The Development Of The Central Sterile Supply Departments In Shandong Province

BackgroundThe central sterile supply department(CSSD)and sterility supply room(SSR)are departments responsible for the cleaning,disinfection,sterilization,and supply of medical devices and instruments in hospitals,which is directly related to the quality of medical care,patient safety,infection control and medical service efficiency,and directly impact the quality of medical care.In recent years,there have been many hospital infection deaths caused by improper disinfection and sterilization of instruments at home and abroad,which caused huge economic losses.Currently,the focus of hospital infection control has gradually shifted from the environment to the source of infection,including the building layout,equipment and facilities,staffs,management model,and information technology,to strengthen the process quality control and evaluation.In 2009,the National Health and Family Planning Commission(formerly the Ministry of Health)issued three mandatory health industry standards,WS310-2009,for the construction of CSSD/SSR;in 2012,the Shandong Center for Nosocomial Infection Control was established,and began to implement the Centralized Management Model;in 2016,the Center set up a professional quality indicator system to conduct quality assessment over the province.ObjectiveThe study is based on the research of the CSSD/SSR in secondary and tertiary hospitals in Shandong Province,and the observation on the progress of its infrastructure construction before and after the implementation of the centralized management reform.It seeks to find the main factors affecting the quality of the CSSD/SSR's work and provides scientific evidence and advice for the construction in the future.MethodsIn this study,using 76 CSSD/SSR secondary and tertiary hospital form Shandong province as the objective of the study,which were required to complete the "Shandong Province Central Sterile Supply Department(Room)Questionnaire" in 2011 and 2015,and participate in the quality assessment of the year 2017 based on the professional quality indicator system.Data was collected by Excel and SPSS(Statistical Package for Social Sciences)statistical software;the general conditions of hospital were mainly described by percentage,proportion and other descriptive index;the differences of basic construction from 2011 to 2015 were analyzed by single-factor chi-square test;the relationship between infrastructure and quality were analyzed by Linear regression analysis.ResultsThe basic construction study surveyed a total of 73 hospitals,including 40 tertiary hospitals and 33 secondary hospitals.From 2011 to 2015,the province's CSSD/SSR building area remained insufficient,especially the tertiary hospital with the compliance rate 64.38%.The equipped rate of single facility like sterilizers,dryers has increased significantly,basically more than 90%,but the number of hospitals with all equipment and facilities installed is still very low;the number of staff kept in a deficient state,with the compliance rate 26.03%in 2015,but the age of the personnel tended to be younger and the level of academic qualifications has improved;the use of centralized management model and the construction of information technology had a significant progress with 93.15%and 54.79%respectively;the number of hospitals that have performed quality monitoring on individual links increased,however only 20.55%of the hospitals have been able to achieve full control.The research on the relationship between basic construction and quality has analyzed 28 tertiary hospitals.It has been found that whether the building area is up to the standard and whether quality of the work flow is under control have a significant impact on the quality of work of the CSSD/SSR.Conclusions and SuggestionsThe study found that the building area of the tertiary hospital CSSD/SSR was difficult to expand and could not keep up with the increase in the number of visits and the workload;the staff gradually became younger and more highly educated,but the number of staff was getting worse insufficient;CSSD/SSR has a complex workflow,and any leaks in any one of the links will cause sterilization failure and cause medical problems,so he quality inspection of the key links needs to be strengthened;the expansion of the CSSD/SSR building area as required,and the quality control at the key work links,can promote the improvement of the work quality.In order to improve the quality of the CSSD/SSR work in Shandong Province,the Shandong Center for Nosocomial Infection Control should provide unified guidance and planning for the CSSD/SSR building layout;strengthen the work of continuing education,set up related majors and train specialized talents;pay attention to the quality control aspects of the work flow of disinfection and sterilization;continually promote the use of modern technology,and encourage the construction of regional CSSDs.