ObjectiveThis study aims to design and fabricate a custom drying rack for precision microsurgical instruments and to evaluate its clinical effectiveness.MethodsA total of 680 precision microsurgical instruments, manually cleaned between January and February 2025, constituted the control group, and 660 instruments manually cleaned between March and April 2025 constituted the experimental group. The control group underwent drying using conventional methods, while the experimental group was dried using the custom-made drying rack for precision microsurgical instruments.ResultsThe drying pass rates for the control and experimental groups were 73.82% and 91.97%, and the drying times were 1 081.47±15.36 s and 568.69±13.75 s, respectively. Between-group comparisons demonstrated statistically significant differences (P<0.05).ConclusionThe custom-made drying rack for precision microsurgical instruments effectively shortens the drying time, improves drying efficacy, and accelerates the turnover of surgical instruments.
ObjectiveThis study aims to evaluate the effectiveness of bundled management measures in controlling environmental contamination by multidrug-resistant organisms (MDROs) in the intensive care unit (ICU), and to provide a practical basis for reducing the risk of MDRO contamination in the ICU environment and decreasing the incidence of nosocomial infections.MethodsPatients colonized or infected with MDROs in the ICU were screened using the hospital-acquired infection surveillance system. Environmental hygiene monitoring was performed on high-frequency contact surfaces of MDRO patients, healthcare workers’ hands, medical textiles, and sinks. The fluorescent labeling method was employed to monitor the implementation of surface cleaning and disinfection in the ICU. Targeted bundled rectification measures were then implemented, and environmental hygiene monitoring and evaluation were repeated after four months.ResultsA total of 90 samples were collected from high-frequency contact surfaces, textiles, and sinks in the ICU both before and after the intervention. Following the implementation of targeted rectification measures, the detection rate of microbial specimens decreased from 71.11% to 17.78% with a statistically significant difference (P<0.05). For environmental cleaning monitored using the fluorescent labeling method, 960 points were marked before the intervention, of which 367 were cleared; after the intervention, 950 points were marked, and 830 were cleared. The clearance rate increased from 38.23% before the intervention to 87.36% after the intervention, and the difference was statistically significant (P<0.05).ConclusionImplementation of corresponding environmental rectification measures can reduce environmental surface contamination by MDROs in the ICU, effectively interrupt transmission routes, and decrease the incidence of nosocomial infections.
Driven by the large-scale expansion of healthcare services and innovations in surgical procedures, the clinical application scope of loaner instruments has expanded continuously. These instruments feature complex structures and frequent inter-institutional turnover, and their management involves multiple responsible parties, including manufacturers, distributors, central sterile supply departments (CSSDs), and surgical teams. Traditional manual management models are insufficient to meet the requirements of precision management. In the management of loaner instruments, the application of information traceability systems has gradually evolved from single-technology validation to integrated, multi-scenario implementation, accompanied by a steady increase in the volume of related research. This paper systematically reviews the application of information traceability systems in loaner instrument management in China. It highlights the advantages of these systems, including improved identification rates of loaner instruments, reduced instrument defect rates, enhanced reprocessing efficiency, greater medical staff satisfaction, and savings in medical resources. The review also summarizes the practical challenges and limiting factors currently encountered in their application, to provide a reference for medical institutions that wish to develop a more accurate, standardized, and fully traceable management system for loaner instruments.
ObjectiveThis study aimed to address the low efficiency of sterile item storage management in the Central Sterile Supply Department (CSSD) and to construct and validate the actual performance of a dual-robot collaborative scheduling system.MethodsA system integrating automated storage equipment and an intelligent scheduling algorithm was developed. A randomized controlled experiment was conducted to compare the time consumed to complete outbound and inbound tasks between a single-robot mode and a dual-robot mode.ResultsThe dual-robot collaborative strategy significantly improved operational efficiency. Under the single inbound port configuration, outbound efficiency increased by 21.8% and inbound efficiency by 10.1%. Under the dual inbound port configuration, inbound efficiency rose by as much as 43.5%. The inbound/outbound port was identified as a critical bottleneck affecting system performance.ConclusionDual-robot collaborative scheduling effectively enhances storage efficiency when combined with the optimization of key nodes, and has the potential for widespread adoption in similar hospital settings.
ObjectiveThis study aims to evaluate the application value of combining QR code and near field communication (NFC) in the whole-lifecycle management of equipment in the Central Sterile Supply Department (CSSD) and to provide a reference for optimizing equipment operation and maintenance processes.MethodsA total of 35 conventional devices in use at the CSSD of our hospital from January to December 2025 were selected as the study subjects. The traditional manual ledger management model applied from January to June 2025 served as the control group, while the intelligent management model combining QR code and NFC applied from July to December 2025 served as the observation group. In the observation group, a unique electronic identity was established for each device, enabling one-click retrieval of device information, rapid online fault reporting, automatic inspection task reminders, real-time uploading of maintenance records, and full-process traceability. The control group continued to use traditional management methods, including paper registration, manual reminders, and handwritten ledgers. The two groups were compared in terms of equipment repair response time, record retrieval time, and the number of overdue regular maintenance events.ResultsThe median equipment repair response time and record retrieval time in the observation group were significantly shorter than those in the control group (repair response time (median): 40 min vs. 65 min; record retrieval time (median): 4 min vs. 20 min), and the number of overdue regular maintenance events was significantly lower (99.30% vs. 79.60%). The differences between the two groups for all three indicators were statistically significant (all P<0.05).ConclusionThe integration of QR code and NFC enables intelligent, visual, and traceable management of CSSD equipment, enhances the efficiency of equipment operation and maintenance along with management precision, ensures reliable equipment performance, and contributes to the quality and safety of sterile items.
ObjectiveThis study aims to evaluate the effectiveness of critical node control management based on the “structure-process-outcome” quality evaluation indicators combined with a fully automatic cleaning and disinfecting machine for the cleaning and disinfection of dental handpieces.MethodsA phased implementation grouping method was adopted. From March to July 2025, 500 dental handpieces were selected as the control group and received routine quality management. From August to December 2025, another 500 dental handpieces were selected as the observation group and received critical node control quality management combined with treatment using a fully automatic cleaning and disinfecting machine. The two groups were compared in terms of pre-processing pass rate, cleaning pass rate, incidence of oil stain wet pack, and clinical satisfaction.ResultsThe observation group showed a significant higher pre-processing pass rate (99.2% vs. 95.6%, P<0.05) and a higher cleaning pass rate (99.4% vs. 97.6%, P<0.05) than the control group, as well as a lower incidence of oil stain wet pack (0.6% vs. 3.8%, P<0.05). In addition, satisfaction among both doctors and nurses improved significantly after the intervention (P<0.05).ConclusionCritical node control management combined with a fully automatic cleaning and disinfecting machine can effectively improve the cleaning and disinfection quality of dental handpieces, reduce the incidence of oil stain wet pack, and enhance clinical service satisfaction, thereby offering great value in preventing iatrogenic cross-infection.
ObjectiveThis study aims to analyze the application effects of different management models in the Central Sterile Supply Department (CSSD), providing a reference for hospitals in selecting appropriate management models.MethodsA systematic literature search was conducted in Web of Science, PubMed, CINAHL, the Cochrane Library, Scopus, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and China Biology Medicine disc (CBM). The search employed a combination of keywords and free-text terms, followed by a summary analysis. The search timeframe spanned from the inception of each database to July 31, 2025.ResultsA total of 22 articles was included, involving nine management models: the centralized management model, scientific management theory model, integrated care model, refined management model, whole-process quality control (QC) model, Plan-Do-Check-Act (PDCA) cycle model, defect management model, quality collaboration management (QCM) chain model, and three-chain (3C) model. Based on their primary focus, these nine models were categorized into three orientations: process-oriented, QC-oriented, and responsibility chain-oriented. By analyzing their theoretical foundations, implementation processes, and typical cases, the commonalities and differences among the models were examined. Furthermore, the suitability of each model for hospitals of different scales was assessed based on their respective characteristics.ConclusionA horizontal analysis indicates that while the various CSSD management models have different emphases, their core objective is to improve CSSD management quality and instrument sterilization effectiveness. A vertical analysis reveals a developmental trend towards refinement, automation, and intelligence. All nine management models are suitable for large and medium-scale hospitals. However, only the scientific management theory and the PDCA cycle are suitable for small hospitals. Different hospitals should select appropriate management models based on their resource configurations and actual needs, and continuously refine them by integrating modern technologies to achieve efficient CSSD operation.
This study aims to analyze the current status of dental unit waterline (DUWL) disinfection and bacterial contamination in stomatology departments in Nanjing’s healthcare institutions. Targeted stomatology departments, a specialized investigation was conducted focusing on DUWL disinfection methods, disinfection frequency, water quality monitoring, and bacterial contamination, systematically analyzing current disinfection management deficiencies and potential risks of bacterial contamination. The investigation revealed significant variations in the implementation effectiveness of DUWL disinfection measures among stomatology departments in Nanjing’s dental institutions. Some institutions exhibited deficiencies such as singular disinfection methods, insufficient frequency, and weak water quality monitoring. The bacterial contamination levels exceeded relevant standards, posing an impact on treatment safety. This study suggests to optimize disinfection procedures and strengthen monitoring mechanisms in accordance with industry standards to reduce contamination levels and ensure the safety of dental treatment water.
ObjectiveThis study aimed to investigate the current status of the management and processing of loaner surgical instruments and implants in healthcare institutions across China and to provide evidence for standardizing practices in this field.MethodsA cross-sectional study was conducted in October 2024 using a self-administered questionnaire developed based on industry standards, clinical guidelines, and a literature review. The survey was distributed via a questionnaire platform Wenjuanxing to central sterile supply department (CSSD) in secondary and tertiary hospitals in China.ResultsValid responses were collected from 861 hospitals across 18 provinces. Significant disparities were observed between tertiary and secondary hospitals across multiple domains (P<0.05). In management, differences were noted in the clinical departments using loaner instruments, the provision of handover forms by suppliers, the frequency of organized training, the assignment of dedicated CSSD personnel/position for loaner instruments, and the establishment of departmental-level management systems. During handover, disparities existed in the availability of an independent receiving area, the use of information traceability systems, the presence of a dedicated loaner instrument module within those systems, the establishment of information-sharing platforms, the ability of the system to track instrument quantities, and the cleanliness of delivered instruments. For cleaning, disinfection, and sterilization, differences were found in compliance with manufacturer instructions, the use of validated washer-disinfector programs for loaner instruments, cleaning verification, the use of dedicated sterilization programs specific to loaner instruments, the basis for sterilization parameter selection, and the frequency of early instrument release. In post-use processing, variations were identified in preprocessing practices, the timeliness of instrument retrieval (within two days), the maintenance of return records, and the traceability of those records.ConclusionWhile the management and processing of loaner surgical instruments and implants in China show a trend toward standardization, significant gaps remain. There is a pressing need to strengthen dedicated staffing, establish independent processing zones, accelerate the implementation of comprehensive traceability systems, promote the use of validated cleaning and sterilization protocols, and improve post-use handling and return procedures.
This study aims to construct and evaluate an index system for assessing property service quality following the adoption of logistics socialized outsourcing in public hospitals, providing a reference for evaluating the service quality of outsourced property companies. Based on the SERVQUAL model (also known as the gap model) and combined with literature analysis and expert interviews, a preliminary evaluation index system was established. The Delphi expert consultation method and analytic hierarchy process (AHP) were employed to screen the indices according to expert opinions and scoring results. An evaluation system including five first-level indicators of tangibility, reliability, responsiveness, assurance and empathy and 22 second-level indicators was established. The expert authority was high (Cr=0.914), and the opinions were well coordinated (W=0.47, P<0.05). The constructed evaluation index system for property service quality in public hospitals is scientific and feasible, offering a theoretical reference for accelerating the transformation and upgrading of logistics service levels in public hospitals and enhancing their performance evaluation.
ObjectiveThis meta-analysis aimed to systematically compare the disinfection efficacy of Peracetic Acid (PAA) and Phthalaldehyde (OPA) for digestive endoscopes.MethodsRandomized controlled trials (RCTs) comparing PAA and OPA for digestive endoscope disinfection were independently identified by two investigators through systematic searches of databases, including Wanfang Data, China National Knowledge Infrastructure (CNKI), VIP Database, Chinese Biomedical Database (CBM), PubMed, Cochrane Library, Web of Science, and Embase. Study selection, data extraction, and quality assessment of included studies were also performed by them independently. A meta-analysis was conducted using RevMan 5.4 software on studies that met the predefined quality criteria.ResultsSeven RCTs involving a total of 1038 digestive endoscope procedures were included. The meta-analysis demonstrated a significantly higher disinfection qualification rate for PAA compared to OPA (OR=2.31, 95% CI: 1.04-5.12, P=0.04). No statistically significant differences were found between the two disinfectants regarding post-disinfection bacterial colony counts or associated disinfection costs (P>0.05 for both).ConclusionImmersion in PAA provides superior disinfection efficacy for digestive endoscopes compared to OPA.
ObjectiveThis study aims to evaluate the effectiveness of a medical vacuum cleaner in cleaning ophthalmic microsurgical instruments.MethodsThe ophthalmic microsurgical instrument packs processed from January to June 2023 were collected as the control group, which were cleaned manually; the instrument packs processed from April to June 2023 were the experimental group, cleaned using a medical vacuum cleaner. The cleaning quality of the two groups was assessed using visual inspection and adenosinetriphosphate (ATP) bioluminescence assay, and the cleaning time for both groups was statistically analyzed.ResultsThe visual inspection showed no significant difference in the cleaning qualification rate between the two groups (χ²=1.330, P>0.05). However, the ATP bioluminescence assay demonstrated a significant difference (χ²=4.891, P<0.05). The cleaning times for both groups were significantly different (W=2 500, P<0.001).ConclusionThe medical vacuum cleaner improves cleaning quality, enhances work efficiency, and reduces infection risks caused by incomplete cleaning in cleaning ophthalmic microsurgical instruments.
ObjectiveTo explore the inspection methods for flexible intramedullary reamers (FIRs) to ensure cleaning quality and evaluate their potential value in reducing the risk of surgical site infection (SSI) in patients.MethodsFIRs are categorized into “wave-type” and “thread-type” based on structural characteristics. FIRs used consecutively within the same medical institution were designated as Group A, while those used non-consecutively (by circulating across institutions) were as Group B. During the trial period, FIRs from both groups were cleaned according to a unified standard procedure. The turnover frequency and cleaning effectiveness of the two FIR types within the same institution were recorded for both groups. Cleaning quality was assessed using adenosinetriphosphate (ATP) bioluminescence assay and two types of visual inspection devices.ResultsOverall, the qualification rates for FIR surfaces and lumens via visual inspection were lower than those from the ATP bioluminescence assay for the corresponding areas (P<0.001). Comparative results from visual inspection devices showed that the cleaning qualification rate for wave-type FIRs was significantly higher than for thread-type FIRs (89.03% VS 73.39%, χ2=11.14, P<0.001); the cleaning qualification rate for Group A FIRs was significantly higher than for Group B (89.86% VS 73.28%, χ2=12.39, P<0.001). Multivariate logistic regression analysis indicated that, after adjusting for cumulative usage count, instrument type (thread-type VS wave-type, odds ratios (OR) =3.21, 95% confidence interval (CI): 1.67~6.18, P<0.001) and usage mode (Group B VS Group A, OR=3.58, 95% CI: 1.84~6.97, P<0.001) remained independent risk factors for cleaning failure.ConclusionFor lumens with complex structures, such as FIRs, only tested by ATP is insufficient to fully demonstrate cleanliness; visual inspection devices is recommended to introduce as a supplement. In addition, it is advised to establish and implement standardized cleaning procedures to ensure consistency and effectiveness of cleaning operations across different medical institutions. Furthermore, where conditions permit, wave-type FIRs may help achieve more reliable cleaning results, thus serving as one component of comprehensive measures to reduce the risk of surgical infection.
ObjectiveThe present study aims to investigate the application efficacy of the Supply-Process-Output (SPO) and Healthcare Failure Mode and Effects Analysis (HFMEA) methodologies in infection prevention and quality management practices within a central sterile supply department (CSSD).MethodsBased on literature reviews and the specific circumstances in an institution, an integrated systemic prevention framework was constructed by combining HFMEA-based failure mode analysis with the SPO model. A risk assessment scale for infection control in CSSD was developed to identify and analyze potential failure modes and their consequences, thereby formulating targeted quality control measures and mitigating hospital-acquired infection (HAI) risks.ResultsComparative data before (March to June 2024) and after (October to December 2024) implementation demonstrated significant improvements in key metrics, including instrument cleaning compliance rate, equipment failure frequency, emergency item processing efficiency, and clinical department satisfaction scores. The Risk Priority Numbers (RPN) were markedly reduced (P<0.01) with statistically significant differences.ConclusionA scientific and systematic assessment of HAI risks in CSSD based on the HFMEA and SPO methodologies and in consideration of actual operational conditions effectively mitigates infection risks and enhances medical safety and quality assurance.
A key microbiological factor facilitating surface environment-mediated transmission of Clostridioides difficile (C. difficile), norovirus (NoV) and Candida auris (C. auris) is their relative resistance to disinfectants used on environmental surfaces. Multiple outbreaks involving C. difficile, NoV and C. auris in healthcare settings are linked to widespread environmental contamination. The notable resilience of C. auris underscores the need for broad-spectrum disinfectants with proven efficacy and a lower risk of material degradation. This review examines the current science understanding of C. difficile reservoirs in hospital environment, identifies deficiencies in cleaning practices for colonized and infected patient rooms, discusses the advantages and disadvantages of currently available sporicidal germicides, and explores the development of a non-bleach, hydrogen peroxide-based sporicidal agent.
ObjectiveThe present study aims to explore the most difficult-to-sterilize location within the chamber of pulse vacuum sterilizers, providing a reference for the placement of biological monitoring packs during routine operation.MethodUsing temperature and pressure detectors, temperature testing was conducted on 16 identical models of pulse vacuum sterilizers in four Grade Ⅲ-A hospitals under different loading conditions, including no-load, instrument load, and dressing load. The location of the slowest heating point within the sterilizer chamber was determined.ResultStatistics from 43 batches, totaling 258 data points show that the slowest heating point appeared most frequently at the lower level of the sterilizing rack, near the loading door, occurring 29 times, accounting for 67.44%; the location at the upper level of the sterilizing rack near the loading door occurred 14 times, accounting for 32.56%.ConclusionThe most difficult-to-sterilize locations for this model of pulse vacuum sterilizer were near the loading side door, with the highest probability at the lower-level location near the door. Therefore, it is recommended to place the biological monitoring pack at the lower level of the sterilizing rack, near the loading side door, during routine biological monitoring.
ObjectiveThis study aims to explore the application of a temperature-pressure measurement device for real-time monitoring of physical parameters in pre-vacuum steam sterilizers by analyzing critical parameters and evaluating sterilizer performance, thereby ensuring sterilization effectiveness and providing a scientific basis for the physical monitoring practice of sterilizers.MethodsUsing calibrated temperature-pressure detectors and 7 kg simulated test packs, real-time monitoring of physical parameters for three pre-vacuum steam sterilizers was conducted every two months under both full-load and partial-load conditions from January 2024 to March 2025. Parameters recorded included mean sterilization temperature, maximum and minimum sterilization temperatures, temperature uniformity, sterilization time, equilibrium time, sterilization hold time, and sterilization pressure. These were compared against preset sterilization parameter standards, and the causes of data deviations were analyzed.ResultsA total of 50 monitoring and re-testing sessions were conducted on the three sterilizers, of which 20 sessions were under partial load (14 qualified; qualification rate of 70%) and 30 were under full load (28 qualified; qualification rate of 93.33%), resulting in an overall qualification rate of 84%. Among the eight unqualified sessions, one session had a temperature exceeding 137℃, one session had a temperature below 134℃, eight sessions had an equilibrium time exceeding 30 seconds, and four sessions had temperature uniformity >2℃.ConclusionThe temperature-pressure measurement device can detect physical parameters of pre-vacuum steam sterilizers. Deviations in the sterilization process can be promptly identified and corrected through real-time monitoring and recording of critical parameters, ensuring that sterilization effectiveness meets standards. Differences were observed compared to the standard 4 kg test pack. It is recommended to incorporate this device into the routine sterilizer monitoring system to strengthen medical safety.
ObjectiveThe present study aims to deeply understand the functional maintenance and explore the criteria of surgical scissors in the central sterile supply department (CSSD) so as to evaluate the function of surgical scissors, and to provide basic data for the construction of a surgical scissors function detection and evaluation index system in CSSD.MethodsA total of seven CSSD device managers, 11 surgeons of different specialties, and four device repairers were selected by a purposeful sampling method to conduct semi-structured interviews. The thematic content analysis method was applied to analyze the interview data and extract the theme.ResultsFour themes (appearance, performance, use experience, and quantitative indicators) and eight sub-themes (functional end evaluation, non-functional end evaluation, sharpness, tightness, comfort, appearance damage degree, use frequency, and cost) were extracted and investigated.ConclusionThe functional evaluation of scissors includes multiple aspects. In addition to the basic requirements for the appearance of scissors, CSSD has stricter requirements for the performance test of scissors. The establishment and improvement of standards and the construction of a quality evaluation index system are to be solved urgently.
