation of 4 times evaluation results were statistically significant(P<0.05). Conclusion The evaluation index system could continuously improve the work quality of nurses in disinfection and isolation management.