消毒供应中心灭菌质量评价指标体系构建的初步研究

目的构建消毒供应中心灭菌质量评价指标体系,为医疗用物灭菌规范化提供客观依据,确保无菌物品质量,降低院内感染率。方法在文献回顾、行业指南标准解读和专家访谈的基础上,以结构过程结果质量模型为基本框架编写专家函询问卷,进行2轮德尔菲专家函询,研究小组根据统计分析结果和专家意见修订质量评价指标,用层次分析法根据各指标重要性评分均数(第二轮)计算各指标权重,通过统计学检验,保证良好的一致性。结果两轮德尔菲专家函询法的专家权威系数分别为0.76和0.82,问卷的有效回收率分别是77%(20/26)和100.0%(20/20);第2轮各条目重要性赋值均大于4分,变异系数均<0.20;2轮的Kendall和谐系数分别是0.232、0.345(P均<0.001)。消毒供应中心灭菌质量评价指标体系包含3个维度,11个二级指标和58个条目。结论结合结构-过程-结果质量模型和德尔菲专家函询法构建的消毒供应中心灭菌质量评价指标体系,研究方法科学,过程严谨,为规范化的灭菌管理提供依据,预防院内感染,保障患者生命安全。

Preliminary Study on the Construction of the Evaluation Indicator System of Sterilization Quality in Central Sterile Supply Department

Objective To construct a evaluation index system of sterilization quality of the disinfection supply center to provide objective basis for the standardization of sterilization of medical materials and ensure the quality of sterile products.Methods Combining the literature review,the industry standard interpretation and semi-structured interview guide,we used Structure-Process-Outcome quality model as the basic framework to write experts enquiry for the questionnaire,for 2 rounds of Delphi expert enquiry.The team revised the quality evaluation index according to the result of statistical analysis and expert opinion,and according to the result of each index importance assignment(second)weight was calculated by the analytic hierarchy process,and ensured good consistency through statistical test.Results The expert authority coefficients of the two rounds of expert consultation were 0.76 and 0.82 respectively,and the effective recovery rates of the questionnaire were 77%(20/26)and 100.0%(20/20)respectively.In the second round,the importance of each item was greater than 4 points,and the coefficient of variation was less than 0.20.The two rounds of Kendall harmony coefficient were 0.232 and 0.345(P<0.001),respectively.The evaluation index system of sterilization quality in the disinfection supply center includes 3 dimensions,11 secondary indexes and 58 items.Conclusion Based on the Structure-Process-Outcome quality model and Delphi expert consultation,the evaluation index system of sterilization quality of the disinfection supply center was established.The scientific research method,rigorous process and standardized sterilization management can provide the basis for preventing nosocomial infection and ensuring patient safety.