ABSTRACT
Objective:To discuss the application effect of quality management of quality control circle (QCC) for reducing re-washing rate of suction aspirator tip in the quality management of medical instrument of hospital.Methods: Through established QCC group to designate one topic, to investigate its current situation and to protocol project plan of quality management. The qualified rate of first washing of 904 suction aspirator tips was analyzed before control management of QCC was implemented, and then series of QCC methods including fishbone diagram were applied to analyze and confirm main factors. The protocol countermeasure, depend on above information, achieved improvement for washing quality of 856 suction aspirator tips after the quality management of QCC was implemented in practice. The re-washing rates of washing quality of suction aspirator tip between before and after QCC was applied were compared.Results: The qualified rate of first washing of 904 suction aspirator tips before the quality management of QCC was implemented was 65.7%, while it was 97.6% for 856 suction aspirator tips after quality management of QCC was implemented. The washing qualified rate of suction aspirator tip after quality management of QCC was applied was significantly higher than that before it was applied (x2=8.429,P<0.05), and the result has achieved the aim that continuous improved quality.Conclusion: The application of quality management of QCC can decrease re-washing rate of suction aspirator tip, and contribute to decrease cost, to increase work efficiency, to strengthen the attention and degree of involvement of staff for work quality. Therefore, the management can fully exert potential of member of quality management of QCC, and enhance washing quality of suction aspirator tips.
ABSTRACT
Objective To investigate the effect of sufentanil and midazolam assisted epidural anesthesia for cholecystectomy on sedative effects,visceral pulling reaction and the functions of respiratory and circulatory system.MethodsFourty patients underwent cholecystectomy received informed consent, were randomly allocated to two groups:group A and group B( n =20 each). When the level of epidural block is appropriate,auxiliary medicine infusion was given 5min before the skin incision. In group A,first injection was sufentanil 0. lμg · kg-1 and midazolam 0. 02mg · kg-1 in 1-2 min, then continuous infusion of sufentanil and midazolam was given at the rate of 0. 2μg ·kg-1 · h-1 and 0. 04μg · kg-1 · h-1 respectively,and the infusion was stopped at the time of wound closure. Group B received slow intravenous injection of pethidine 1mg · kg-1 and droperidol 0. 5mg · kg-1. We recorded the differences of SBP、DBP、SpO2 、HR、Ransay score and visceral pulling reaction classification. Results SBP、DBP、HR after anesthesis,were decreased in different degree in the above groups,but there was no statistically significant difference( P ＞0. 05). According to Ramsay score,in group A there were 3 cases in grade Ⅱ、8 cases in Ⅲ and 9 cases in Ⅳ ,while in group B there were respectively 4 cases in Ⅱ、13 cases in Ⅲ and 3 cases inⅣ. By comparision,the differences had statistical significance ( u = 3.75, P ＜ 0. 05 ); Group A according to visceral pulling reaction classification (0- Ⅲ ), were 9 cases in grade 0,9 cases in Ⅰ , 1 cases in Ⅱ and 1 cases in Ⅲ, while in group B there were respectively 4,5,7 and 4 cases. By comparision, the differences had statistical significance(u = 4. 01,P ＜ 0. 01 ). Conclusion In the cholecystectomy,sufentanil and midazolam assisted epidural anesthesia,could improve the level of sedation ,prevent visceral pulling reaction ,and had a minor interference to respiratory and circulatory function.