FOCUS-PDCA对提高消化内镜清洗消毒质量的影响

Application Research of FOCUS-PDCA in Improving Quality of Cleaning and Disinfection of Digestive Endoscopes

目的 探究FOCUS-PDCA在消化内镜清洗消毒中的应用效果。方法 在消化内镜清洗消毒过程中,运用FOCUS-PDCA模式,查找清洗消毒失效环节并进行改进,检测内镜消毒后菌落总数,比较不同阶段内镜消毒合格率,对比改进前后护士、清洗工人知识掌握情况。结果 在改进措施实施前(2021年9月—2022年2月),共对186条内镜进行了检测,合格率为97.8%(182/186)。在改进措施实施过程中(2022年3月—2022年10月),共检测了106条内镜,合格率为95.3%(101/106)。在改进措施实施后(2022年11月—2023年8月),共检测了131条内镜,合格率达到了100.0%(131/131),差异无统计学意义(P=0.340)。胃镜内镜菌落总数检测合格率由98.8%提升至100.0%(P=0.016),肠镜内镜菌落总数检测合格率由97.6%提升至100.0%(P=0.602),其他内镜(十二指肠镜、超声内镜、小肠镜)菌落总数检测合格率由94.7提升至100.0%(P=0.497)。改进后,护士清洗消毒知识考核得分为(93.00±4.860)分,助理护士清洗消毒知识考核得分为(95.33±4.04)分,洗消人员清洗消毒知识考核得分为(97.00±2.94)分,均分别高于改进前的(91.00±1.20)分、(90.33±2.31)分、(91.25±3.20)分,差异有统计学意义(P<0.05)。结论 在消化内镜清洗消毒中运用FOCUS-PDCA模式,可以有效改善消化内镜的清洗消毒质量。

Objective To explore application effect of FOCUS-PDCA in cleaning and disinfection of digestive endoscopes.Methods During process of cleaning and disinfecting digestive endoscopes,the paper identified and improved ineffective cleaning and disinfection links with FOCUS-PDCA mode,detected total number of bacterial colonies after endoscopic disinfection,compared qualified rate of endoscopic disinfection at different stages,and knowledge mastery of nurses and cleaning workers before and after improvement.Results Before improvement(from September 2021 to February 2022),186 endoscopes were detected,with pass rate of 97.8%(182/186).During improvement(from March 2022 to October 2022),106 endoscopes were detected,with pass rate of 95.3%(101/106).After improvement(from November 2022 to August 2023),131 endoscopes were detected,with pass rate of 100%(131/131)(P=0.340).Pass rate of total bacterial count detection in gastroscopy increased from 98.8%to 100%(P=0.016),and that of total bacterial count detection in colonoscopy increased from 97.6%to 100.0%(P=0.602),while that of other endoscopes increased from 98.8%to 100.0%(P=0.602).Pass rate of total bacterial count detection with duodenoscopy,endoscopic ultrasonography,and enteroscopy increased from 94.7%to 100%(P=0.497).After improvement,assessment scores of nurses for cleaning and disinfection knowledge were(93.00±4.860)points,those of assistant nurses were(95.33±4.04)points,those of working staff were(97.00±2.94)points,higher than(91.00±1.20)points,(90.33±2.31)points,and(91.25±3.20)points befor improvement,difference was statistically significant(P<0.05).Conclusion FOCUS-PDCA mode can improve quality of cleaning and disinfection effectively in cleaning and disinfection of digestive endoscopes.