摘要
目的:基于软件-硬件-环境-人员(SHEL)专项管理模型构建医疗设备诊疗安全效能评价模型,探讨其在麻醉科医疗设备诊疗安全效能提升中的应用价值。方法:基于管理制度、设备设施、诊疗场所和医务工作者,选定管理、运行、条件和操作效能4个层面构建安全效能评价模型。采用几何平均法计算指标权重综合评估设备诊疗安全效能,制定规范化培训、风险性管理、信息化升级和预防性维护的专项管理措施进行设备管理。选取2020年至2023年保定市第二医院麻醉科在用的115台医疗设备,将2020年1月至2021年12月期间使用的104台医疗设备采用传统管理模式,2022年1月至2023年12月期间使用的108台(含传统管理在用的97台)采用专项管理模式。对比两种管理模式的设备诊疗安全效能评分和安全管理质量,以及参与设备使用管理的12名医生、18名护士、5名技师和6名工程师对两种管理模式的设备临床使用满意度。结果:采用专项管理模式的麻醉科医疗设备管理效能、运行效能、条件效能和操作效能平均评分分别为(89.09±4.79)、(91.08±4.21)、(90.58±3.87)和(92.25±3.36)分,均高于传统管理模式,差异有统计学意义(Z=2.344、2.457、3.498、2.601,P<0.05);采用专项管理模式的麻醉设备、监护设备、急救设备、治疗设备及其他辅助类设备的平均安全风险比率分别为(1.45±0.69)%、(1.62±0.61)%、(1.15±0.39)%、(1.22±0.38)%和(1.84±0.53)%,均低于传统管理模式,差异有统计学意义(Z=2.686、3.149、3.236、3.640、3.323,P<0.05);参与设备使用管理的医生、护士、技师及工程师对采用专项管理模式的麻醉科医疗设备临床使用满意度评分分别为(91.29±3.47)、(92.34±2.28)、(93.80±3.01)和(90.07±3.73)分,均高于传统管理模式,差异有统计学意义(Z=2.207、2.705、2.554、3.069,P<0.05)。结论:SHEL模型下的医疗设备诊疗安全效能评价模型专项管理模式能够提高设备使用安全效能,降低设备运行安全风险,改善设备临床服务质量。
Objective:To construct an evaluation model of safety efficiency of medical equipment in diagnosis and treatment on the basis of special management model of software-hardware-environment-liveware(SHEL),and to discuss its application value in improving the safety effectiveness of medical equipment in diagnosis and treatment of anesthesiology department.Methods:Based on the management system,equipment and facilities,diagnosis and treatment areas and medical personnel,a safety effectiveness evaluation model was constructed with four levels:management,operation,condition and operational efficiency.The geometric average method was used to calculate the index weight to comprehensively evaluate the safety efficacy of equipment in diagnosis and treatment.Special management measures,including standardized training,risk management,information upgrades,and preventive maintenance,were formulated for equipment management.A total of 115 medical equipment in clinical use in the Department of Anesthesiology of the No.2 Hospital of Baoding from 2020 to 2023 were selected.From January 2020 to December 2021,104 medical equipment were managed using the conventional management mode,and from January 2022 to December 2023,108 equipment were managed using the special management mode.The safety efficacy scores and safety management quality of the two management modes were compared,and the satisfaction of 12 doctors,18 nurses,5 technicians and 6 engineers with the clinical use of the two management modes were compared.Results:The average scores of management efficacy,running efficacy,conditional efficacy and operational efficacy of medical equipment in anesthesiology using a special management mode were(89.09±4.79)points,(91.08±4.21)points,(90.58±3.87)points and(92.25±3.36)points,respectively,all of which were higher than those of conventional management mode.The differences were statistically significant(Z=2.344,2.457,3.498,2.601,P<0.05).The average safety risk ratio of anesthesia equipment,monitoring equipment,first aid equipment,treatment equipment and other auxiliary equipment using special management mode were(1.45±0.69)%,(1.62±0.61)%,(1.15±0.39)%,(1.22±0.38)%and(1.84±0.53)%,respectively.These ratios were all lower than those using the conventional management mode,and the differences were statistically significant(Z=2.686,3.149,3.236,3.640,3.323,P<0.05).The satisfactions of doctors,nurses,technicians and engineers with the clinical use of medical equipment in anesthesiology using the special management mode were(91.29±3.47)points,(92.34±2.28)points,(93.80±3.01)points and(90.07±3.73)points,respectively,all of which were higher than those using the conventional management mode.The differences were statistically significant(Z=2.207,2.705,2.554,3.069,P<0.05),respectively.Conclusion:The special management mode of evaluation model of safety efficiency of medical equipment in diagnosis and treatment under SHEL model can improve the safety efficiency of equipment in usage,and reduce safety risk of equipment operation,and improve the quality of equipment in clinical service.
作者
张雪
袁蕾
葛磊
董彦海
Zhang Xue;Yuan Lei;Ge Lei;Dong Yanhai(Department of Anesthesia,The No.2 Hospital of Baoding,Baoding 071000,China)
出处
《中国医学装备》
2024年第12期137-142,共6页
China Medical Equipment
关键词
SHEL模型
医疗设备
诊疗安全
效能评价
风险控制
SHEL model
Medical devices
Diagnosis and treatment safety
Effectiveness evaluation
Risk control
作者简介
通信作者:袁蕾,Email:bingjinglei-9766@163.com。
