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Objective@#To improve the opening method of humidifier, enhance the efficiency and success rate of opening the humidifiers.@*Methods@#Use all the recycled humidifier from respirators in the wards from 1st of May to 31st of October 2015 as control group. Use the recycled humidifiers from 1st Feb to 31st July 2016 as the test group. Use metal tools to open humidifier bottles in the control group while use the newly developed and improved opening device to open the bottles in the test group to test and compare the damage rate.@*Results@#The testing group that used the practical opening device for humidifier has a decrease in damage rate from 5.97% (16/268) to 1.22% (3/245), and this difference before and after was statistically significant (χ2=8.082, P<0.01).@*Conclusions@#The use of the opening device for humidifier can enhance the intact rate, greatly improve working efficiency and save the cost.
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Objective To study the application effectiveness of standard operating procedure (SOP) video in management of minimally invasive device cleaning.Methods Standard management began to be implemented in a hospital since January 2015, training was mainly conducted with video-based SOP lecture, defect rate of devices, qualified rate of sterilization package, and satisfaction of surgical staff before (in 2014) and after (in 2015) implementing SOP were compared, management efficacy was evaluated.Results After the implementation of SOP, device defect rate reduced from 6.19％ before the implementation to 0.99％, qualified rate of sterilization package increased from 90.03％ to 98.34％, satisfaction of surgical staff increased from 80.00％ to 97.78％, differences were all statistically significant(all P<0.05).Conclusion The implementation of SOP management can effectively improve the cleaning quality of surgical devices, reduce defect rate of devices, and improve the learning effect of staff, which is worth to be popularized and applied in clinical practice.
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Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.
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Objective: To explore the drying effect of pressure steam sterilization under different packing planes of non-woven fabrics so as to avoid the phenomenon of wet packages. Methods: 600 apparatus packages that packed by using non-woven fabrics were divided into A group(the packaging plane of apparatus bag used convex shape, that the center was higher and the periphery was lower), B group(The packaging plane of apparatus bag used horizontal shape) and C group (The packaging plane of apparatus bag used concave shape, that the center was lower and the periphery was higher)as random number table. All of the three groups adopted same package (the inner package was cotton and the outside package used non-woven fabrics of double-deck). Through pressure steam of impulse vacuum to achieve sterilization, and then the wet package rates of three groups were compared. Results: The wet package rates of the three groups were 1%, 8.5% and 37.5%, respectively, and the differences of wet package rates among the three groups were statistically significant (x2=10.135, P<0.05). Conclusion: The wet package rate of A group was lower than that of B group and C group, respectively. Therefore, this method of A group can ensure drying effect and guarantee the safety of clinical use.
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Objective To investigate the management status of loaner surgical instruments,and evaluate the effect of plan-do-check-act cycle (PDCA)quality control on loaner surgical instrument management.Methods From July 2011 to June 2012,8 965 pieces of loaner surgical instruments before adopting PDCA quality control management was as control group;from July 2012 to June 2013,8 564 pieces of loaner surgical instruments adopting PDCA quality control was as ob-servation group.The defects of loaner surgical instruments during application process and effect of PDCA quality control on loaner surgical instrument management were analyzed.Results There were many problems in checking-tracking,cleaning quality and company personnel of loaner surgical instruments.The qualified rate of observation group was higher than that of control group(99.36% vs 96.27%)(χ2 =194.74,P <0.01).The main causes for unqualification of observation group were unqualified cleaning (n=21 ,38.18%)and incomplete function of instruments(n=8,14.55%);while the main causes for unqualification of control group were the loss of instruments(n=81,24.25%),lack of monitor and record (n=71, 21.26%),unqualified cleaning(n=55,16.47%)and the soaking of package(n=54,16.17%).Conclusion PDCA quality control is an effective method for loaner surgical instruments management,it is helpful for building long-term effective quali-ty control system for loaner surgical instruments,and make loaner surgical instrument management more scientific,system-atic,and standard.
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Objective To investigate the incidence and influencing factors for sharp injuries occurred in workers in central sterile supply departments (CSSDs).Methods In October-November 2012,a multicenter cross-sectional survey was conducted,a total of 95 workers in CSSDs of 16 hospitals in Hunan Province were surveyed through questionnaires.Results A total of 89 workers (93.68%)in CSSDs sustained sharp injuries,46 (48.42%)of whom sustained 1 -5 times of sharp injuries,22(23.16%)sustained 6-10 times of sharp injuries,and 11 (11 .58%)sus-tained for at least 10 times of sharp injuries.81 workers (85.26%)sustained at least one time of sharp injuries one year before survey,52 (54.73%)of whom were injured by contaminated needles or other sharps.Logistic regression analysis revealed that higher educational background was protective factor for sharp injuries(OR 90%CI :0.05-0.87);while poor sleep quality(OR 90%CI :1 .03-17.94),frequent touching sharps(OR 90%CI :1 .11 -12.15),and irrational placing of objects by the other medical stuff (surgeons and nurses in operating rooms)(OR 90%CI :1 .23-16.98)were the risk factors for sharp injuries.Conclusion The incidence of sharp injuries among workers in CSSDs is high,which is related to personal factors and environmental factors.It is suggested to strengthen staff training to enhance their awareness of precaution.
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Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.
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Objective To study the effectiveness of alkaline electrolyzed water (AEW)in the cleaning of medical instruments and its corrosive effect on metal. Methods Medical instruments of solid smooth,solid with gear or tube were cleaned with AEW adding ultrasonic washing,cleaning efficacy were compared with conventional method, AEW without pulsing ultrasonic washing and control group,corrosive effect of AEW on metal immersed in AEW was tested. Results Cleaning efficacy of solid smooth,solid with gear or tube instruments were significantly differ-ent among four groups(F= 10.868,14.268,6.146,respectively,all P0.05). AEW had no corrosive effect on stainless steel and copper. Conclusion The cleaning efficacy of AEW on solid smooth,solid with gear instruments is su-perior to conventional cleaning method,and can achieve better effectiveness if ultrasonic cleaning is added.
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Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.
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Objective To design and apply the quality tracking system for central sterile supply department,complete the quality tracking of sterile medical products,rental surgical devices and high level disinfected products,conform the second-class storage management and human resource management.Methods By using the modern technology of WiFi wireless network,mobile PDA technology and two dimensional barcode,through establishing the team,collecting the data,installing the hardware,debugging the system,training and education,the development and application of the system was completed.Results The system has been operated for two years nearly in central sterile supply depamnent and other departments in hospital,it showed great practicability and convenience,covered all the daily work in central sterile supply department,achieved the information management in mobile digital way.Conclusions The application of digital mobile quality management system accelerates the central sterile supply department in standard way and realizes scientific in strategic decision and management.
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Objective To discuss the systematic training method for new nurses in central sterile supply department(CSSD),in order to improve the training effects of new nurses and special practice ability,and make them to be qualified for jobs in CSSD.Methods 18 new nurses in CSSD were divided into the control group and the experimental group with 9 nurses in each group.The experimental group adopted systematic training method combining with unit tests and comprehensive evaluation.The control group chose the traditional training method.The testing results were compared between two groups.Results The experimental group all passed through the unit evaluation and comprehensive evaluation,could work independently after the training,got excellent achievement in comprehensive assessment of the department after 3 months on-the-job,and could finish all the work and solve various emergencies.4 passengers failed in unit assessment in the control group,and 3 failed in the comprehensive evaluation.The average results in the experimental group were obviously higher than that of the control group.Conclusions Scientific training content,the systematic training method,comprehensive evaluation method can avoid the blindness and arbitrariness in training and improve training effect.The implementation of unit access system and post access system in standardized training of new nurses can improve the study enthusiasm and strengthen the risk and responsibility consciousness of nurses,which is beneficial to the growth of new nurses and professional value guidance.
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ObjectiveTo study the application of lean management in operation processing of central sterile supply department(CSSD)in order to promote its efficiency and quality improvement.MethodsFrom collecting international and domestic related literatures of lean thoughts, lean medical management, summarizing and introducing the application of lean management in medical domain, discussing the implementation of lean management in CSSD.ResultsThe implementation of lean management was ensured to be successful through establishing value stream mapping, mobile operation, waste elimination, obtaining support of top management, reforming of organization construction, placing personal and technological operation.ConclusionsThe flow of operation can be improved, the business model will be re-build and the efficiency and quality of CSSD can be improved by establishing the value stream mapping in CSSD and using the information technology.
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Objective To study installation, construction design and infection control of CSSD (central sterile supply department)equipment. Methods The merits of advanced CSSD building layout was studied as reference. International advanced disinfection & sterilization equipment was used. The laminar flows of the air in sterile room were purified. All apparatus and articles were controlled by computers. The third zone was equipped with full-automatic cleaning disinfection & sterilization apparatus. Results The quality and index all meet the requirement in construction design and infection control. Conclusion The design meets modern disinfection standards and can control the infection effectively.