目的 探讨消毒供应中心的管理方法，切实提高其质量。 方法 2008年8月－2010年12月应用PDCA循环管理模式，对消毒供应中心实施标准化、规范化、系统化和科学化的管理。 结果 应用PDCA循环管理模式以来，消毒供应中心的建筑布局及工作流程得以规范；手术器械处置效率、清洗消毒灭菌质量得以提高；手术切口、Ⅰ类手术切口的感染率均得以降低。2009年与2008年、2010年与2008年比较，手术切口感染率均得以降低，差异有统计学意义（χ2=39.95，P＜0.05；χ2=27.80，P＜0.05）；2009年与2010年比较，手术切口感染率差异无统计学意义（χ2=0.02，P＞0.05）。2009年与2008年、2010年与2008年、2010年与2009年比较，Ⅰ类手术切口感染率降低，但差异无统计学意义（χ2=2.83，P＞0.05；χ2=2.21，P＞0.05；χ2=0.05，P＞0.05）。 结论 推行PDCA循环管理模式，促进了消毒供应中心的规范化管理，实现了消毒器械质量控制的前馈控制、过程控制以及反馈控制；拓展了消毒供应专业领域，使医院的现有资源得到了最为高效的利用；使患者安全得到了切实保障。
In order to promote the implementation of the three standards of central sterile supply department (CSSD), new standards for cleaning and disinfection/sterilization of flexible endoscope, dental instruments, and environmental surface in healthcare, this article elaborates about central management of CSSD; management of loaners and implants; technique of autoclave sterilization, ethylene oxide sterilization, and hydrogen peroxide sterilization; high level disinfection or sterilization of flexible endoscope; disinfection and sterilization of dental instruments; daily and enhanced cleaning and disinfection of environmental surface in healthcare facilities. This could help clinical healthcare workers to implement these new standards, effectively prevent nosocomical infection, and guarantee the personal safety of patients.
ObjectiveTo understand the economic burden of disinfection supply to medical institutions in Yibin City, and explore the feasibility of establishing a regional centralized management model of disinfection supply center in Yibin City.MethodsFrom April to May 2018, 263 medical institutions in the eight counties and two districts of Yibin City were investigated by means of mobile phone application-designed questionnaire, to obtain the information of cost accounting and economic burden of disinfection supply.ResultsThere were 263 medical institutions involved in the survey, in which 61 (23.19%) had set up the central sterile supply department (CSSD), including 43 public hospitals and 18 private hospitals; 202 medical institutions were without CSSD, which were mainly secondary hospitals [195 (74.14%), including 120 public hospitals and 75 private hospitals]. The higher the hospital level was, the larger the average area of the CSSD was; the difference was statistically significant (χ2=40.009, P<0.001). The higher the hospital level was, the more full-time personnel were employed, and the difference was statistically significant (χ2=31.862, P<0.001), and the care staff were the majority (66.23%). The cost burden of CSSD was more than 1 million yuan in the tertiary hospitals, which was 100 000 yuan or above in 61.90% of the secondary hospitals, and was below 100 000 yuan in hospitals below secondary level. The higher the hospital level was, the higher the total cost burden became; the difference was statistically significant (χ2=37.995, P<0.001). ConclusionIn view of the heavy economic burden of CSSD in medical institutions and the unbalanced setting up of medical institutions below secondary level, the establishment of a regional CSSD centralized management model is a new direction, new trend, and new model for future development, which is conducive to improving the quality of disinfection and sterilization, reducing medical care costs, making rational use of health resources, effectively preventing hospital infections, and ensuring the medical safety.