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审查无菌加工部门对外科器械的再加工
Lawrence D Fredendall1, Sayed Rezwanul Islam2, Kevin Taaffe3
1Department of Management, Clemson University, 409A Powers Building, Clemson, SC, 29634-1305, United States.
概括
优化无菌加工部门 (SPD) 需要基于证据的最佳实践. 需要进行研究,以了解如何最好地管理SPD流程和环境,以提高效率和患者安全.
科学领域:
- 医疗保健运营管理 医疗保健运营管理
- 系统工程 系统工程
- 患者安全 患者安全
背景情况:
- 无菌处理部门 (SPD) 对于安全的外科手术至关重要,但它们的运行成本很高.
- 在SPD流程中的低效率,例如仪器迟到或非无菌仪器,危及患者安全并增加医院成本.
- 缺乏设计和管理SPD流程的既定最佳实践,包括清除污染,组装,消毒,储存和采集仪器组.
研究的目的:
- 审查关于无菌加工部门 (SPD) 工艺的现有文献.
- 为 SPD 工具流程的每个步骤确定已知的最佳实践.
- 突出需要研究的领域,以开发基于证据的最佳实践,用于SPD管理.
主要方法:
- 根据PRISMA 2020指南进行了一项文献审查.
- 用患者安全系统工程倡议 (SEIPS) 框架和缓冲理论提取和合成数据.
- 分析了30篇相关文章,包括案例研究,干预,实验和定性访谈.
主要成果:
- 大多数已识别的绩效改进干预措施都缺乏关键的环境细节,以实现通用性.
- 干预措施往往侧重于单个变量,忽视它们对多个系统组件的影响.
- 改善吞吐量的关键干预措施包括增加仪器库存,提高装配能力,减少未使用的仪器 (加工仪器的25-48%).
结论:
- 未来的SPD研究需要更多关于运营环境的数据,以确保可概括的发现.
- 由于环境数据有限,处理能力,仪器库存和工艺布局的最佳组合仍然是未知的.
- 现有的研究对有效设计和管理SPD瓶过程提供了有限的洞察力.
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