骨科手术外来器械及植入物的安全管理课件

Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline骨科手术外来器械及植入物的安全管理郑亚娟2016.2Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline目录一.外来器械及植入物二.骨科植入物分类：三.外来器械及植入物术前安全管理四.外来器械及植入物术中安全管理五.外来器械及植入物术后安全Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline一.外来器械及植入物（一）外来医疗器械：1.外来医疗器械：是由医疗器械生产厂家、公司租赁或免费提供给医院的可重复使用的医疗器械，它是在普通手术器械基础上增加的局部专项操作器械。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline一.外来器械及植入物2.外来器械的特点：针对性强、价格昂贵、品种繁杂、专业性强、更新迅速。一般医院不作常规配备，其中以骨科植入性手术相应的配送器械、动力工具等最为多见。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline一.外来器械及植入物3.外来医疗器械处理中的潜在风险（1）在清洗和包装过程中易发生器械的遗失或功能性的损坏。由于结构复杂，多沟槽，多纹路，多孔洞等特点，给清洗带来困难，不易彻底清洗干净。（2）在各医院之间频繁流动使用，各医院处理器械的条件和质量不同，其感染危险性比医院自备的手术器械大得多。（3）部分器械包超重、超大。（4）时间的随意性Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline一.外来器械及植入物（二）植入物：1.植入物：放置于外科操作造成的或者生理存在的体腔中，留存时间为30天或者以上的可植入型物品。2.可追溯：对影响灭菌过程和结果的关键要素进行记录，保存备查，实现可追踪Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline二.骨科植入物分类：人工关节膝关节、全髋关节、股骨头,主要用于老年人退行性关节炎、股骨颈骨折、股骨头坏死等疾病的关节置换；Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline二.骨科植入物分类：骨折固定器材：有不锈钢和钛合金的髓内针、接骨板、椎弓根固定系统、记忆合金环抱器、同种异体骨和脊柱固定系统、外固定支架、髌骨爪等；Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline骨折固定器材：Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline骨折固定器材：Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline骨折固定器材：Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline三.外来器械及植入物术前安全管理（一）.外来器械的管理要求：1.外来器械应在手术前24小时由器械供应商交消毒供应中心回收清洗间，由消毒中心当班人员负责清点，双方在清单上签名完成本包器械完整性的确认。2.外来器械供应商必须提供合格、无锈、无蚀、性能正常的器械，对需要特殊清洗及灭菌的器械必须在清洗前与消毒供应中心接收的当班工作人员予以明确交代，否则引起的一切后果由器械商自行负责。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline三.外来器械及植入物术前安全管理Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline三.外来器械及植入物术前安全管理（二）.跟台人员的要求：1.外来器械公司首先应该对跟台人员进行专业培训，以掌握器械的基本性能和操作方法，并由医务部签发“跟台证明”2.跟台人员进入手术室必须遵守手术室有关规章制度，了解手术室的基本结构、布局、流程，严格遵守无菌技术操作。3.未经消毒的包和箱等物品一律不得进入手术间，应按照要求存放在指定位置。4.跟台人员一律不得违反医院的一切规章制度，如有违反，手术室有权拒绝其进入手术室。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline三.外来器械及植入物术前安全管理（三）.植入物术前注意事项：术前医师根据手术所需通知供应商备齐手术科室所需的各种规格型号植入物材料，填好联系单送至物质管理部门，由专业管理人员逐项验收生产批号、产品有效期、注册号等并登记好术前联系单。验收完毕交由供应商送至手术室验收打包消毒。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline四、外来器械及植入物术中安全管理1.外来器械的使用外来手术器械包在使用时，必须经巡回护士检查、核对、开启后传递至器械台上。巡回护士应扫描外来手术器械包的条形码编号，并将条形码粘贴在手术护理记录单上背面。同时在植入物登记表上记录器械的名称、规格、数量、厂家等信息，随病历保存以便追溯，从而完整的记录外来器械的使用过程。巡回护士对一次性使用无菌手术器械进行验收，查看包装是否完整，有无中文标识，是否在灭菌有效期内，符合要求者方可提供给手术医师。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline四、外来器械及植入物术中安全管理2.植入物的危险因素微生物容易繁殖只要很少的细菌就能感染抗菌素不容易杀灭微生物微生物得以定植生物膜形成Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,combinedwiththefiveregulationsandfivenewrequirementsofstate-ownedEnterpriseleaders'integrityandself-discipline四、外来器械及植入物术中安全管理3.植入物使用中应注意的问题（1）.植入物应接近使用时开启，开启后尽可能减少不必要的接触，取用安装植入物前，用无菌盐水洗涤手套上的血迹，手术野加铺无菌巾。（2）.金属植入物包装时，应使用器械盒独立包装，避免与器械之间碰撞，造成金属表面的磨损。（3）.可吸收植入物，每个包装只可以一次使用，包括未用或剩余部分，不可再包装使用。Accordingtotheassessmentrequirementsofpartyconductandcleangovernment,c