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Optimized Nursing Management for Ophthalmic Surgical Instruments: A Retrospective Study
Liping Xia1, Jin Yan1, Xiaohua Guo1
1Department of Ophthalmology, The Ninth Medical Center of the People's Liberation Army General Hospital, Beijing, People's Republic of China.
Purpose:
To examine associations between an optimized nursing management model and instrument workflow, quality-related outcomes, and direct expenditure in ophthalmic surgery.
Methods:
This single-center retrospective study included 2422 procedures managed conventionally in 2022 (n = 1201) and under the optimized model in 2023 (n = 1221). The optimized model combined barcode-based traceability, standardized processing procedures, and periodic staff training. Adjusted analyses used regression models for continuous, ordinal, and binary outcomes and segmented interrupted time-series regression for monthly expenditure.
Results:
The optimized period was associated with shorter preparation time (adjusted mean difference, -1.533 min; 95% CI, -1.925 to -1.140; P < 0.001), higher timeliness scores (adjusted proportional OR, 1.430; 95% CI, 1.240-1.649; P < 0.001), and higher labeling clarity scores (adjusted proportional OR, 1.739; 95% CI, 1.505-2.009; P < 0.001). In exploratory analyses, packaging errors (adjusted RR, 0.592; 95% CI, 0.367-0.956; P = 0.032), surgical delays (adjusted RR, 0.737; 95% CI, 0.572-0.951; P = 0.019), and recorded instrument-related process events (adjusted RR, 0.442; 95% CI, 0.225-0.870; P = 0.018) were less frequent, whereas cleaning qualification was slightly higher (adjusted RR, 1.020; 95% CI, 1.001-1.039; P = 0.035). Interrupted time-series analysis showed an immediate reduction in monthly direct damage-related expenditure at the period transition (coefficient, -15,550.200 CNY; 95% CI, -26,116.910 to -4983.491; P = 0.006), with no clear slope change.
Conclusion:
The optimized nursing management model was associated with improved instrument workflow, lower recorded instrument damage burden, and lower direct damage-related expenditure. Damage and loss measures lacked use-based exposure denominators, and secular confounding cannot be excluded. Structured traceability may support organizational quality assurance and operational risk control, but effects on patient safety require direct evaluation in multicenter prospective studies.
