梁希希　彭园园　唐媛　章菁菁　凌晓浅　宋林晓　任岳萍　陈彩芬

[關键词] 信息化;集中配包模式;眼科器械;术前准备;医疗质量;医疗资源;满意度

[中图分类号] R473          [文献标识码] B          [文章编号] 1673-9701（2021）27-0180-05

Application of centralized distribution model in the management of ophthalmic surgical instruments

LIANG Xixi1   PENG Yuanyuan1   TANG Yuan2   ZHANG Jingjing1   LING Xiaoqian1   SONG Linxiao1   REN Yueping1   CHEN Caifen1

1.Operating Room， Eye Hospital of Wenzhou Medical University， Wenzhou   325000， China; 2.School of Optometry and Biomedical Engineering， Wenzhou Medical University， Wenzhou   325000，China

[Abstract] Objective To construct an information management model of centralized distribution model by the disinfection supply center and to explore the application value of this model in the management of ophthalmic surgical instruments. Methods An information-based centralized distribution management model in our hospital′s disinfection supply center was established in October 2019. The preoperative preparation time， the satisfaction of medical care， distribution error rate， and changes in equipment turnover of the management model before implementation （June to July 2019） and after implementation （November to December 2019） were compared. Results After the implementation of the information-based centralized distribution management model， the preoperative preparation time for cataract surgery and vitrectomy was （8.81±1.67）min and （19.06±2.21）min. Before the implementation of the information-based centralized distribution management model，the preoperative preparation time for cataract surgery and vitrectomy was （20.63±2.46）min and （33.53±3.93）min，and the difference was statistically significant（t=28.975， 25.011， both P<0.05）. After the implementation， the medical and nursing satisfaction was （4.60±0.50）， （4.78±0.49）points. Before the implementation， the medical and nursing satisfaction was （2.70±0.66）points and （1.91±0.64）points. The difference was statistically significant（t=-9.970， -18.679， both P<0.05）. After the implementation， the distribution error rate dropped from 2.81% to 0.24%， and the difference was statistically significant（χ2=137.585， P<0.05）.The turnover of the cataract phacoemulsification handle decreased from 100.00% to 82.95% after the implementation， and the difference was statistically significant（χ2=16.398， P<0.05）.After the implementation， the turnover of cataract kits decreased from 100.00% to 80.88%，and the difference was statistically significant（χ2=14.374， P<0.05）. Conclusion The centralized distribution model of full-process information traceability truly realizes the closed-loop management of ophthalmic equipment packages， which can effectively guarantee the centralized， efficient and precise management of ophthalmic surgical instruments， and improve the efficiency and medical quality of ophthalmology clinical work， medical care satisfaction， and medical resources utilization rate.

[Key words] Informatization; Centralized distribution model; Ophthalmic instruments; Preoperative preparation; Medical quality; Medical resources; Satisfaction

眼健康是人民健康的重要组成部分，是涉及民生的重大公共卫生问题和社会问题[1]。近年来，随着我国人口老龄化、生活方式转变、工作强度增大、过敏源增加等多种因素的影响[2]，各种眼病罹患率逐年增加，眼科市场增长较快[3]。研究表明全球眼科手术量预计将以4.3%的年复合成长率（Compound annual growth rate，CAGR）发展，从2017年的2430万件，增加到2022年超过3000万件的规模[4]。眼科是个精细的学科，眼科手术器械以显微器械为主，具有种类繁多、价格昂贵、结构精密、专业性强等特点[5-6]，由于眼科手术量大、连台手术多、转台快[7]，使得传统纸质化配包模式的弊端日益凸显，给眼科手术器械规范化的管理带来挑战，探索新的眼科数字化管理模式已是大势所趋[8-9]。每日供需矛盾的有效解决及器械供应流程的优化逐渐成为眼科手术器械有效管理的重要影响因素[10]。本研究构建了一种全新的由消毒供应中心集中配包的信息化管理模式，它是在传统纸质化配包管理模式的基础上进行深化及改进，突出集中、高效、精准为特征的眼科手术器械包全程追溯闭环管理，比较分析信息化集中配包模式对眼科术前准备时间、医护满意度、配包差错率及器械周转量的影响，旨在为眼科手术器械的安全化和有效化管理提供参考，现报道如下。……