降低供應室器械包盤滅菌效期到期重消率之專案

A Refinement of the Supply System to Reduce Instrument Packaging Re-Sterilization Rates

背景：
預先滅菌消毒的手術器械包盤雖可加速手術中器械的供應，但是太多手術器械包盤超過滅菌效期會造成材料成本支出增加，引發本專案改善動機。
目的：
藉由器械包盤供應系統的重整以降低到期重消率，減少醫療資源浪費達到醫院節流之目標，亦提升病人使用器械安全性。
解決方案
器械包盤供應系統的重整包括安排在職教育課程、修訂包裝方式延長有效期限、制定分類警語標示、定期檢討器械包盤設定量及建立稽核機制。
結果：
到期包盤由改善前2,505包／月減少為592包／月，到期率由原25.7%下降為5.9%；重複消毒成本由82,665元／月減少為19,536元／月，共節省63,129元／月。
結論：
器械包盤供應系統的重整的確降低包盤之過期重消率進而降低成本，亦可使供應服務作業順暢，確實建立一個高效、快捷、準確、優質的服務。

Background: Sterilized instrument packages facilitate instrument availability in surgery. However, repeated sterilizations after expiration of disinfection validity results in additional costs. Last year, an average of 2,505 instrument packages were re-sterilized each month due to expiration. Reducing the re-sterilization rate is an issue in terms of cost reduction.
Objects: In this study, we tried to decrease the instrument package re-sterilization rate by refining the hospital instrument supply system. The result reduced costs and enhanced patient safety.
Resolution: Refinement procedures included staff re-education, changing sterilization and packing methods to extend the validity period, establishing a warning system, periodic examination of demand, and establishing an auditing system. Average numbers of expired packages and sterilization costs were compared pre- and post-study period.
Results: The average amount of expired packages fell from 2505/month to 592/month. The expiration rate decreased from 25.7 % to 5.9 %. Costs of re-sterilization decreased from 82,665 NTD per month to 19,536 NTD per month (i.e., a decrease of 63,129 NTD in costs per month).
Conclusion: Refining the supply system can reduce expiration and re-sterilization rates for instrument packaging, achieving lower costs without sacrificing quality.