应用品管圈提高手术室物体表面污染物清除率

Application of quality control circle to improve the removal rate of contaminants on object surface in operating room

摘要:

目的 探讨品管圈(QCC)对提高手术室物体表面污染物清除率、降低手术部位感染(SSI)发病率的效果。 方法 应用QCC管理模式对手术室物体表面清洁消毒质量实施监督管理, 2020年10—11月为改善前期, 2020年12月—2021年3月为改善后期, 并持续监测至2021年9月, 借助荧光标记设备和微生物培养两种方法, 找出物体表面污染物清除率低的原因, 通过改进洁具、完善制度流程、优化培训模式三大对策, 对比QCC改善前后物体表面污染物清除率及SSI发病率的差异。 结果 手术室物体表面污染物清除率由改善前的52.26%提高至改善后的88.02%;工作人员知识考核合格率从46.82% 提高至90.29%;SSI发病率从0.18%下降至0.07%;差异均有统计学意义(均P＜0.05);2021年4—9月SSI发病率为0.06%, 手术室物体表面污染清除率分别为89.24%、90.80%、91.67%、92.53%、93.40%、94.10%, 改善效果维持良好。 结论 应用QCC进行持续质量改进, 可有效提高手术室物体表面污染物清除率及不同岗位工作人员环境清洁消毒知识掌握合格率, 保障手术室清洁质量有助于降低SSI发病率, 同时圈员能力得到提升, 值得推广应用。

Abstract:

Objective To explore the effect of quality control circle (QCC) on improving the removal rate of contaminants on object surface in the operating room and reducing the incidence of surgical site infection (SSI). Methods The QCC management mode was applied to supervise and manage the cleaning and disinfection quality of object surface in the operating room. The period of pre-improvement was from October to November 2020, and that of post-improvement was from December 2020 to March 2021, and monitoring continued until September 2021. Fluorescence labeling and microbiological culture were adopted to identify the causes for low removal rate of contaminants on object surface in the operating room. Through 3 strategies including improving equipments, refining procedural protocols, and enhancing training methods, differences in the removal rate of contaminants on object surface in the operating room as well as the incidence of SSI before and after the improvement were compared. Results The removal rate of contaminants on object surface in the operating room increased from 52.26% before improvement to 88.02% after improvement. The passing rate of staff's knowledge assessment increased from 46.82% to 90.29%. Incidence of SSI decreased from 0.18% to 0.07%. Differences were all statistically significant (all P < 0.05). From April to September 2021, incidence of SSI was 0.06%, removal rates of contaminants on object surface in the ope-rating room were 89.24%, 90.80%, 91.67%, 92.53%, 93.40%, and 94.10%, respectively, maintaining a good improvement trend. Conclusion The application of QCC for continuous quality improvement can effectively improve the removal rate of contaminants on object surface in the operating room and the passing rate of environmental clea-ning and disinfection knowledge among staff with different occupations. Ensuring the cleaning quality of the operating room can help reducing the incidence of SSI, meanwhile, the abilities of QCC members are improved, making it a valuable approach for widespread application.