Emergency preparedness in the central sterile supply department: a multicenter cross-sectional survey.

OBJECTIVE: To investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses' emergency attitude and ability. METHODS: This study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses' emergency capacity and attitudes. RESULTS: The data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants' institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill's participants exceeding 50%. The respondents' emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05). CONCLUSIONS: Most medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated.

Mental state of central sterile supply department staff during COVID-19 epidemic and CART analysis.

BACKGROUND: During the COVID-19 epidemic, the central sterile supply department (CSSD) staff handled many devices, implements and non-disposable protective articles used by suspected or confirmed COVID-19 patients. As a result, the CSSD staff may have experienced psychological stress, however, the mental state of the CSSD staff during the COVID-19 epidemic has been rarely studied. We aim to investigate the mental state of the CSSD staff and relevant influencing factors experienced during the COVID-19 epidemic. METHODS: The survey utilising a general information questionnaire, Chinese perceived stress scale (CPSS), self-rating anxiety scale (SAS), and Connor-Davidson resilience scale (CD-RISC) was conducted with 423 CSSD staff members from 35 hospitals in Sichuan Province, China. Data was analysed in SPSS24.0. Classification and regression tree (CART) was utilised to analyse variables and find variation between groups. A chi-square test was performed on enumeration data, and t-test and analysis of variance were performed on measurement data. RESULTS: The CSSD staff's SAS score was 37.39 ± 8.458, their CPSS score was 19.21 ± 7.265, and their CD-RISC score was 64.26 ± 15.129 (Tenacity factor score: 31.70 ± 8.066, Strength factor score: 21.60 ± 5.066, Optimism factor scores: 10.96 ± 3.189). The CPSS score was positively correlated with the SAS score (r = 0.66; P < 0.01), the CPSS score was negatively correlated with the CD-RISC score (r = - 0.617, P < 0.01), and the SAS score was negatively correlated with the CD-RISC score (r = - 0.477, P < 0.01). The job position, age, and political status of the CSSD staff were the main factors affecting their mental state; for example, the CPSS score and SAS score of the CSSD nurses were significantly different from those of the CSSD logistic staff (P < 0.01). CONCLUSION: During the epidemic, the CSSD staff's psychological resilience was at a low level; the anxiety level of the CSSD nurses was higher than that of the CSSD logistic staff. Therefore, more attention should be given to the mental health of the CSSD staff, including taking protective measures regarding the risk factors to ensure they can maintain a healthy mental state.

Application of a sub-specialties management model improves quality control in a central sterile supply department.

BACKGROUND: The management of medical devices is crucial to safe, high-quality surgical care, but has received little attention in the medical literature. This study explored the effect of a sub-specialties management model in the Central Sterile Supply Department (CSSD). METHODS: A traditional routine management model (control) was applied from September 2015 through April 2016, and a newly developed sub-specialties management model (observation) was applied from July 2016 through February 2017. Health personnel from various clinical departments were randomly selected to participate as the control (n = 86) and observation (n = 90) groups, respectively. The groups were compared for rates of personnel satisfaction, complaints regarding device errors, and damage of medical devices. RESULTS: The satisfaction score of the observation group (95.8 ± 1.2) was significantly higher than that of the control (90.2 ± 2.3; P = 0.000). The rate of complaints of the observation group (3.3%) was significantly lower than that of the control (11.6%; P = 0.035). The quality control regarding recycle and packing was significantly higher during the observation period than the control period, which favorably influenced the scores for satisfaction. The rate of damage to specialist medical devices during the observation period (0.40%) was lower than during the control period (0.61%; P = 0.003). The theoretical knowledge and practical skills of the CSSD professionals improved after application of the sub-specialties management model. CONCLUSIONS: A management model that considers the requirements of specialist medical devices can improve quality control in the CSSD.

NHS generic project: response from the wound care community.

This series of letters outlines the response from MA Healthcare, key opinion leaders, and industry to the news that the Government is planning to introduce a generic project for wound dressings, limiting products to three main suppliers.

[Discussion about Management of In Vitro Diagnostic Reagent].

OBJECTIVE: In order to adapt the rapid development of modern medicine, this paper is aimed to analyze the application of in vitro diagnostic reagents (IVD Reagents) in hospital management and improve the overall level of hospital management. METHODS: By groping the management experience of IVD reagents, we discuss the internal hospital management mode of IVD reagents in reality. RESULTS: With the continuous improvements on the information platform of IVD reagents,we can realize benefit analysis of IVD reagents within the process of management. CONCLUSION: Reasonable management on IVD reagentscan improve the working efficiency in hospitals and provide swifter and better medical service for patients.

[The evaluation of bacteria penetration by medical textiles for multiple use and disposable multilayer surgical drapes, according to the PN-EN ISO 22610 standard]. / Badanie przenikania bakterii przez tkaniny medyczne przeznaczone do wielokrotnego uzycia oraz wielowarstwowe oblozenia chirurgiczne jednorazowego uzytku, wedlug normy PN-EN ISO 22610.

INTRODUCTION: Cotton as well as synthetic textile medical products are widely used as barrier materials and individual protection against displacement of biological infectious factors. The required level of protection of these products for multiple use and disposable multilayer laminates against the penetration of microbes depends on the risk connected with type of surgical procedure defined in normative documents. METHODS. Cotton and syntetic medical textiles for multiple use, 30-times subjected to processes simulating conditions of the use as well as disposable multilayer surgical drapes were tested. Resistance to microbial wet penetration was conducted according to the PN-EN ISO 22610: 2007 standard. RESULTS: The barrier of cotton fabrics was reduced after first washing and then systematically grew after each often cycles to the value close to the value at the beginning. From the twentieth cycle of simulated conditions of the use, barrier index was reduced. The barrier of the synthetic textile stayed on the average level, while multilayer disposable products ensured the full impermeability for the bacteria. CONCLUSIONS: Natural cotton textiles for multiple use could be apply on operative blocks in limited range because of the changes of the cotton structure caused by repeated laundering process and sterilization. Synthetic materials also have limited application, although are more resistant to cleaning and sterilization processes. Disposable synthetic laminates with many layers use guarantee impermeability for bacteria and may be applied in operative blocks without restrictions.

The Supervision and Management Mode of Disinfection Supply Center Improves the Standardization of Sterile Goods Management in Clinical Departments.

Background: In daily inspection, the nonstandard management of sterile articles in clinical departments of hospitals often leads to the destruction of the sterilization effectiveness of sterile articles. Therefore, it is necessary to strengthen governance and improve this phenomenon. This study intends to investigate the mode in which the disinfection supply center participates in the supervision and management of the management of sterile items in clinical departments. It played a role in improving the standardization of the management of sterile articles in clinical departments and ensured the closed-loop management of the sterilization effectiveness of sterile articles. Methods: Every quarter, the disinfection supply center of our hospital will inspect the standardized management of sterile articles in all clinical departments of the hospital, mainly including the storage environment and facilities of sterile articles, the cleanliness of storage cabinets, placement principles, whether they are stored by category, and the quality and validity management of sterile articles. The quarterly inspection results were summarized and analyzed to find the existing problems and the causes. The disinfection supply center shall supervise the improvement. After the disinfection supply center inspected the standardized management of sterile articles in all clinical departments of the hospital for the first time according to the inspection contents, under the guidance and assistance of the nursing department and the hospital infection department, it improved the sterile article management system, conducted knowledge training for the whole hospital, and incorporated the standardized management of clinical sterile articles into the quality control inspection of the nursing department. In the later stage, the disinfection supply center is responsible for conducting routine inspection and supervision on the standardized management of sterile articles in all clinical departments of the hospital every quarter according to the inspection contents, including summarizing, analyzing, and urging the clinical departments to achieve the improvement of the management of sterile articles in clinical departments. Results: The standardization of aseptic articles after improvement was significantly higher than before and during improvement, and the qualified rate was significantly different (99.4% vs 97.9% vs 89.5%, P < 0.05). The average number of lost packages caused by nonstandard management in the department was significantly reduced. The average rate of lost sterile packages during and after the improvement was significantly lower than that before the improvement (10.5% vs 97.9% vs 89.5%, P < 0.05). It also effectively reduced the cost caused by the loss of sterile packages. Conclusion: The disinfection supply center participates in the quality control and management of sterile articles in the nursing department and regularly inspects and supervises the management of sterile articles in clinical departments. It can effectively improve the standardized management of sterile articles in clinical departments, ensure the safety of sterile articles, and form a closed loop of sterilization effectiveness.

Impact of negative pressure system on microbiological air quality in a Central Sterile Supply Department.

OBJECTIVE: Guidelines recommend that the cleaning area in a Central Sterile Supply Department (CSSD) maintain a negative pressure of the environmental air, but how much this system can impact the contamination of the air by bioaerosols in the area is not known. The objective of this study was to assess the impact of negative pressure on CSSD by evaluating the microbiological air quality of this sector. METHODS: Microbiological air samples were collected in two CSSD in the same hospital: one with and one without a negative air pressure system. Outdoor air samples were collected as a comparative control. Andersen six-stage air sampler was used to obtain the microbiological air samples. RESULTS: The concentration of bioaerosols in the CSSD without negative pressure was 273.15 and 206.71 CFU/m3 , while in the CSSD with negative pressure the concentration of bioaerosols was 116.96 CFU/m3 and 131.10 CFU/m3 . The number of isolated colonies in the negative pressure CSSD was significantly lower (P = .01541). CONCLUSION: The findings showed that the negative pressure system in the CSSD cleaning area contributed to the quantitative reduction in bioaerosols. However, the concentration of bioaerosols was lower than that established in the guideline for indoor air quality of many countries. Therefore, it cannot be concluded that CSSDs which do not have a negative pressure system in their cleaning area offer occupational risk.

ARC: An Open Web-Platform for Request/Supply Matching for a Prioritized and Controlled COVID-19 Response.

In 2020 the world was hit by the COVID-19 pandemic putting entire governments and civil societies in crisis mode. Around the globe unprecedented shortages of equipment and qualified personnel were reported in hospitals and diagnostic laboratories. When a crisis is global, supply chains are strained worldwide and external help may not be readily available. In Switzerland, as part of the efforts of the Swiss National COVID-19 Science Task Force, we developed a tailor-made web-based tool where needs and offers for critical laboratory equipment and expertise can be brought together, coordinated, prioritized, and validated. This Academic Resources for COVID-19 (ARC) Platform presents the specialized needs of diagnostic laboratories to academic research groups at universities, allowing the sourcing of said needs from unconventional supply channels, while keeping the entities tasked with coordination of the crisis response in control of each part of the process. An instance of the ARC Platform is operated in Switzerland (arc.epfl.ch) catering to the diagnostic efforts in Switzerland and sourcing from the Swiss academic sector. The underlying technology has been released as open source so that others can adopt the customizable web-platform for need/supply match-making in their own relief efforts, during the COVID-19 pandemic or any future disaster.

Medication room madness: calming the chaos.

Nurses work in stressful environments, encountering interruptions and distractions at almost every turn. The aim of this medication safety project was to improve the physical design and organizational layout of the medication room, reduce nurse interruptions and distractions, and create a standard medication process for enhanced patient safety and efficiency. This successful change improved the medication administration process, decreased medication errors, and enhanced nursing satisfaction.

Chasing zero: our journey to preventing surgical site infection.

After an increase in methicillin-resistant Staphylococcus aureus infections was discovered at a health care facility in Arizona, a multidisciplinary team convened to investigate the underlying problem and work toward eliminating surgical site infections. The team investigated environmental factors, held inservice sessions to reinforce sterile technique, and made important changes to the facility culture in efforts to eliminate surgical site infections. The team's efforts were put into practice on October 30, 2008, and only one surgical site infection was identified in the following seven months.

Quality of life at work in a central sterile processing department.

OBJECTIVES: to evaluate the quality of life of nursing professionals who work in a central sterile processing department. METHODS: a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire "Medical Outcomes Study Short-Form 36" were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects. CONCLUSIONS: This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.

Lean-Oriented Layout Design of a Health Care Facility.

BACKGROUND: In this article, we propose a method that integrates systematic layout planning techniques to lean health care practices aided by multicriteria decision analysis that could be applied to reformulate the layout of health care facilities. METHODS: We analyze a high-variety sterilization unit of a large public hospital located in Brazil. The unit is currently implementing lean practices, and layout changes are required to provide more efficient materials and information flows. RESULTS: Traditional design of health care facilities is not aligned with lean implementation and its underlying practices and principles. We propose the integration of such approaches to enhance their benefits. To rank and select the best layout alternative, a multicriteria decision analysis method (analytic hierarchy process) is adopted. CONCLUSIONS: There are 3 contributions here: the integration of lean principles into traditional health care facility design practices, the use of multicriteria decision analysis to refine the determination of the best layout solution, and the application of our propositions in a real case study.

Bundles for the central sterile supply department.

BACKGROUND: 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). METHODS: 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. RESULTS: Six bundles were developed: cleaning, inspection, preparation and packaging, sterilization, and storage resulting from 384 responses and 373 agreements (Interassessor coefficient = 97%). DISCUSSIONS: Items obtained from the criteria assessment received majority agreement from the first document. CONCLUSIONS: Agreement among varying professionals was achieved, and bundles were successfully developed to evaluate the processing of goods in CSSDs.

Surgical Instrument Decontamination: A Multistep Process.

Surgical instrument decontamination requires the collective input of facility leaders, OR staff members, and sterile processing department personnel. Individual accountability can ensure that instruments are cleaned according to the manufacturers' written instructions for use, appropriate regulations, and facility policies. Information about the instrument decontamination process-from point of use to sterilization-should help enable perioperative nurses to advocate for and participate in the appropriate implementation of the necessary process steps. Sterile processing department leaders should develop policies and procedures for decontamination of surgical instruments and devices and the various accountabilities for the process steps. They also should help provide education for their staff members and complete required documentation. This article reviews the steps of instrument cleaning and decontamination and provides a framework to help perioperative leaders and educators facilitate these steps in their work environments, prevent instrument damage, and help ensure safe patient care.

Shifting the sterile processing department paradigm: a mandate for change.

Sterile processing department (SPD) staff members have the difficult task of processing complicated instrumentation, containing costs, and managing limited resources; and how they face these challenges has a direct effect on patient care. Recent technological advances require SPD staff members to be more knowledgeable about what instrument trays are used together and the conditions in which they are used to help prevent costly delays in processing. This article explores how one health care system was successful in facing these challenges by implementing a solid orientation and education program.

Using simulation to design a central sterilization department.

A simulation project was performed to assist with redesign of the surgery department of a large tertiary hospital and to help administrators make the best decisions about relocating, staffing, and equipping the central sterilization department. A simulation model was created to analyze department configurations, staff schedules, equipment capacities, and cart-washing requirements. Performance measures examined include tray turnaround time, surgery-delay rate, and work-in-process levels. The analysis provides significant insight into how the proposed system will perform, allowing planning for expected patient volume increases. This work illustrates how simulation can facilitate the design of a central sterilization department and improve surgical sterilization operations.