RESUMEN
Background: Professional, standardized, and scientific management of the disinfection supply room is the prerequisite to ensure medical quality and improve the comprehensive strength of the hospital. This study aimed to evaluate the application of the defect management improvement mode of the Joint Commission International (JCI) standard in improving the cleaning and disinfection effect as well as the management quality of instruments in the central sterile supply department (CSSD). Methods: From January 2020 to December 2020, 32 medical staff in the hospital CSSD were divided into control and observation groups according to the random number table method, with 16 staff members in each group. The control group adopted the standardized management mode and the observation group adopted the defect management improvement mode based on the JCI standard. During the management period, we compared the disinfection effect and incidence of adverse events of the instruments and articles in the CSSD of the two groups, and evaluated the work and satisfaction of both groups of subjects. Linear correlation analysis and multiple linear regression analysis were used to determine the influencing factors of satisfaction. Results: During the standardized management, the instruments and articles were used 611 times in the control group and 602 times in the observation group. The cleaning qualified rate, infection awareness rate, standard implementation rate, hand hygiene implementation rate, theoretical knowledge score, and practical operation ability of the observation group were significantly higher than those of the control group (P<0.05). The incidence of adverse events in the observation group was significantly lower compared to the control group (P<0.05), and the satisfaction scores of the observation group were significantly higher than those of the control group (P<0.05). The total satisfaction score is independently related to the training method, educational background, and professional title. Conclusions: Adopting the defect management improvement mode under the JCI standard for CSSD is conducive to improving the cleaning effect of instruments, enhancing the work situation and job satisfaction of medical staff, and reducing the incidence of adverse events. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100053068.
RESUMEN
Sufentanil, with a potent analgesia effect, has been wildly used in anesthesia and analgesia, especially for the cardiovascular surgeries. The aim of the study was to evaluate whether sufentanil provides cardioprotection and the effect of connexin 43 on the cardiac infarct size reduction. Sufentanil post-conditioning (bolus injection at 0.1, 0.3, 1, 3, 10 µg/kg) or ischemic post-conditioning (3 cycles of a 10s reperfusion alternating with a 10s ischemia) was induced in an intact rat heart model of ischemia-reperfusion injury. Both ischemic and sufentanil post-conditioning reduced the myocardial infarct size compared with control group. The infarct size limitation of sufentanil was dose-dependent, 1 µg/kg has the optimal effect and increasing dosage could not afford further cardioprotection. Connexin 43 underwent dephosphorylation in response to ischemia-reperfusion measured by Western blot at the anterior myocardium tissues of left ventricle while sufentanil preserved the phosphorylation of connexin 43. The results demonstrated that sufentanil limits myocardial infarct size which is similar with ischemic post-conditioning at the dosage of 1 µg/kg. Preservation of phosphorylation of connexin 43 plays an important role in the cardioprotection of ischemic and sufentanil post-conditioning.