操作室的环境清洁和消毒:通过人为因素和系统工程镜头进行系统范围审查
Anping Xie1,2, Hugo Sax3, Oluseyi Daodu1
1Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
Infection control and hospital epidemiology
|March 13, 2024
概括
在手术室的环境清洁和消毒显示出不良的合规性和不一致的有效性. 未来的研究应该检查工作系统因素和重新设计流程以优化.
科学领域:
- 医疗保健的质量和安全.
- 预防和控制感染.
- 人类因素工程 人类因素工程
背景情况:
- 环境清洁和消毒对于预防手术室 (OR) 感染至关重要.
- 目前的实践及其有效性并未完全通过系统工程镜头来理解.
- 患者安全系统工程倡议 (SEIPS) 模型为分析复杂的医疗保健过程提供了一个框架.
研究的目的:
- 综合有关OR环境清洁和消毒的证据.
- 使用人类因素和系统工程方法识别文献差距.
- 将SEIPS模型应用于指导分析.
主要方法:
- 按照PRISMA指南进行了系统范围审查.
- 搜索了四个数据库 (PubMed,EMBASE,OVID,CINAHL) 的实证研究.
- 使用SEIPS模型对研究进行了分类和编码;对相关研究设计进行了质量评估.
主要成果:
- 审查了40项研究,分为有效性 (11),合规性 (1) 和干预性 (28).
- 只有3项研究检查了影响清洁效率的工作系统组件.
- 大多数干预都集中在单个组件上 (工具,任务,组织),只有2个针对多个组件.
结论:
- 手术室的清洁和消毒表现出低于最佳的遵守和不一致的有效性.
- 改进工作主要针对工具,技术和人员培训.
- 未来的研究必须系统地调查工作系统因素,并重新设计整个系统,以改善OR环境卫生.
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