消毒供应中心缺陷包影响因素

Discussion of the management of defective wrapping in central sterile supply department

目的分析探讨消毒供应中心缺陷包发生的原因及影响因素并提出改进对策。方法通过回顾性研究,收集医院新院区消毒供应中心信息系统全面上线后2020年5月1日-2020年12月31日登记的科内缺陷包,进行描述性统计及数据分析。结果登记缺陷包共326例,主要原因描述为七个方面:污迹(包内或包外)178例,包装破损122例,湿包11例,包内化学指示卡变色不合格4例,包装封口不合格3例,包内异物3例,设备故障5例。缺陷包相关因素主要有:装载不规范、器械结构复杂、清洗不充分、包装材质选择欠妥、器械特殊材质、蒸汽问题、查对制度未落实、包装技术欠熟练等。结论发生缺陷包的原因及相关影响因素较多,存在极大的安全隐患,同时缺陷包会增加成本,应关注缺陷包的发生情况,有针对性的采取措施,有助于加强质量安全管理,成本管理,也有助于预防手术部位感染。

OBJECTIVE To analysis and discuss reasons and influencing factors of defective wrappings in central sterile supply department,and to put forward some countermeasures for improvement.METHODS In a retrospective study,the defective wrappings registered from May 1,2020 to Dec 31,2020 were collected after the information system of the new hospital central sterile supply department has been fully online.Descriptive statistics and data analysis were performed.RESULTS A total of 326 defective wrappings were registered,the main reasons were described in seven aspects,including 178 cases of stain(inside or outside of the wrapping),122 cases of package breakage,11 cases of wet packs,4 cases of unqualified discoloration of chemical indicator in wrappings,3 cases of unqualified sealing,3 cases of foreign body in wrappings and 5 cases of sterilization failure.The relevant factors relating to the defective wrappings were mainly irregular loading of the sterilizer,complexity of the instruments,inadequate cleaning、inadequate cleaning,use of inappropriate packaging materials,special materials of instruments,steam problems,unimplemented checking system,unskilled packaging technique,etc.CONCLUSION There are many reasons and related influencing factors for defective wrappings,and great potential safety hazards may be exist.Defective wrrapings would increase costs.We should pay attention on defective wrappings and targeted measures should be taken to strengthen quality and safety management and cost management,as well as to prevent surgical site infection.