Purpose: Adverse events bring pain to patients, prolong hospitalization, and may even endanger life, it is necessary to effectively identify and manage adverse events. However, in Chinese mainland, there are few studies on adverse events in Central Sterile Supply Department. The purpose of this study was to investigate the prevalence of adverse events in Central Sterile Supply Department and offer suggestions for enhanced quality management.
Materials and Methods: A retrospective study was conducted to assess the prevalence of adverse events in a tertiary hospital from January 2020 to December 2022, employing a convenient sampling approach. The occurrence of adverse events of CSSD shall be collected for the basic information of the principal person of adverse events and the information of the adverse event. Descriptive statistics are described by frequency (percentage) and are analyzed by using X² test.
Results: A total of 101 adverse events were reported, with the majority being attributed to substandard cleaning quality (34, 33.66%), followed by faulty instrument assembly (25, 24.75%) and defective marking (7, 6.93%). Additionally, incorrectly sterilized items (6, 5.94%), occupational exposures (3, 2.97%) and late distribution (5, 4.95%) were also observed, accidents (8, 7.92%) and other types of adverse events (13, 12.87%). The highest risk chain for adverse events was identified as inspection and packaging (49, 48.51%) and device cleaning (32, 31.68%), with the majority of adverse events occurring on a scale of three (30, 29.7%) and four (70, 69.31%), respectively. Furthermore, it was determined that the type of person responsible, education, years of work and the structure of the device, the number of instruments in the operating kit, and the size of the kit may be factors in the occurrence of adverse events (P < 0.05).
Conclusion: Adverse events occur frequently in central sterile supply department, thus necessitating strict supervision during cleaning and inspection of packaging. Managers should pay special attention to staff with low working life and education. Furthermore, a grading system, in line with the central sterile supply department, should be implemented to ensure the management of adverse events and the quality of services provided is harmonized.
Keywords: central sterile supply department, surgical instruments, adverse events, sterilization, nurse