摘要
目的:构建心内科医疗器械供应可靠性管理指标体系,形成可靠性评估策略,提升可靠性管理水平.方法:从医疗器械使用前备件、使用中追踪和使用后处理3个环节,划分13个供应管理事项,在全程管理中开展工作差错概率、质量问题概率和诊疗风险预期评估,形成分级分层、质量规范、部门合作的全过程管理对策.采用随机抽样法选取2021-2022年深圳市龙华区人民医院心内科病房126台医疗器械运行的2 000次数据资料,按照器械供应模式不同,分别采用部门协同式管理的协同管理模式(1 000次)和可靠性评估管理的评估管理模式(1 000次)进行器械供应管理.对比不同管理模式医疗器械供应可靠性和满意度.结果:采用评估管理模式的医疗器械使用前备件、使用中追踪、使用后处理3个环节以及供应全程的工作差错概率分别为(4.74±2.19)%、(4.39±1.85)%、(5.75±1.88)%和(8.29±1.30)%,均低于协同管理模式,其差异有统计学意义(t=5.367、5.663、5.432、6.847,P＜0.05),质量问题概率分别为(4.13±1.67)%、(3.89±1.25)%、(5.28±1.84)%和(7.64±1.18)%,均低于协同管理模式,其差异有统计学意义(t=6.504、6.229、5.123、6.166,P＜0.05),诊疗风险预期分别为(2.74±0.89)%、(2.47±0.96)%、(3.42±0.95)%和(4.02±1.09)%,均低于协同管理模式,其差异有统计学意义(t=7.027、6.509、8.915、9.266,P＜0.05);相关工作人员对采用评估管理模式的医疗器械性能质量、消毒规范、供应及时性、协作水平和使用安全性的满意度分别为(93.54±4.65)%、(91.67±4.11)%、(94.58±4.34)%、(92.39±3.82)%和(90.97±3.76)%,均高于协同管理模式,其差异有统计学意义(t=2.809、3.030、2.843、4.939、3.739,P＜0.05).结论:可靠性管理模式可降低医疗器械供应中的工作差错问题和安全风险,提高供应可靠性,改善供应服务质量.
Abstract
Objective:To construct a reliability management index system of cardiology medical equipment supply,to form a reliability evaluation strategy,and to improve the effectiveness of reliability management.Methods:13 supply management items were decomposed from the three links of spare parts before use,tracking during use and post-use processing of 126 medical equipment,and the probability of work error,probability of quality problems and risk expectation of diagnosis and treatment were evaluated in the whole process management,and the whole-process management countermeasures of grading and stratification,quality standardization and department cooperation was formed.2,000 pieces(sets)of medical equipment used in The People's Hospital of Longhua from 2021 to 2022 were selected by random sampling method,and the department cooperative management[referred to as collaborative management mode,1,000 pieces(sets)times]and reliability evaluation management[referred to as evaluation management mode,1,000 pieces(sets)times]were adopted respectively.The reliability and satisfaction of medical equipment under different management modes were compared.Results:The work error probabilities of pre-use spare parts,in-use tracking,post-use processing and supply of medical equipment adopting evaluation management mode were(4.74±2.19)%,(4.39±1.85)%,(5.75±1.88)%and(8.29±1.30)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=5.367,5.663,5.432,6.847;P<0.05);the probabilities of quality problems were(4.13±1.67)%,(3.89±1.25)%,(5.28±1.84)%and(7.64±1.18)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=6.504,6.229,5.123,6.166,P<0.05);the risk expectations of diagnosis and treatment were(2.74±0.89)%,(2.47±0.96)%,(3.42±0.95)%and(4.02±1.09)%,respectively,which were lower than the collaborative management mode,the difference was statistically significant(t=7.027,6.509,8.915,9.266,P<0.05).The satisfaction of the relevant staff on the performance quality,sterilization specifications,supply timeliness,level of collaboration and safety of the medical equipment adopting the evaluation management mode were(93.54±4.65)%,(91.67±4.11)%,(94.58±4.34)%,(92.39±3.82)%and(90.97±3.76)%,respectively,which were higher than the collaborative management mode,the difference was statistically significant(t=2.809,3.030,2.843,4.939,3.739,P<0.05).Conclusion:The reliability management model can reduce the work errors and security risks in medical equipment supply,improve the reliability of supply and improve the quality of supply service.
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