Abstract：Objective To explore the effect of adopting refined management based on the theory of constraints (TOC) in the administration of medical devices in the central sterile supply department (CSSD) on nosocomial infection prevention and control and its impact on the management ability of CSSD personnel. Methods A total of 2,782 medical devices from CSSD of Beijing Friendship Hospital from January 2020 to December 2022 were selected as the study subjects. The routine management group served as the control group, and the implementation period was from January 2020 to May 2021, with 1,158 pieces. The fine management group based on TOC was considered as the improvement group, with the implementation period from June 2021 to December 2022 and 1,624 pieces. 32 disinfection staff members working at CSSD served as the subjects receiving the training for device management, and 27 departments using medical devices were enrolled into the evaluation on relevant indicators. We compared the scores of satisfaction with the use of medical devices in the departments, the scores of disinfection quality and medical device quality before and after cleaning medical devices, the incidence rate of nosocomial infection related to medical devices, the control status of quality defects, the score of each item concerning management ability in the CSSD staff members, and the assessment performance of theory and operation associated with medical devices between the control group and the improvement group. Results The satisfaction scores of departments using medical devices (including service attitude, product quality,product handover, device delivery, and information traceability) were higher in the improvement group than in the control group, with statistically significant differences (P<0.05). The scores of medical device disinfection quality and medical device quality were higher in the improvement group than in the control group, with statistically significant differences (P<0.05). The total incidence rate of nosocomial infection related to medical devices, and the ratios of hand contamination after disinfection,discrepancies between devices and records, inconsistent labels, inaccurate number of recovered devices and improper storage location were significantly lower in the improvement group than in the control group, showing statistically significant differences (P<0.05). Compared with the control group, the CSSD staff members in the improvement group had higher scores on environment management ability, device management ability, risk prevention awareness, risk identification ability, sterilization packaging, theoretical knowledge, cleaning and disinfection, and treatment process, showing statistically significant differences (all P<0.05). Conclusion Application of refined management based on TOC to medical devices of CSSD can improve the satisfaction of departments using medical devices, promote the qualities of disinfection and medical devices,enhance the management ability of CSSD staff members and their theoretical and operational abilities related to devices, and effectively reduce the incidence rate of nosocomial infection related to medical devices and quality defects, and it has certain clinical application value.
许媛媛, 袁宜, 文高静, 许娜. 精细化管理在消毒供应中心的应用及感染预防的研究[J]. 实用预防医学, 2023, 30(7): 889-893.
XU Yuanyuan, YUAN Yi, WEN Gaojing, XU Na. Application of fine management in disinfection supply center and study on infection prevention. , 2023, 30(7): 889-893.
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2023, Vol. 30 
