Objective:To explore the application effect of FOCUS-PDCA (plan, do, check, and action) cycle management model in the cleaning of long-stay surgical instruments.Methods:From January to April 2019, 60 562 surgical instruments which were placed for more than 12 hours in our hospital before the implementation of FOCUS-PDCA cycle management model, were selected as a control group. From May to August 2019, 64 803 surgical instruments which were placed for more than 12 hours in our hospital after the implementation of FOCUS-PDCA cycle management model, were selected as an observation group. The control group received the routine cleaning and disinfection management model, and the observation group received the FOCUS-PDCA cycle management model. The quality improvement topic was improving the cleaning quality of long-stay surgical instruments, and a continuous quality improvement team was set up to analyze the reasons from four aspects: personnel, cost, equipment and facilities, and management. It was established that the main influencing factors were the detention of surgical instruments in the operating room at night, insufficient manpower in the supply room, untimely recovery, difficulty in cleaning, no pretreatment and moisturizing of the used instruments, unclear job responsibilities, improper selection of cleaning tools, and other factors. A variety of measures were taken to verify the improvement. The rewashing rate of surgical instruments and the satisfaction of 21 doctors on surgical instruments were compared between the two groups.Results:The rewashing rate of surgical instruments in the observation group was lower than that in the control group [1.30% (84/64 803) vs.3.68% (223/60 562)], with a statistically significant difference ( P<0.001). The satisfaction degree of 21 doctors on surgical instruments in the observation group was higher than that in the control group [100.00% (21/21) vs.66.67% (14/21)], with a statistically significant difference ( χ2=8.400, P=0.004). Conclusions:The FOCUS-PDCA cycle management model has a good application effect in improving the cleaning quality of long-stay surgical instruments, which is beneficial to improving the qualification rate of instrument cleaning, reducing the rewashing rate of surgical instruments, and improving the satisfaction of doctors in the use of surgical instruments.

目的 探讨本院消毒供应中心的职业环境状况及其对工作人员健康状况的影响,提出改善职业环境措施及职业安全防护对策.方法 回顾性分析本院消毒供应中心2018年2月—2019年2月职业环境状况及发生的职业暴露危险事件,通过1年改善职业环境的噪音污染、加强职业安全防护培训,提高工作人员对消毒供应中心环境中物理、化学、利器损伤等危害的预防意识;结果 本院消毒供应中心平均噪声环境及职业暴露危险事件减少39例;结论 针对消毒供应中心存在的职业危害因素实施相应的改进措施、加强对工作人员的职业安全防护培训,能有效降低职业环境因素对工作人员的损害,在确保医疗安全的同时实施"以人为本"的人性化管理方式.

目的 探讨自制鼻镜装载架在供应室的应用效果.方法 选取2016年11月至2017年5月本院耳鼻喉门诊、五官科病房、体检中心使用后的鼻镜为研究对象,将其随机等分成试验组和对照组,把单日回收的鼻镜作为对照组,双日回收的鼻镜作为试验组,若遇以单日结束月,选取样本以最后双日止.对照组使用传统鼻镜清洗装载架装载清洗,试验组使用新研制的鼻镜清洗装载架装载清洗,每次装载40个鼻镜一组,共计完成100次试验对照,即每组各4000个,比较两组鼻镜清洗效果、干燥效果、损坏数.结果 试验组鼻镜的清洗效果与干燥明显好于对照组,两组比较差异有统计学意义(P<0.05);试验组鼻镜的损坏数明显低于对照组,两组比较差异有统计学意义(P<0.05).结论 自制鼻镜清洗装载架可保证鼻镜的清洗质量,提升医疗器械灭菌质量,节约经济成本,值得临床应用推广.

目的：介绍妇科器械清洗装载架在妇科器械清洗中的研制及应用价值。方法研制一种妇科器械清洗装载架，装载清洗妇科常用器械中的窥阴器和妇科吸管为观察组，用传统清洗框装载清洗同样器械为对照组；比较两组器械清洗效果、干燥效果、器械耗损和装载时间。结果观察组器械清洗效果、干燥效果、器械完好性均优于对照组（P<0.05），两组器械在装载时间上（P=0.566）差异无统计学意义（P>0.05）。结论应用妇科器械清洗装载架可提高妇科器械的清洗效果、干燥效果，减少器械耗损。

[目的]研制一种妇科常用器械清洗装载架,探讨其在临床的应用效果.[方法]应用传统装载方法的作为对照组,应用妇科器械清洗装载架的作为实验组,对妇科器械中的窥阴器和妇科吸管的装载时间、清洗效果、干燥效果和器械损坏数等方面进行比较.[结果]实验组清洗效果(P＜0.005)、干燥效果(P＜0.005)、器械完好率(P＜0.005)均优于对照组,但两组器械所用装载时间差异无统计学意义.[结论]妇科器械清洗装载架的应用可提高妇科器械的清洗质量、减少器械损坏、提高工作效率,与应用传统清洗框清洗相比,有一定优势.

Objective To explore the application of Orem self-care model in self-care of patients with permanent colostomy.Methods 82 cases of colostomy were randomly divided into two groups,the experimental group received part compensation system of Orem self-care model,home care intervention of support-the education system,the control group received routine care.Results In the experimental group the time required for daily stoma care,stoma self-care ability and mastery of knowledge were better than those in the control group,with statistically significant difference(P <0.01).Conclusion Orem self-care model can improve the patients' knowledge and mastery of stoma and daily living skills,reduce dependence on others,restore confidence and normal social function,effectively improve the quality of life.

Objective:To improve the cleaning enema effect for colostomy patients and improve the patient satisfaction.Methods:60 colostomy patients were divided into 2 groups according to the ID number,control group with 30 cases was treated with the traditional enema method,experimental group with 30 cases was treated with the improved enema method,substituting the anal canal for the Foley Catheter.The enema effect and patient satisfaction were compared between the two groups.Results:Compared with control group,the enema effect of experimental group was significantly better(u=-2.758,p=0.006);the patient satisfaction was higher(χ2= 13.416,p=0.000).Conclusion:The application of improved enema method is simple to operate,can get satisfactory enema effect,reduce the frequency of enema and the negative emotion of patients,improve the patient satisfactory.

[目的]建立一套适合外科病人肠内营养支持的预防性护理程序,更好地完成肠内营养支持,减少肠内营养并发症。[方法]选择腹部手术后需行营养支持10d以上外科病人80例,随机分为观察组和对照组各40例,观察组采用预防性护理程序,对照组采用常规护理程序,比较两组营养支持完成情况、并发症发生率及营养状况改善情况。[结果]观察组各项指标比对照组各项指标效果好,差异有统计学意义(P<0.05)。[结论]预防性护理程序能够减少肠内营养并发症的发生,更好地改善病人营养状况和完成营养支持治疗,促进护理专业的发展。