OBJECTIVE To control the quality of cleaning and sterilization of rent instruments and to secure medical safety of patients undergoing operations.METHODS We randomly chose 60 pieces of rent instruments and divided them into two groups,machinery wash group and hand wash group.Occult blood test was performed before and after washing and rinsing.RESULTS Positive rate of occult blood tests was 86.67% before either machinery or hand wash.While after machinery wash and hand wash it was 0% and 6.67%,respectively.Both wash methods had significant effect on depleting occult blood(P0.05).CONCLUSIONS Hospitals must enhance the management of rent instruments cleaning which is of poor quality at present by regulating the procedure and monitoring methods so as to ensure the quality of rent instruments cleaning and secure patients safety.

Objective:To study the effect of heated carbon dioxide pneumoperitoneum on the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot.Methods:A total of 307 patients who underwent pancreaticoduodenectomy by Da Vinci robot from January 2016 to December 2018 were selected as subjects. 140 patients who underwent pancreaticoduodenectomy from January 2016 to April 2017 were selected as the control group, and room temperature carbon dioxide pneumoperitoneum was used. From May 2017 to December 2018, 167 patients were set as the intervention group, and heated carbon dioxide pneumoperitoneum was used. Body temperature, heart rate and blood oxygen saturation of the two groups were compared after entering the operating room, before anesthesia, before the establishment of carbon dioxide pneumoperitoneum and after the closure of carbon dioxide pneumoperitoneum, and the duration of operation, intraoperative blood loss, postoperative anesthesia recovery time, hospitalization time and postoperative complication rate were recorded.Results:There was no significant difference in body temperature after entering the operating room, before the establishment of carbon dioxide pneumoperitoneum between the two groups ( P>0.05). After the closure of carbon dioxide pneumoperitoneum, the decline range of the body temperature of the control group was(1.24±2.36) ℃, which was significantly higher than that of the intervention group (0.60±0.25) ℃, and the difference was statistically significant ( t value was 6.892, P<0.05). There were no statistically significant differences between the two groups in terms of operation duration, number of cases with blood oxygen saturation < 0.90, incidence of gastrointestinal fistula and incision infection ( P>0.05). The intraoperative blood loss, resuscitation time, drainage time was (291.08±265.42) ml, (27.04±10.89) min, (8.69±6.64) d in the intervention group and (364.29±309.28) ml, (32.60±12.17) min, (10.76±6.25) d in the control group, and the difference was statistically significant ( t value was 2.232, 7.294, 2.789, P<0.05 or 0.01). There was statistically significant difference in The incidence of pancreatic fistula and biliary fistula, and length of hospital stay was 20 cases, 7 cases, (27.62±17.30) d in the intervention group, and 31 cases, 15 cases, (32.38±12.22) d in the control group, and the difference was statistically significant ( χ2 value was 4.653, 4.870, t value was 6.284, P<0.05). Conclusions:Warming carbon dioxide pneumoperitoneum can reduce the incidence of perioperative hypothermia and improve the prognosis of patients undergoing pancreaticoduodenectomy by Da Vinci robot.

Objective:To construct an evaluation index system of nursing quality for pressure injury in Operating Room based on Donabedian structure-process-outcome three-dimensional quality assessment model to provide a reference for nursing quality assessment by nursing managers in Operating Room.Methods:From March to July 2018, we selected 18 experts such as chairman of Committee of Operating Room of Shanghai Nursing Association, head nurses of Operating Room at ClassⅢ Grade A general hospitals in Shanghai, nurse specialist of pressure injury management team, by purposive sampling as subjects. The consultation form was designed based on search of operation related pressure injury at home and abroad as well as Donabedian structure-process-outcome three-dimensional quality assessment model. Delphi method was used to 2 rounds of expert consultation. Items in all levels were deleted, merged and revised according to expert opinions and to define the evaluation indexes in all levels of nursing quality for pressure injury in Operating Room as well as the weight.Results:This study carried out 2 rounds of expert consultation, with 0.989 for the expert judgment coefficient, 0.956 for the expert familiarity coefficient and 0.973 for the expert authority coefficient. The variation coefficients of second-level indexes and third-level indexes ranged from 0.109 to 0.138 in 2 rounds of expert consultation. The evaluation index system of nursing quality for pressure injury in Operating Room included 3 first-level indexes, 9 second-level indexes and 28 third-level indexes.Conclusions:This study constructs a scientific and reasonable evaluation index system of nursing quality for pressure injury in Operating Room with the method of Delphi which can be used to nursing quality assessment for pressure injury in Operating Room and is in favor of continuous quality improvement of nursing in Operating Room.

Objective:To build a scientific, systematic and standardized index system suitable for emergency management of sudden acute infectious diseases in Operating Rooms of general hospitals.Methods:From June 2020 to March 2021, guided by the 4R crisis management theory, the index framework was initially formulated by scientific methods of literature research and expert interviews. A total of 16 medical and nursing experts from the fields of Operating Room nursing, nursing management, nosocomial infection, disease prevention and control and infectious diseases were further screened and determined indicators at all levels by applying the Delphi expert consultation method. The weight values of indexes at all levels were determined by analytic hierarchy process (AHP) and priority map method, and the emergency management system of nursing for sudden acute infectious diseases in Operating Rooms of general hospitals was finally formed.Results:The positive coefficients of experts in the two rounds of consultation were both 100.00%. The experts who provided opinions accounted for 68.75% and 31.25% respectively. The authoritative coefficient of experts was 0.906 3. The coefficient of variation of indicators at all levels was less than 0.25. The coordination coefficients of the first-level, secondary and tertiary indexes were 0.228, 0.322, 0.288 and 0.252, 0.406, 0.326 (all P<0.01) , respectively. Finally, a nursing emergency management system for sudden acute infectious diseases in Operating Rooms of general hospitals was formed, including 4 first-level indicators, 13 second-level indicators and 64 third-level indicators, and the weight distribution of indicators was reasonable. Conclusions:The constructed nursing emergency management system for sudden acute infectious diseases in Operating Rooms of general hospitals is scientific and reliable, which can provide scientific references for Operating Room nursing managers to deal with emergency nursing management of acute infectious diseases.

Objective: To investigate the status quo of surgical instrument maintenance at 549 hospitals nationwide and analyze the existing problems, so as to lay a foundation for further development of relevant standards. Methods: In January 2019, 549 hospitals of different grades in 33 provinces, autonomous regions and municipalities were surveyed by a convenience sampling. The survey covered the basic information, the cognition of the management personnel on instrument maintenance, and the status quo of surgical instrument maintenances of the hospitals. Descriptive analysis was carried out on the data, and the number and percentage of counting data were described. Results: 368(59.74%)hospitals were manned with special post for cleaning precision surgical instruments, 426(69.16%) were manned with special post for cleaning quality inspection, and 382(62.01%) were manned with special post for assembly and packaging. 347(56.33%)for manufacturers training, 299(48.53%)for self-study manufacturers instruction, 420(68.18%)by department internal training; 116(18.83%)for manual cleaning, 413(67.05%)for manual and ultrasonic cleaning, 87(14.12%)for mechanical cleaning; High pressure steam sterilization was used in 518(84.10%), hydrogen peroxide plasma sterilization was used in 398(64.61%), and ethylene oxide sterilization was used in 222(36.04%) hospitals. Conclusions The maintenance of surgical instruments should be carried out by professional personnel, relevant training should be carried out, management personnel should strengthen the inspection, and relevant standards and norms should be formulated to unify the management of surgical instruments.