首页|基于RCA的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响

基于RCA的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响

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目的:探究基于根本原因分析(RCA)的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响.方法:以 2021 年 7 月中国人民解放军联勤保障部队第九一〇医院消毒供应室实施基于RCA的路径式质控管理干预为分界线,将 2020 年 1 月—2021 年 6 月实施常规消毒灭菌管理的 86 组手术器械纳为管理前组,将 2021 年 7 月—2022 年 12 月实施基于RCA的路径式质控管理的 86 组手术器械纳为管理后组.观察两组灭菌合格率[目测法、蛋白质残留检测、三磷酸腺苷(ATP)荧光检测、细菌菌落检测]、管理质量(器械管理、医疗垃圾处理、手卫生管理、技能考核培训)、器械相关感染发生率、临床科室及手术室人员对消毒供应中心服务满意度.结果:管理后组目测法、蛋白质残留检测、ATP荧光检测、细菌菌落检测合格率高于管理前组,差异有统计学意义(P<0.05);管理后组器械管理、医疗垃圾处理、手卫生管理、技能考核培训评分高于管理前组,差异有统计学意义(P<0.05);管理后组器械相关感染发生率为 3.49%,低于管理前组的 12.79%,差异有统计学意义(P<0.05);管理后组服务态度、物品质量、物品交接、器械配送、信息追溯满意度高于管理前组,差异有统计学意义(P<0.05).结论:基于RCA的路径式质控管理可改善消毒供应中心的灭菌合格率,提升器械管理质量,降低院内器械相关感染率,且临床科室及手术室人员较满意.
Influence of RCA-based Pathway Quality Control Management on Sterilization Qualification Rate,Management Quality and Infection Rate in Disinfection Supply Center
Objective:To explore the influence of root cause analysis(RCA)-based pathway quality control management on sterilization qualification rate,management quality and infection rate in disinfection supply center.Method:Taking the implementation of RCA-based pathway quality control management intervention in the disinfection supply room of the 910th Hospital of Joint Logistics Support Force of People's Liberation Army in July 2021 as the dividing line,86 groups of surgical instruments that implemented routine disinfection and sterilization management from January 2020 to June 2021 were included in the pre-management group,and 86 groups of surgical instruments that implemented RCA-based pathway quality control management from July 2021 to December 2022 were included in the post-management group.The sterilization qualification rate[ocular estimate,protein residue detection,adenosine triphosphate(ATP)fluorescence detection,bacterial colony detection],management quality(instrument management,medical waste disposal,hand hygiene management,skill assessment training),incidence rate of instrument-related infection,and satisfaction of clinical departments and operating room personnel with service of disinfection supply center were observed in two groups.Result:The qualified rates of ocular estimate,protein residue detection,ATP fluorescence detection and bacterial colony detection in the post-management group were higher than those in the pre-management group,and the differences were statistically significant(P<0.05).The scores of instrument management,medical waste disposal,hand hygiene management,skill assessment training in the post-management group were higher than those in the pre-management group,and the differences were statistically significant(P<0.05).The incidence rate of instrument-related infection in the post-management group was 3.49%,which was lower than 12.79%in the pre-management group,the difference was statistically significant(P<0.05).The satisfaction of clinical departments and operating room personnel with service of disinfection supply center in the post-management group were higher than those in the pre-management group,and the differences were statistically significant(P<0.05).Conclusion:RCA-based pathway quality control management can enhance the sterilization qualification rate of disinfection supply center,improve the quality of instrument management,and reduce the incidence rate of nosocomial infection,and it has high satisfaction with the use of instruments by clinical departments and operating room personnel.

Root cause analysisPathway quality control managementDisinfection supply centerSterilization qualification rateManagement qualityInfection rate

陈萍茹、林彬红、陈玲娇

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中国人民解放军联勤保障部队第九一〇医院 福建 泉州 362000

根本原因分析 路径式质控管理 消毒供应室 灭菌合格率 管理质量 感染率

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(18)