供应室在消毒管理中施行全程质控管理对医院感染防控的作用分析

目的 探讨供应室在消毒管理中应用全程质控管理的作用及其对医院感染控制的效果。 方法 2016年7月,衢州市中医医院供应室开始在消毒管理中推行全程质控管理。对实施全程质控管理前(2014年7月—2016年6月)供应室的清洁消毒灭菌物品共25 012件,实施后(2016年7月—2018年6月)供应室的清洁消毒灭菌物品共27 885件进行统计分析,对实施前、后供应室灭菌物品的合格率、医院感染率进行比较。 结果 实施全程质控管理前的物品消毒合格率为83.0%、灭菌合格率为86.0%、无菌包装合格率为86.0%、无菌发放合格率为85.0%,实施全程质控管理后的物品消毒合格率为97.5%、灭菌合格率为100.0%、无菌包装合格率为100.0%、无菌发放合格率为100.0%,实施后与实施前比较,物品消毒、灭菌、无菌包装、无菌发放的合格率均提高(χ2=3 269.004、4 181.060、4 181.060、4 502.324,均P<0.05)。实施全程质控管理后总的医院感染发生率(3.25%vs. 1.76%)降低(χ2=120.451,P<0.05);实施全程质控管理前、后手术部位/切口(1.57%vs. 0.27%)与呼吸系统(1.14%vs. 0.93%)的感染发生率比较,差异均有统计学意义(χ2=255.925、5.956,均P<0.05)。 结论 供应室消毒管理中施行全程质控管理,提高了灭菌物品合格率,降低了医院感染发生率。 

Analysis of the effect of the whole process quality control management in disinfection management of supply room on the prevention and control of hospital infection

Objective To explore the effect of whole process quality control management in disinfection management of supply room and its effect on hospital infection control. Methods The supply room of Quzhou Hospital of traditional Chinese Medicine began to implement the whole process quality control management in disinfection management from July 2016. A total of 25 012 cleaning, disinfection and sterilization articles in the supply room before the implementation of the whole process quality control(from July in 2014 to June in 2016) and 27 885 cleaning, disinfection and sterilization articles in the supply room after the implementation(from July 2016 to June 2018) were statistically analyzed. The qualification rate and nosocomial infection rate of sterilized articles in the supply room were compared before implementation and after implementation. Results Before the implementation of the whole process quality control management, the qualified rate of disinfection, sterilization, aseptic packaging and aseptic distribution were 83.0%, 86.0%, 86.0% and 85.0% respectively. After the implementation of the whole process quality control management, the qualified rate of disinfection, sterilization, aseptic packaging and aseptic distribution were 97.5%, 100.0%, 100.0% and 100.0% respectively. After the implementation, the qualified rates of sterilization, aseptic packaging and aseptic distribution were all increased(χ2=3 269.004, 4 181.060, 4 181.060, 4 502.324; all P<0.05). The total incidence of nosocomial infection(3.25% vs. 1.76%) decreased after the implementation of the whole process quality control management(χ2=120.451, P<0.05). There were significant differences in the infection rate of the surgical site/incision(1.57% vs. 0.27%) and the respiratory system(1.14% vs. 0.93%) before and after the implementation of the whole process quality control management(χ2=255.925, 5.956, all P<0.05). Conclusion The whole process quality control management in disinfection management of the supply room can improve the qualified rate of sterilization articles and reduce the incidence of hospital infection.