Quality of life at work in a central sterile processing department.

OBJECTIVES: to evaluate the quality of life of nursing professionals who work in a central sterile processing department. METHODS: a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire "Medical Outcomes Study Short-Form 36" were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects. CONCLUSIONS: This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.

Quality of life at work in a central sterile processing department / Calidad de vida en el trabajo en una central de materiales y esterilización / Qualidade de vida no trabalho numa central de materiais e esterilização

ABSTRACT Objectives: to evaluate the quality of life of nursing professionals who work in a central sterile processing department. Methods: a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire "Medical Outcomes Study Short-Form 36" were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects. Conclusions: This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.

RESUMEN Objetivos: evaluar la calidad de vida de los profesionales de enfermería que actúan en una central de materiales y esterilización. Métodos: estudio exploratorio, descriptivo, cuantitativo, realizado con 82 profesionales de enfermería que actuaban en una central de materiales y esterilización (CME) de un Hospital Universitario, en el período de septiembre a noviembre de 2017. Se utilizó un instrumento semiestructurado y el cuestionario Medical Outcomes Study Short-Form 36. Resultados: los participantes eran, en su mayoría, del sexo femenino, estaban casados y en el grupo de edad de 31-40 años; El 47,6% tenía entre 6-10 años de profesión y el 82,9% mencionó el tiempo de servicio en CME de 1-5 años. Los Dominios de calidad de vida más frecuentes fueron Dolor, Vitalidad, Estado General de Salud y Aspectos Sociales. Conclusiones: El estudio reveló que es necesario repensar y recrear la dinámica del trabajo en CME para que se mejore la calidad de vida de esos profesionales de enfermería.

RESUMO Objetivos: avaliar a qualidade de vida dos profissionais de enfermagem que atuam em uma central de materiais e esterilização (CME). Métodos: estudo exploratório, descritivo, quantitativo, realizado com 82 profissionais da enfermagem que atuavam na central de materiais e esterilização de um hospital universitário, no período de setembro a novembro de 2017. Foi aplicado um instrumento semiestruturado e um questionário, "Medical Outcomes Study Short-Form 36". Resultados: os participantes eram, em maioria, do sexo feminino, casados, na faixa etária de 31-40 anos; 47,6% tinham de 6-10 anos de profissão e 82,9% referiram tempo de serviço em CME de 1-5 anos. Os domínios de qualidade de vida mais atingidos foram Dor, Vitalidade, Estado Geral de Saúde e Aspectos Sociais. Conclusões: O estudo mostrou que é preciso repensar e recriar a dinâmica do trabalho em CME na perspectiva de melhorar a qualidade de vida desses profissionais de enfermagem.

How does joint procurement affect the design, customisation and usability of a hospital ePrescribing system?

The aim of this article is to explore the effect of the joint procurement model adopted during the English National Programme for Information Technology (NPfIT) on the customisation, design and usability of a hospital ePrescribing system. Drawing on qualitative data collected at two case study sites deploying an ePrescribing system jointly procured within one of the NPfIT's geographical clusters, we explain how procurement decisions, difficult relationships with the supplier and strict contractual arrangements contributed to usability issues and difficulties in the customisation process. While some limited change requests made by users were taken up by the developers, these were seen by users as insufficient to meet local clinical needs and practices. A joint procurement approach, such as the NPfIT, thus limited the opportunity and scope of the changes to the ePrescribing system, which impinged not only on the perceived success of the implementation but also on the system's usability.

Mejorando la cadena de suministro en un hospital mediante la gestión Lean / Improving a hospital's supply chain through lean management

Objetivos. La gestión del suministro constituye un área en la que los hospitales tienen importantes oportunidades de mejora. Este trabajo pretende analizar cómo la aplicación de los principios de Lean puede mejorar los costes logísticos y la satisfacción de los usuarios. Métodos. Análisis de los resultados de una experiencia de reorganización del sistema logístico de un hospital basada en algunos principios Lean. Para el cálculo de los costes logísticos se ha utilizado el método del coste completo o full costing de contabilidad analítica de gestión. La satisfacción del usuario se evaluó mediante encuesta anónima. El tratamiento de los datos de la encuesta incluyó análisis factorial y el modelo de análisis de la varianza ANOVA. Resultados. Los datos obtenidos mostraron una mejora en la gestión de logística tras la implantación de Lean, con reducción de costes y mejora del nivel de satisfacción del usuario interno. Se ha observado que el personal sanitario percibe y valora el servicio logístico de manera global, sin diferenciar los aspectos del servicio, detectándose diferencias en cuanto al grado de satisfacción percibida por distintos grupos de usuarios. Conclusiones. La experiencia analizada ha permitido comprobar la aplicabilidad e idoneidad de los principios Lean para mejorar los costes e incrementar la satisfacción de los usuarios de servicios logísticos hospitalarios (AU)

Objectives: Supply management is an area where hospitals have significant opportunities for improvement. The main objective of this paper has been to analyze how the application of Lean principles can improve logistics costs and user satisfaction. In connection with satisfaction, it also aimed to examine which aspects of the service define it and check for differences between different groups of users. Methods: The results of an experience to reorganize the hospital logistic system based on some Lean principles have been studied. This is therefore a case study, which combine different methods of data collection. The logistics cost calculation was carried out using the full costing method. To measure satisfaction of healthcare personnel, the internal logistics service users, an anonymous survey was conducted. Processing of the data obtained from the survey have included exploratory analysis, factor analysis and ANOVAs. Results: The data have showed an improvement in logistics management after the implementation of Lean principles. Logistics costs were reduced and the satisfaction level of the internal users with the new logistics system was increased. Some differences in the degree of satisfaction by different groups of users were also detected, although they did not seem to distinguish between different aspects of logistic service. Conclusions: The analyzed experience shows the applicability and suitability of Lean principles to improve logistics operational costs and increase user satisfaction (AU)

Clinical staff resource use with intravenous patient-controlled analgesia in acute postoperative pain management: results from a multicenter, prospective, observational study.

The purpose of this study was to evaluate hospital resource utilization associated with intravenous patient-controlled analgesia (IV-PCA), with a focus on nursing, pharmacy, and central supply/engineering time spent from a hospital perspective. Data were collected during a multicenter (29 sites), prospective observational study in the United States of subjects who underwent total knee replacement (TKR), total hip replacement (THR), or abdominal hysterectomy (AH) and were administered analgesia through IV PCA for the management of acute postoperative pain. Nursing staff recorded the IV PCA-related tasks they performed for a subject and the duration of time required to perform each task from initial IV PCA set-up to discontinuation. Hospital administrators, nursing managers, central supply/engineering staff, and pharmacy directors were interviewed to obtain data regarding other IV PCA labor resource use. The distribution of surgery type among the 457 subjects was 31.1% THR, 35.9% TKR, and 33.0% AH. The average duration of IV PCA use was 32.6 hours. Nurses reported having to perform an average of 39.6 IV PCA-related tasks, which required an average of 67.4 minutes. The most common IV PCA-related tasks were evaluating pump use and settings, assessing the IV site, evaluating and addressing analgesia side effects, instructing/reinstructing the subject on use, administering supplemental pain medications, assisting with self-care or moving the subject, and assisting the subject with use of the button. Pharmacists reported that they spend approximately 7.9 minutes and pharmacy technicians spend approximately 9.8 minutes, per subject daily course of IV PCA therapy, on the following tasks: checking and verifying the order, doing inventory of the analgesia, preparing the analgesia (ie, filling reservoirs), checking the analgesia, and delivering the analgesia to the nursing units. In addition, pharmacists and RNs spend an average of 47.3 and 40.7 minutes per year in IV PCA-related training. Intravenous patient-controlled analgesia postoperative care requires coordination and involvement of numerous hospital departments. It is labor intensive and involves numerous time-consuming tasks, oversight of IV PCA, and ongoing training. Alternative methods of patient-controlled pain management with similar efficacy that reduces labor resource utilization may be warranted.

[Assessment of the sterilization of medical devices--an important challenge to health care in Poland]. / Ocena procesów sterylizacji wyrobów medycznych jako istotnego elementu higieny szpitalnej w wybranych szpitalach.

The aim of the study was the evaluation of sterilization of medical devices in Polish hospitals. The system that we use to establish which sterilization procedures should be employed to reduce the risk of hospital infections associated with medical devices. Based on inquiries, the conditions for the sterilization of medical devices in 21 Warsaw hospitals were assessed. The following issues were taken into consideration: preparation of medical supplies for sterilization, methods of sterilization and the monitoring system. In order to evaluate hygienic conditions due to sterilization points system was applied. 10% of the hospitals had Central Sterilization Service Department with 3 zones where automatic washing and disinfection, sorting, packaging, sterilization and storage of medical devices had been performed. The other 20% had CSSD without zones. In more than 65% there were common services for sterilization only. Instruments were delivered already prepared for sterilization. In remaining hospitals all steps, including sterilization were performed in words. According preparation of medical devices for sterilization it was established that mainly chemical disinfection just after use and than manual cleaning was used; the automatic cleaning in washer-disinfectors is used mainly in CSSD. Steam was the preferred method of sterilization, but also low temperature methods were used for heat sensitive devices. The monitoring of sterilization processes was satisfactory. There were first trials of the validation of the sterilization processes. There is still a need for improvement in the sterilization of medical devices, especially including: the organisation of CSSD in all Polish hospitals; replacement of manual cleaning processes by automatic cleaning; organisation of advanced training courses for the heads and staff of the CSSD.

1994 survey--healthcare materiel management and central service professions.

Our 1994 professional survey shows an industry in flux. Institutions seem to be getting smaller, job tenure is shrinking for CS managers and materiel managers are convinced there will be fewer of them around. Salaries seem to be flattening for materiel managers, female materiel managers are being financially discriminated against and CS managers, though making more money, are losing benefits. Job dissatisfaction appears to be on the rise for both professions.

Results of the 1993 survey of the healthcare materiel management and central service professions.

Our 1993 professional survey showed materiel managers gearing for change, as they expect to see their ranks decrease in number but gain influence. Central service managers seem to be warily watching CS contract services. Salaries increased more for materiel managers than CS managers, though both showed some losses in some regions. Bed size again had a direct bearing on compensation, and those who made more tended to have more benefits. Benefits were lost by 14 percent of materiel managers and 21 percent of CS managers. Few of either group changed jobs. Materiel managers again reported in the largest numbers to finance and CS to materiel management, though this reporting structure seems to be weakening. Education gains were up for both groups, and membership to one or more associations was high for both groups. Materiel managers seem more satisfied with their jobs than they did last year, but CS managers seem decidely less satisfied.