Sterile Supply Research Articles

Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India.

BackgroundLow self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city.MethodsThis cross-sectional study included a random sample of health-care workers of various cadres – doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom–Melamed Burnout Measure were used as study tools.ResultsAmong the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress.ConclusionsHealth-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36–5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02–6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.

Effects of quality-sensitive indicators in the management of disinfection supply room

Objective To explore the effects of quality-sensitive indicators in the management of disinfection supply room. Methods The management model modified based on quality-sensitive indicators was applied in the Disinfection Supply Room of the Second Affiliated Hospital of Fujian Medical University since October 2016. The pass rate of the instrument inspection and the quality indicators of the disinfection supply room before and after modification were compared. Results The pass rates of instrument inspection and Bowie-Dictest in the disinfection supply room after modification were better than those before modification (P<0.01) . After modification, the qualification of the disinfection supply room in terms of instrument recovery, washing, packaging, item distribution and sterilization was better than that before modification (P<0.05) . Conclusions In the prevention of nosocomial infection in the disinfection supply room, the application of quality-sensitive indicators can effectively improve the qualification in instrument recovery, washing, packaging and sterilization, thus ensuring the quality of device disinfection. Key words: Quality control; Central Sterile Supply Department; Quality of work; Device disinfection; Quality-sensitive indicator

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Competence investigation on insulation testing on electrosurgical instruments and needs analysis of training for Central Sterile Supply Department staff

Objective: The objective of this article is to investigate the competence of Central Sterile Supply Department (CSSD) staff in insulation testing on electrosurgical instruments, to analyze the needs of training for CSSD staff, and also to strengthen the effectiveness of monitoring the insulation testing on electrosurgical instruments for CSSD staff to provide a reference for the nursing safety training.Materials and Methods: A total of 180 CSSD staff from 36 hospitals were enrolled as the research objects and investigated using “self-assessment questionnaire of the competence in insulation testing on electrosurgical instruments and the needs of training”.Results: The overall self-assessment score of competence in insulation testing on electrosurgical instruments for CSSD staff is 3.10 ± 0.42, including four dimensions which are attitude, system, cognition, and skills with the scores 3.31 ± 0.55, 2.80 ± 0.63, 2.74 ± 0.68, and 3.03 ± 0.36, respectively. Based on the survey of training needs for CSSD staff, the top three ranked training needs are trace management record of insulation testing on electrosurgical instruments (93.89%), disposal procedures for insulation damage of electrosurgical instruments (92.78%), and adverse events caused by leakage of electrosurgical instruments (80.55%).Conclusion: The competence of insulation testing for CSSD staff is at a low level by overall. The competence of CSSD staff could be improved by analyzing the needs of training, establishing a systematic training system, and taking effective training action, thus ensuring the safety of patients and medical personnel.

Should the Central Sterile Supply Department in Every Hospital?

Hospitals as health services should prevent the risk of infection for patients and hospital staff. One indicator of success in hospital services is the low number of nosocomial infections or Healthcare-Associated Infection. Efforts to reduce the incidence of nosocomial infections are by carrying out good Central Sterile Supply Department services. This study aims to describe the process of sterilization transition in Mitra Delima Hospital Malang from a decentralized system to a centralized system. This study uses a qualitative approach that is focused on the Sterilization Unit of General hospital of Mitra Delima Malang. The study was conducted in August-October 2019. This research was conducted using interviews, observations, document studies, and literature studies. Sterilization activities at Mitra Delima Malang General Hospital which is still decentralized, starting from the decontamination process to labelling in other units, it is necessary to have a plan to develop a Central Sterilization Installation that is in line with the needs of Mitra Delima Malang General Hospital and accordance with the regulations, guidelines, and standards of Installation Central Sterilization to achieve the ideal Central Sterilization Installation. Sterilization in hospitals should use a centralized system. With a centralized and independent sterilization system with other departments, hospitals can be efficient, economical, safe, and valid in implementing sterilization equipment. This also ensures that the sterilization process will be overseen by specialized staff and runs according to the standard operating procedures.

Application of Continuous Quality Improvement in Manual Cleaning of Fine Hollow Device

Objectives: The study aims to explore the effect of continuous quality improvement on manual cleaning quality of fine hollow device in hospital central sterile supply department. In terms of methods, it mainly optimize the manual cleaning process of fine hollow device as follow: Seperated cleaning basket is employed with 3% hydrogen proxide solition to clean the blood stains and organic matters in fine hollow device. And then, 90°C pure water is used to soak the fine hollow device to dissolve and clean the solidly attached bone wax in the inner side of absorption tube. And the study primarily compares the difference between the data about optimizing the manual cleaning process of fine hollow device through continuous quality improvement, the blood (stain), tissue residue, foreign body residue, bone wax from August to September in 2019, and those from October to November in 2019. Results: The quality of fine hollow device manual cleaning in reference group are improved significantly, with outstanding differences in control group (X²=59.36, P=0.000), indicating the effectiveness of the continuous improvement measures. Conclusion: The continuous quality improvement was applied to the manual cleaning of fine hollow device, and the cleaning effect was satisfactory. The removal rate of blood (stain), tissue, foreign body and bone wax of fine hollow device was improved.

PDCA Circulation in the Prevention of Clinical Rust Effect Observation

Objective: The study aims to prevent rusting of clinical instruments by using PDCA circulation. Methods: The routine recovery and cleaning rusty instruments management for clinical diagnosis and treatment instruments from October to December in 2018 are chosen as before implementation. And after the PDCA continuous quality improvement measures from January to September in 2019, the implementation of recovery and cleaning rusty instruments management for clinical diagnosis and treatment instruments from October to December in 2019 are chosen as post-experiment. And the rust situation before and after the implementation of clinical diagnosis and treatment instruments will be compared. And the study investigates the satisfaction of clinical departments with the improvement measures of Central sterile supply department before and after the implementation. Results: After implementing PDCA continuous quality improvement measures, the rust rate of clinical diagnosis and treatment instruments was significantly lower than before implementation (P<0.05), and the difference was statistically significant. After implementation, the satisfaction of 58 clinical departments was 100%, significantly higher than that before (100.00% vs 81.03%, P<0.05). Conclusion: PDCA continuous quality improvement measures can effectively prevent the rust of medical devices, improve the quality of instruments of cleaning and sterilization, reduce hospital sense risk and medical cost, improve the satisfaction of clinical departments, and the application value is remarkable.

Optimize the Management and Effectiveness of Orthopedic Spare Loaner Instrumentation and Implants in Central Sterile Supply Department

Objective: Loaner Instrumentation due to various comprehensive factors, the equipment often can not be delivered to the disinfection supply center according to the prescribed time, which not only affects the handling quality of the equipment, but also affects the timely supply andusage of the equipment. The study aims to explore the managing method of orthopedic spare loaner instrumentation and implants in Central Sterile Supply Department of the hospital (hereinafter referred to as CSSD). Methods: 418 orthopedic operations use orthopedic spare loaner instrumentation and implants in 2018 were selected as per-implementation. The routine methods were used to manage the orthopedic spare loaner instrumentation and implants. 437 orthopedic operations use orthopedic spare loaner instrumentation and implants in 2019 were selected as the implementation. Using the optimized method to manage the orthopedic spare loaner instrumentation and implants is to compare the changes of timely supply rate, double closed loop management execution rate and doctor satisfaction before and after the implementation of orthopedic spare loaner instrumentation and implants in our hospital. Results: After the implementation of optimized management measures, the timely supply rate of orthopedic spare loaner instrumentation and implants reached 100%; the implementation rate of double closed-loop management increased from 69.86% to 100%; and the doctor satisfaction increased from 77.78% to 97.22%. Conclusion: By optimizing the management measures of orthopedic spare loaner instrumentation and implants, we can improve the timely supply rate, achieve the whole process trace ability and improve the doctor's satisfaction, further improve the safety of the instruments, reduce the surgical infection, and ensure the safety of patients.

COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National).

COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National).

Streamlining workflows and redesigning job roles in the theatre sterile surgical unit

The theatre sterile surgical unit (TSSU) is an essential core to support the operating theatres in National University Hospital. Surgical instruments and supplies are processed, packaged and sterilised safe for...

Application of closed-loop management in production process of acidic electrolyzed oxidizing water in Central Sterile Supply Department

Objective To improve the management of the production process of acidic electrolyzed oxidizing water (AEOW) , detection of its physiochemical indicators and supply in the Central Sterile Supply Department with the closed-loop management and to ensure that its physiochemical indicators meet the requirement. Methods The current operation process of AEOW generators as well as detection and supply of AEOW in the Central Sterile Supply Department, Children's Hospital, Capital Institute of Pediatrics were analyzed and the existing problems were identified between January and March 2017. The closed-loop management process was developed and implemented according to the existing problems. The satisfaction rate and compliant were compared before and after the management was modified. Results The satisfaction score before the closed-up management (October to December, 2016) was (90.04±11.75) . There were 1 complaint about unsatisfactory physiochemical indicators and 9 complaints about late supply of AEOW. The satisfaction score after the closed-up management (January to March, 2017) was (95.24±5.22) . There was no complaint about unsatisfactory physiochemical indicators and 1 complaints about late supply of AEOW. Conclusions The closed-up management helps to improve the production process of AEOW in the Central Sterile Supply Department, which enables timely feedback and problem-solving, avoids problems and complaints regarding its physiochemical indicators, satisfies clinical needs, and continuously improves the working quality of the Central Sterile Supply Department. Key words: Central Sterile Supply Department; Acidic electrolyzed oxidizing water; Closed-up management; Process improvement

Bundles for the central sterile supply department

Traditional resources, such as bundles, can help experts define essential steps of health product processing to prevent infections. The present study developed bundle content construction and validation criteria for central sterile supply departments (CSSDs). The present study employed a Delphi technique modified for content evaluation. Eleven professionals with at least 4 years of experience in sterilization were enlisted. Participants discussed main stages of the process virtually and compiled a list of items based on scientific references justified by law and/or logical reasoning. Agreement, disagreement, and/or suggestions on each step resulted in bundles for a CSSD. Items were then reassessed by experts using a Likert scale with a 90% approval criterion. Six bundles were developed: cleaning, inspection, preparation and packaging, sterilization, and storage resulting from 384 responses and 373 agreements (Interassessor coefficient = 97%). Items obtained from the criteria assessment received majority agreement from the first document. Agreement among varying professionals was achieved, and bundles were successfully developed to evaluate the processing of goods in CSSDs.

Influence of centralized management mode on disinfection and sterilization of flexible endoscopes in Central Sterile Supply Department

Objective To explore the influence of centralized management mode on disinfection and sterilization of flexible endoscopes in Central Sterile Supply Department (CSSD) . Methods By cluster sampling, the endoscopes processed in the First People's Hospital of Shangqiu in He'nan province from 2015 to 2016 were selected for investigation. The endoscopes processed from 2015 to 2018 were put into the control group (n=47 250) and those processed from 2017 to 2018 were in the experimental group (n=55 319) .The cleaning and sterilization room was set up to manage the flexible endoscopes in the control group while the CSSD centralized management mode was adopted in the experimental group. The quality of sterilization and disinfection in the two groups were compared. Results There were statistically significant differences between the two groups of endoscopes in the sterilization and disinfection quality monitoring results (P<0.05) . Conclusions The cleaning, disinfection and sterilization of flexible endoscopes under the CSSD centralized management mode ensures the quality of disinfection and sterilization of flexible endoscopes and the safety of doctors, nurses and patients by reasonably equipping facilities and personnel and strict quality control. Key words: Sterilization; Disinfection; Flexible endoscope; Central sterile supply department; Centralized management

PERSONAL PROTECTIVE EQUIPMENT UTILIZATION IN CENTRAL STERILE SUPPLY DEPARTEMENT PKU MUHAMMADIYAH HOSPITAL SURAKARTA

Personal Protective Equipment (PPE) utilization are very effective in minimizing injuries and accident for healthcare workers. Due to high availability of potential hazard in Central Sterile Supply Departement (CSSD) PKU Muhammadiyah Surakarta hospital management decided PPE utilization as an obligation for all healthcare workers This study aim to analyze risk and hazard factor, PPE function and availability, and healthcare workers PPE utilization in CSSD unit based on goverment regulations. This study used observational method and describe PPE utilization and implementation in CSSD unit as a result. The result of this study is the biggest risk factor, which is biological hazard. CSSD unit already prepared PPE that suit the goverment regulations. PPE utilization still not yet fully implemented regarding to CSSD regulations. Conclusion from this study, in general, PPE utilization and implementation in CSSD unit is according to goverment regulation UU No.1 Tahun 1970 and Per 08/MEN/VII/2010 from Kemnakertrans. Keyword : PPE implementation, PPE utilization

Errors in packaging surgical instruments based on a surgical instrument tracking system: an observational study

BackgroundSurgical instrument processing is important for improving the safety of surgical care in hospitals. However, it has been rarely studied to date. Errors in surgical instrument processing may increase operative times and costs, and increase the risk of surgical infections and perioperative morbidity. We aimed to investigate the errors occurred in packaging surgical instruments.MethodsSurgical instrument tracking system in a central sterile supply department (CSSD) was used to collect the packaging data during January–August 2016 in the First Affiliated Hospital of Soochow University, Suzhou City, China.ResultsData on 33,839 surgical instrument packages were collected. A total of 398 (1.18%) errors occurred, including incomplete packages (n = 70), instrument missing (n = 77), instrument malfunction (n = 27), instrument in wrong specification (n = 175), wrong packaging tag (n = 8), box and cover mismatched (n = 14), wrong packing material (n = 15), indicator card missing (n = 6), and wrong count of instruments (n = 6). The highest error rates were observed among least experienced nurses (N1 level) and during the 16:00–20:00 time period (both p < 0.05). A relatively high error rate was detected in the Department of Orthopedics as well as in the Department of Gynecology and Obstetrics.ConclusionWrong instrument specifications were the primary packing error identified in the current study. Further effort is needed to standardize the packing procedure for instruments under the same category and more effort is required to reduce the error rate during high risk times, or in the surgery department.

Organization and workflow management of central sterile supply department of a tertiary care hospital of Haryana

Background: Nosocomial infection cause significant health issues and economic loss to the patients as well as the health care facilities. To combat hospital acquired infections, hospitals need an effective method of disinfection and sterilization which can be taken care by the central sterile supply department (CSSD). The objective of establishing a CSSD is to make reliably sterilized articles available at the required time and place. Aim and objectives were to study the organization and workflow management of CSSD of a tertiary care institution.Methods: This observational study was carried out from February 2018 to April 2018. An observation checklist was used for the purpose of study after obtaining permission from appropriate authorities.Results: CSSD of the institution is centrally located within the hospital premises and has 11 staff members. Linen, cotton, dressings, instruments and trays are sterilized in the CSSD. Sterilization is done by steam sterilization and gas sterilization with a total of seven autoclaves and two ETO machines. Physical, chemical and biological indicators are regularly used during the process of sterilization.Conclusions: CSSD of the institution is contributing its part towards reduction of nosocomial infections. Quality of standards for sterilization and disinfection is maintained.

Application of intelligent recovery information system in instrument handover management in special period

Objective To improve the handover quality of instruments between operating room and central sterile supply department (CSSD) in special period. Methods The instrument recovery records between operating room and CSSD during special period, including weekends, holidays and night shifts from September to December 2016 and from September to December 2017 in Union Hospital of Tongji Medical College, Huazhong University of Science and Technology were collected. The records from September to December 2016 were assigned as control group, using artificial transition method. The records from September to December 2017 were assigned as intervention group, using using new intelligent information system. The quality of instrument handover and the incidence of adverse events were compared between the two groups. Results After using intelligent information system, the accuracy rate of records and the content of instrument package of the intervention group were both higher than those of the control group, and the differences were statistically significant (P<0.01) . The incidences of instrument loss, instrument defect, occupational exposure and problem traceability in the intervention group were lower than those in the control group, and the differences were statistically significant (P<0.01) . Conclusions The intelligent information system has good application effect on instrument handover between operating room and CSSD in special period. It can solve handover problem in time and can be popularized. Key words: Central supply, hospital; Intelligent information system; Surgical instrument recovery; Special time

Study on criterion of continuous quality improvement management of loaner instrumentation and implants in central sterile supply department

Objective: To investigate the influence of continuous quality improvement on Criterion of management of loaner instrument and implants in central sterile supply department. Methods: By optimizing the processing flow of loaner instrument and implants, the first data after optimizing the advance release rate and the eligibility rate of disassembly of instruments were compared with those after optimizing year by year. In order to implement the management of cleaning and disinfection of loaner instrument and implants and the first sterilization verification, the accuracy rate of knee joint surface replacement kits was compared before and after implementation. Results: After continuous quality improvement persistently, the first data after optimizing the early release rate, instrument disassembly and the accuracy rate of knee joint surface replacement kits were increase/decrease significantly (P < 0.05). After operation, the cleaning and disinfection management and first sterilization effect verification achieved expected efficiency. Conclusion: The application of continuous quality improvement in the management of loaner instrument and implants has achieved satisfactory results and improved the management level of loaner instrument and implants.

Pengaruh Partisipasi Karyawan Terhadap Kinerja Keselamatan dan Kesehatan Kerja Rumah Sakit (K3RS) Santo Borromeus

Occupational safety and health is an effort to provide safety assurance and improve the health of workers by prevention of occupational accidents and diseases, hazards in the workplace, health promotion, treatment and rehabilitation. Hospitals have a variety of potential hazards, therefore Hospital is required to implement safety and health efforts through the implementation of safety and health management work carried out in an integrated and comprehensive. Employee participation is an important factor in improving safety and health performance.This study aims to determine and analyze the extent of the influence of employee participation on the performance of occupational safety and health of Hospital Santo Borromeus. This type of research is a survey study, supported by the spread of questionnaires as a means of data collection. The research method used is a mix method with descriptive analysis technique. Other research data were obtained from interviews, observations, and document studies. This study was restricted to the Laboratory unit and the Central Sterilization Supply Department (CSSD) unit of Santo Borromeus Hospital. The results showed that employee participation has a significant influence on the performance of occupational safety and health of Santo Borromeus Hospital with total influence of 31.2%. And based on the result of correlation analysis, the type of work accident has a significant influence on job position, this is proved by significance value &lt;0,05. Keywords:Employee Participation, Occupational Health and Safety Hospital, Occupational Types

The application effect of continuous quality improvement in the management of the communication of central sterile supply department and clinical department

Objective To explore the effect of continuous quality improvement (CQI) in the communication management between central sterile supply department (CSSD)and clinical departments. Methods The communication management mechanism between CSSD and clinical departments should be established, and CQI measures should be carried out to strengthen the quality supervision and enhance communication between CSSD and clinical departments.The quality score, service efficiency and satisfaction of the clinical department to CSSD were compared before the implementation of CQI ( from January 2015 to December 2015 ) and after the implementation (from January 2016 to December 2016). Results After the implementation of the CQI, the recovery and cleaning, the quality of the packaging, the quality of sterilization and the quality of the sterile articles distribution were significantly higher than before the implementation(P<0.05). After the implementation of CQI, the job satisfaction of the clinical department to CSSD was 95.45%, which was significantly higher than that before the implementation of the 79.09% (P<0.05). The degree of knowledge mastery of the room and CSSD staff was 90.91% and 100.00% respectively, which was significantly higher than that before the implementation of 74.55% and 80.95%(P<0.05). The delivery time of the CSSD routine and the clinical needed items was significantly shorter than before the implementation (P<0.05). Conclusions The implementation of CQI measures in the communication management of the hospital CSSD and clinical department can effectively improve the work quality and service efficiency, and improve the job satisfaction of the medical staff in each department to the CSSD. Key words: Central sterile supply department; Communication; Continuous quality improvement; Degree of satisfaction