消毒供应中心医疗器械清洗质量不合格的风险预测模型构建

Construction of risk prediction model for unqualified cleaning quality of medical equipments in disinfection and supply center of Hai’an People’s Hospital

目的分析江苏省海安市人民医院消毒供应中心发生医疗器械清洗质量不合格的影响因素,并构建相关因素的风险预测模型。方法选取医院消毒供应中心2019年1月至2020年6月收入清洗的医疗器械,医疗器械使用次数共350次。收集器械清洗相关资料及器械清洗质量等相关情况,评估医疗器械清洗质量不合格发生情况并分为发生组和未发生组,比较2组相关资料,经Logistic回归分析检验海安市人民医院消毒供应中心发生医疗器械清洗质量不合格的影响因素,并构建相关因素的风险模型,绘制ROC曲线,检验医院消毒供应中心医疗器械清洗质量不合格发生风险模型的预测效能。结果350次医疗器械清洗中,清洗质量不合格发生31次,发生率为8.86%;Logistic回归分析显示,预处理不规范、操作流程不规范、清洗剂残留、器械浸泡时间<20 min或>30 min可能是海安市人民医院消毒供应中心发生医疗器械清洗质量不合格的影响因素(OR>1,P<0.05);绘制ROC曲线发现,构建的相关因素风险模型预测南通市海安市人民医院消毒供应中心医疗器械清洗质量不合格风险的AUC>0.80,有一定预测价值;经Hosmer-Lemeshow拟合优度检验,拟合差异无统计学意义(P>0.05),拟合满意。结论南通市海安市人民医院消毒供应中心发生医疗器械清洗质量不合格可能受预处理不规范、操作流程不规范、清洗剂残留、器械浸泡时间<20 min或>30 min等因素影响,构建的风险模型预测医疗器械发生清洗质量不合格准确度好。

Objective To investigate the influencing factors of unqualified cleaning quality of medical equipments in the disinfection and supply center of Hai’an People’s Hospital,and to establish the risk prediction model of related factors.Methods The medical equipments which were cleaned in disinfection and supply center of our hospital from January 2019 to June 2020 were selected,the frequency of use of medical devices was 350 times.The relevant data of device cleaning and device cleaning quality were analyzed,and the occurrence of unqualified cleaning quality of medical equipments was evaluated,which was divided into occurrence group and non-occurrence group,related data of the two groups were analyzed.Logistic regression analysis was performed to analyze the influencing factors of unqualified cleaning quality of medical equipments,and the risk model of related factors was established,and ROC curve was drawn,and the predictive efficiency of the risk model for unqualified cleaning quality of medical equipments was analyzed.Results Of the 350 times of medical equipments cleaning,there were 31 times of unqualified cleaning quality,with the incidence rate being 8.86%.Logistic regression analysis showed that nonstandard pretreatment,nonstandard operation process,residual cleaning agent and equipment soaking time<20min or>30min might be the influencing factors of unqualified cleaning quality of medical devices(P<0.05).ROC curve showed that the AUC>0.80 had a certain predictive value<And Hosmer-Lemeshow test of goodness of fit was performed,there was no significant difference in fitting(P>0.05),and the fitting was satisfactory.Conclusion The unqualified cleaning quality of medical equipments in the disinfection and supply center of our hospital may be affected by nonstandard pretreatment,nonstandard operation process,residual cleaning agent,and device soaking time<20min or>30min,and the risk model has better accuracy in predicting the unqualified cleaning quality of medical equipments.