纸塑袋与棉布包装材料的灭菌效果及成本比较

正《医院消毒供应中心管理规范》的新标准明确要求医用包装材料应符合《最终灭菌医疗器械的包装》(GB/T 19633—2005)的要求。灭菌物品的包装材料是医院供应室、手术室日常用量最大的耗材之一,是医疗间接成本。为了寻找灭菌效果好、成本低廉的灭菌包装材料,我院消毒供应室对纸塑袋包装、棉布类包装进行了对比性研究,现报道如下。     

单件计价式成本核算在区域化消毒供应中心的应用

目的 探讨区域化消毒供应中心的成本核算方法.方法 根据《医院财务制度》等文件,按照消毒供应中心间接成本对全部医疗器械进行单件处理价格成本核算,再根据不同包组成及包装、可计价耗材测算不同包的价格.结果 实施单件计价式成本核算后,消毒供应中心人力成本及耗材成本明显降低,临床科室在使用时也杜绝了浪费,提高了医院的经济效益.结论 在区域化消毒供应中心实行单件计价式成本核算,对不同医院同类包根据包组成定价更公平可行,对改进消毒供应中心内部质量管理和提高临床科室成本管理有重要促进作用.     

应用品管圈降低灭菌物品闭合式包装缺陷发生率

目的分析品管圈在降低灭菌物品闭合式包装缺陷发生率中的应用效果。方法对东莞市人民医院2018年3-8月消毒供应室灭菌物品闭合式包装质量进行回顾性分析,进行品管圈管理,比较管理前(2018年3-4月)与管理后(2018年7-8月)灭菌物品闭合式包装缺陷发生率情况。结果应用品管圈管理后灭菌物品闭合式包装缺陷发生率明显低于管理前,差异有统计学意义(P0.05)。结论消毒供应室灭菌物品闭合式包装管理中采用品管圈管理,可明显降低手术器械闭合式包装缺陷发生率,减少器械重复包装灭菌次数,提高供应室人员工作效率,降低医院感染风险,值得推广。     

加强流程管理提高中心供应室的工作质量

目的 加强中心供应室流程管理,提高工作质量,预防与控制医院感染.方法 按照质量管理标准对中心供应室的建筑布局、工作流程及管理程序进行规范化.结果 对消毒供应室的清洗、包装、灭菌、储存、发放等操作流程规范化管理,有效地提高了工作质量,减少了医院感染危险.结论 中心供应室建立完善、合理的布局和工作流程、严格执行操作规程、规范管理是预防与控制医院感染的重要环节.     

浅谈规范消毒供应室管理

目的:对本医院消毒供应室的管理方法和管理规范效果进行探讨分析,发现和分析问题,促进对供应室的质量管理的改善,提高消毒灭菌质量,有效控制感染.方法:通过对医院消毒供应室职员进行素质与技能的培训,加强再生物品环节的质量管理,对医院消毒和设施进行完善处理.结果:加强对医院消毒供应室的管理,能有效提高其为医院提供合格的灭菌物品,有效防止院内感染发生等问题.结论:对医院的消毒供应室进行管理模式的改善和管理的加强,能够为医院工作的正常运行提供良好的物质保证,有效地预防和控制医院的感染.     

再生物品实施集中管理是预防医院感染的关键

目的集中式管理再生物品,以规范消毒供应清洗消毒与灭菌技术操作和清洗消毒与灭菌效果监测,保证医疗安全。方法将全院的所有医疗器械,严格按照《医院消毒供应中心管理规范》,对所有需要消毒或灭菌后重复使用的诊疗器械、器具和物品由中心消毒供应室按照回收→分类→清洗→消毒→干燥→检查与保养→包装→灭菌→储存→无菌物品发放流程工作。结果集中管理再生物品,规范了供应室操作流程,节省护理人力资源,降低了职业暴露风险。结论由于物品的消毒、灭菌效果得到了保证,实施集中管理是预防医院感染的关键,能很好地控制医院感染率,确保医疗安全。     

加强供应室质量管理控制医院感染

目的 加强医院消毒供应室工作各环节的质量管理，控制医院感染。方法 重视再生物品清洗、包装质量，严格灭菌物品装放，正确选择灭菌方法，加强无菌物品储存和发放管理，完善各项监测措施。结果 加深了供应室工作重要性的认识，确保了无菌物品质量，有效地防止了医院感染的发生。结论 通过落实一系列管理措施，使供应室工作达到科学化、规范化、标准化。     

临床待灭菌包存在问题及管理对策

为了有效控制医院感染,提高医疗护理质量,确保患者安全,加强灭菌工作的质量管理,参照<医院感染管理办法>、<消毒技术规范>,制定统一检查标准,物品的清洗、包装、灭菌质量标准.供应室于2008年12月,对我院24个临床科室的待灭菌包进行了全面认真检查,共计检查1400件各种待灭菌包,现将存在的问题归纳如下.     

标准规范业务流程 提高消毒供应室工作质量

<正>消毒供应室是医院的重要组成部分,它是向全院提供各种无菌物品的重要科室,同时担负着医疗器械回收、清洗、包装、消毒、灭菌和发放工作。我院严格按照卫生部《消毒技术规范》、《医院感染管理规范》、《医院消毒供应中心管理规范》、《广东省医疗卫生机构消毒供应室(中心)审核验收标准》要求,结合医院发展需求,重新改造、合理布局消毒供应室,科学化、标准化、规范化管理,全面提高消毒供应室工作质量。     

消毒供应室对再生医疗器械的感染控制对策

目的 了解消毒供应室感染关键点与程序,探讨预防控制对策.方法 采用回收、清洗消毒、包装、灭菌、无菌物品储存及下送等控制点管理,制定控制感染程序,并落实执行.结果 供给临床质量可靠的无菌物品,封闭回收保证污染物品在运输过程中不传播有害病菌,清洗彻底是保证灭菌成功的关键;正确包装,保证无菌物品建立无菌屏障完整有效性;灭菌合格,有效控制医院感染;正确的无菌物品储存和下送,确保无菌物品使用前不被污染.结论 做好消毒供应室感染控制要点,可提高供应室工作质量,确保无菌物品不被污染.     

Economic impact of a hepatitis A epidemic in a mid-sized urban community: the case of Spokane,Washington

Data reported here represent an effort to build on previous work regarding the costs of hepatitis A. We expand this work to include an estimation of the costs of hepatitis A on a community wide basis. In addition to calculating the costs of disease management and health care delivery, we include an analysis of additional child care costs, lost productivity, costs associated with outbreak management, and the impact on affected restaurants that required public notification and the administration of Immune Globulin to patrons. The work reported here is specific to Spokane county, Washington. The objective is to enable the Spokane Regional Health District to communicate to the community costs of managing an outbreak of hepatitis A and to inform implementation of a hepatitis A vaccination program on a community wide basis. The average cost (direct and indirect) per case for the entire sample is $2,683. The estimated total cost for the sample (145 cases) is approximately $370,193. Inpatient hospital care is the largest direct medical expense and lost productivity is a major indirect cost to the community. Lessons learned from undertaking this task include: (1) costs incurred are not immediately obvious, (2) without infrastructure in place, tracking costs is difficult, if not impossible, (3) potential for large expenditures is apparent, (4) estimates are consistent with those generated in previous studies, and (5) previous findings of vaccination of certain high-risk populations as a cost-efficient approach is corroborated.     

"四分离物品管理机制"创新研究及应用

在物品管理方面,沂水中心医院提出了"四分离物品管理机制"通过这一管理机制的实施,医院实现了对所有物品审批、采购、保管、使用的有效管理.结合沂水中心医院工作实际,对"四分离物品管理机制"的理论、意义、应用以及效益分析等内容进行了阐述与总结.     

Product matrix. Patient-centered care the IS/MM response

No single MMIS vendor has the total solution to meet the needs of patient-centered care. Addressing it should be one of their top priorities, since this is not fleeting fancy, but rather a new era of healthcare delivery. Elements that will be necessary include: increased communication between care centers and materiel management; electronic ordering and purchasing of goods with prime vendors; the ability to relieve inventory and charge patients without intruding on the care of the patient; the ability to track extensive usage data per care center and nurse server. Usage data can be employed during price negotiations and provide materiel management with important "gatekeeping" information. The more usage data that materiel management has, the more bargaining power will exist with the prime vendor, distributor and care center. It is important to note, however, that information must be concise and easy to obtain. Graphical information has more impact and provides the best visual guide for the materiel manager. A 400-page document containing the month's usage will not "cut it" anymore--if it ever did. The transference and reduction of inventory from the warehouses to the care center probably presents the biggest obstacle for materiel management and nursing. The more work that can done upfront by the prime vendor (such as separating the purchased items into bin-type devices for delivery to specific care centers), the faster the goods can be administered to the patient. With care mapping, the items may even be broken down further, based on case mix information. The items could, and sometimes actually are, stored in the patient's room. It is a nurse's dream to have at his or her fingertips all the supplies needed at the time of request. One key for MMIS in realizing this dream is to track and monitor the on-line, real-time information. In fact, some companies' business is providing immediate inventory replacement information using bed-side terminals. I believe everyone--materiel management, nursing, and information systems--must collaborate and be open to new roles in order to ensure the success of patient-centered care.     

某三级甲等综合医院医院感染管理成本研究

目的探究某三级甲等综合医院开展医院感染管理工作的成本,为医院感染管理的成本效果及效益分析提供数据支持,为医院资源的合理配置提供科学依据。方法以该院医院感染管理部门为成本对象,采用微观成本法,收集该部门直接成本的各项目的数量和单价。结果2013年该院在医院感染管理工作上的投入约为87万元,其中人力成本约79万元,固定资产折旧后34 501元,低值易耗品3 800元,宣传培训33 600元,办公耗材5 208元;折算患者人均成本为12.16元,每床位成本为529.69元。结论该院医院感染管理工作投入的成本主要为人力成本。     

Costes de las terapias de las enfermedades neurodegenerativas: aplicación de un sistema de costes basado en las actividades

Objective

To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently.

Method

We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC system to quantify the cost of the activities developed in the center. We identified 60 activities; the information was collected in June 2009.

Results

The ABC system allowed us to calculate the average cost per patient with respect to the therapies received. The most costly and commonly applied technique was psycho-stimulation therapy. Focusing on this therapy and on others related to the admissions process could lead to significant cost savings.

Conclusions

ABC costing is a viable method for costing activities and therapies in long-term day care centers because it can be adapted to their structure and standard practice. This type of costing allows the costs of each activity and therapy, or combination of therapies, to be determined and aids measures to improve management.     

The home health agency as a cost center

Decisions involving the economics of home health care agencies require accurate and useful data on agency finances and cost-efficiency relationships, One step in the direction of improving economic management can be taken by defining the agency as a cost center, that is as an economic entity, with which specific resources, revenues and costs which can be expressly identified. This paper describes the economics and accounting frameworks within which resources and costs are classified and allocated into direct and indirect, and fixed and variable categories.     

The Home Health Agency as a Cost Center

Decisions involving the economics of home health care agencies require accurate and useful data on agency finances and cost-efficiency relationships, One step in the direction of improving economic management can be taken by defining the agency as a cost center, that is as an economic entity, with which specific resources, revenues and costs which can be expressly identified. This paper describes the economics and accounting frameworks within which resources and costs are classified and allocated into direct and indirect, and fixed and variable categories.     

How Do Italian Pharmacoeconomists Evaluate Indirect Costs?

OBJECTIVES: To investigate how indirect costs are evaluated in pharmacoeconomic studies in Italy and the attitude of Italian pharmacoeconomists toward indirect costs. METHODS: A literature review was conducted, specifically focused on pharmacoeconomic studies including indirect costs carried out in Italy, and a suevey among Italian pharmacoeconomics experts. RESULTS: Nineteen studies were available for review. Although the methods used to calculate the value of production loss due to morbidity were all based on the Human Capital Approach (HCA), there was a wide variability among studies in practical methods. The parameters used to value production losses varied widely too. Of the 25 survey responders, 20 considered it important to include indirect costs in pharmacoeconomic studies; 56% of those interviewed stated that health authorities should require indirect cost evaluations. Most of these experts would include indirect cost estimates in drug-pricing calculation. CONCLUSIONS: In Italy studies evaluating indirect costs are still only few, although there is evidence of an increase. Italian pharmacoeconomists are far from reaching any consensus on methods for evaluating these costs. Methods need to be standardized particularly with respect to the parameters used to quantify productive time lost in monetary terms.     

医院物资采购供应信息化管理实践

物资采购管理水平的高低,直接影响医院的社会效益和经济效益.在医院经济管理改革实践中,本院不断优化物资采购流程,整合完善物资管理软件系统,提高了物资采、供、管效能,实现了物资的采购计划、领用和出入库管理网上运行,有效提高了医院物资管理的自动化程度.     

医院科研课题实验动物成本核算研究

由于缺少成本核算,我国各医院对科研课题实验动物的收费标准存在较大差异.文章将动物饲养成本分为直接成本和间接成本两部分,根据各品种动物的累计饲养数量情况,核算成本分摊系数,计算间接成本,可以弥补目前收费标准的不足,提高医院科研经费管理水平.