创伤骨科植入物管理策略及其手术室感染控制的效果

Strategies for management of trauma orthopedic implant and effect on control of infections in operating rooms

  • 摘要:
    目的 探讨创伤骨科植入物管理对手术室感染控制率及器械商跟台率的影响。
    方法 于绍兴市人民医院2023年3月-2024年3月进行创伤骨科植入物管理, 共计2 047例创伤骨科手术, 设为研究组;选取医院2022年3月-2023年2月行常规管理作为对照组, 共计2 067例创伤骨科手术。分析两组创伤骨科植入物管理对手术室工作效率、感染控制率及器械商跟台率。
    结果 研究组巡回配合熟悉满意度、洗手配合熟悉满意度分别为78.65%、91.35%, 均高于对照组(P<0.001);研究组骨科创伤类植入物使用规范、物码对应准确、准时到位占比分别为96.43%、98.19%、98.19%, 均高于对照组, 器械跟台率为3.57%, 低于对照组(P<0.001);研究组工作人员每月核验加班时间、成本、时间成本、复消复洗单次均费、月复消复洗频次均数分别为13.85 h、235.86元/天、25 233.51元、0.35元/次、183.81次/月, 均低于对照组(P<0.001)。研究组耗材准入符合规定、收费准确及准时送达率分别为99.22%、98.58%及97.90%, 均高于对照组(P<0.001)。研究组植入物规范回收率为100.00%, 高于对照组(P<0.001)。对比, 研究组手术部位感染率为1.91%, 低于对照组(P<0.001)。
    结论 本研究构建了融合供应链管理、标识系统及物联网技术的创伤骨科植入物管理体系。该模式有效解决了传统供应商自主管理模式下的多供应商监管难、虚拟入库盲区及物码追溯混乱等核心问题, 显著提升了手术室工作效率, 降低了手术部位感染率, 并实现了器械商跟台率显著降低。

     

    Abstract:
    OBJECTIVE To explore the impact of trauma orthopedic implant management on the operating room infection control rate and the medical device vendor follow-up rate.
    METHODS Trauma orthopedic implant management was implemented at Shaoxing People′s Hospital from Mar. 2023 to Mar. 2024, involving 2 047 trauma orthopedic surgeries (study group). For comparison, a control group consisting of 2 067 trauma orthopedic surgeries from Mar. 2022 to Feb. 2023 under routine management was selected. The impact of trauma orthopedic implant management on operating room efficiency, infection control rate and medical device vendor follow-up rate in both groups were analyzed.
    RESULTS The study group showed satisfaction rates of 78.65% and 91.35% for circulating cooperation familiarity and handwashing cooperation familiarity, respectively, both higher than those in the control group (P < 0.001). The study group also demonstrated higher rates of standardized use of orthopedic trauma implants (96.43%), accurate item-code correspondence (98.19%) and timely availability (98.19%) than those in the control group, with a lower medical device vendor follow-up rate of 3.57% (P < 0.001). The study group′s monthly overtime hours, costs, time costs, average cost per re-disinfection and re-cleaning service and monthly re-disinfection re-cleaning frequency were 13.85 hours, 235.86 yuan/day, 25 233.51 yuan, 0.35 yuan/time and 183.81 times/month, respectively, all lower than those in the control group (P < 0.001). The study group had higher rates of consumable access compliance (99.22%), accurate charging (98.58%) and timely delivery (97.90%) than the control group (P < 0.001). The study group also achieved a 100.00% implant regulatory recovery rate, higher than the control group (P < 0.001). Furthermore, the surgical site infection rate in the study group was 1.91%, lower than that in the control group (P < 0.001).
    CONCLUSIONS This study establishes a trauma orthopedic implant management system integrating supply chain management, an identification system and IoT technology. This model effectively addresses core issues such as the difficulty in regulating multiple vendors, blind spots in virtual warehousing and disorder in item-code tracing under the traditional vendor self-management model. It significantly improves operating room efficiency, reduces the surgical site infection rate, and achieves a notable decrease in the medical device vendor follow-up rate.

     

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