摘要目的? 探讨FOCUS-PDCA模式在改进软式内镜清洗预处理流程中的应用效果.方法? 将实施FOCUS-PDCA模式前2018年3—5月进行诊疗共使用的19 920次消化内镜作为对照组,将2018年6—7月实施FOCUS-PDCA模式后进行诊疗使用的12 700次消化内镜作为观察组.对照组按照《WS 507-2016式内镜清洗消毒技术规范》要求执行预处理流程,观察组应用FOCUS-PDCA模式分析影响软式内镜预处理质量的因素,成立持续质量改进小组,改进并规范预处理操作流程.统计并比较两组的软式内镜水气管道堵管率及内镜护理人员相关知识掌握情况;抽检并比较两组的预处理执行情况及手工清洗质量.结果? 观察组的软式内镜预处理执行合格率、手工清洗合格率分别为95.56%、94.50%,高于对照组的81.50%、86.50%,差异有统计学意义(χ2=135.285、7.444;P＜0.05);对照组水气管道堵管率为0.26%,高于观察组的0.03%,差异有统计学意义(χ2=23.228,P＜0.001);内镜护理人员相关知识得分由(75.0±6.071)分提高到(87.6±4.823)分,差异有统计学意义(t=12.734,P＜0.001).结论? 应用FOCUS-PDCA模式对预处理操作流程进行管理、改进及规范,有效提高了预处理执行及手工清洗合格率,降低了软式内镜水气管道堵管率,保证了内镜再处理质量.

abstractsObjective? To explore the application effect of FOCUS-PDCA mode(l find, organize, clarify, understand, select, plan, do, check, act) in improving the pre-cleaning process of flexible endoscopes. Methods? Totally 19 920 cases of digestive endoscopes used for diagnosis and treatment before the implementation of FOCUS-PDCA model from March to May 2018 were taken as the control group and 12 700 cases of digestive endoscopes used after the implementation of FOCUS-PDCA model from June to July 2018 were taken as the observation group. The pre-cleaning process was carried out according to "WS 507-2016 Technical Specification for Endoscopic Cleaning and Disinfection" in the control group. The FOCUS-PDCA model was carried out in the observation group to analyze the factors affecting the quality of flexible endoscopy pre-cleaning, establish a continuous quality improvement group to improve and standardize the process, analyze and compare the two groups in terms of the flexible endoscope water and gas pipeline blockage rate and endoscopy nurses' related knowledge; sampling and compare the pre-cleaning performance and manual cleaning quality between the two groups. Results? The qualified rates of flexible endoscopes pre-cleaning and manual cleaning were 95.56% and 94.50% respectively,which were significantly higher than the control group (81.50% and 86.50%) with statistical difference (χ2=135.285,7.444;P＜ 0.05). The blockage rate of water and gas pipelines in the control group was 0.26%, higher than the observation group(0.03%) with statistically significant difference (χ2=23.228,P＜ 0.001). The score of endoscopy nurses' knowledge increased from (75.0±6.071) to (87.6±4.823),and the difference was statistically significant (t=12.734, P＜ 0.001). Conclusions? The application of FOCUS-PDCA model to manage, improve and standardize the pre-cleaning operation process effectively improves the qualified rate of pre-cleaning execution and manual cleaning, reduces the blockage rate of water and gas pipelines in flexible endoscopes,and ensures the quality of endoscopy reprocessing.