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将感染预防计划设计并融入到风险管理中:在门诊环境下管理高水平消毒和灭菌。

Design and implementation of the infection prevention program into risk management: Managing high level disinfection and sterilization in the outpatient setting.

机构信息

Scripps Medical Foundation, San Diego, CA.

出版信息

J Healthc Risk Manag. 2020 Jul;40(1):44-49. doi: 10.1002/jhrm.21407. Epub 2020 May 4.

DOI:10.1002/jhrm.21407
PMID:32367590
Abstract

Reusable, invasive medical devices within the outpatient setting pose a risk for patient harm. Ineffective disinfection of medical devices can potentially lead to transmission of pathogens between patients; and improper handling can lead to patient injury. A risk assessment was conducted, and the results strongly supported the necessity to develop a robust infection prevention program within the risk management department. This exclusive program was a proactive approach to preventing patient exposure within our healthcare system. Designing and integrating an Infection Prevention program into the Risk Management Department presented challenges, especially with the magnitude of devices and lack of standardization throughout our 33 clinics. Key components of the program included: capturing an accurate inventory of devices throughout the system, hiring a sterile processing expert, engaging support from senior leadership, adhering to rigorous auditing processes, and establishing a staff competency training structure. Since the program was launched 2 years ago, outcomes include: identification of high-risk practices with immediate resolution, increase in average clinic compliance to device reprocessing standards from 88% to 99%, elimination of 71% of scope reprocessing and 39% of instrument sterilization by clinic staff with allocation to central sterile processing departments, and development of a staff competency training structure.

摘要

在门诊环境中,可重复使用的、侵入性的医疗器械会对患者造成伤害。医疗器械消毒无效可能会导致病原体在患者之间传播;操作不当会导致患者受伤。进行了风险评估,结果强烈支持在风险管理部门内制定一个强大的感染预防计划。该专门计划是在我们的医疗保健系统内预防患者暴露的主动方法。在设计和整合感染预防计划到风险管理部门时,面临挑战,尤其是在我们的 33 个诊所中设备数量庞大且缺乏标准化。该计划的关键组成部分包括:在整个系统中准确捕获设备库存,聘请无菌处理专家,获得高级领导层的支持,坚持严格的审核流程,并建立员工能力培训结构。自该计划启动 2 年来,结果包括:立即解决高风险操作,将平均诊所对设备再处理标准的合规性从 88%提高到 99%,通过中央无菌处理部门分配减少 71%的器械再处理和 39%的器械消毒,以及开发员工能力培训结构。

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