Surgical instrument packaging defects may affect the safety of medical care and patients and waste the hospital workforce, material resources, and financial resources. This study explored the application of healthcare failure mode and effect analysis in controlling surgical instrument packaging defects. We retrospectively evaluated the packaging process of 183,642 surgical instruments packaged in our hospital during January–June 2020 using the healthcare failure mode and effect analysis. Besides, we used a decision tree model to determine the steps requiring improvement and formulate the improvement measures. We applied the improvement measures to 190,231 surgical instrument packs packaged in our hospital during July–December 2020. Based on the healthcare failure mode and effect analysis, we compared the packaging defect rates before and after adopting the improvement measures. Of the 183,642 packs selected before adopting the improvement measures, 98 defects occurred, with a defect rate of 0.053%. However, of the 190,231 packs selected after adopting the improvement measures, 22 defects occurred, with a defect rate of 0.012%. The defect rate of surgical instrument packaging handled by the central sterile supply department staff was significantly reduced (χ² = 50.822, P = 0.001) after adopting the improvement measures. Using the medical failure mode and effect analysis method to control the defects in surgical instrument packaging can effectively reduce the packaging defect rate, ensuring patient safety.

Background and Objectives: Previous studies have shown that improving quality management in the central sterile supply department (CSSD) is an effective measure to control and decrease hospital-acquired infections. This study aimed to establish nursing-sensitive quality indicators for CSSD nursing in China. Methods: We drafted nursing-sensitive quality indicators on the basis of the Structure-Process-Outcome model, and then conducted 2 rounds of consultation with experts using a modified Delphi method to determine the indicators and scientific methods of measurement. Results: We identified five CSSD nursing-sensitive quality indicators. Recovery rates of the 2 rounds of valid questionnaires were 100%. Expert authority coefficients were 0.810 and 0.902, respectively. Kendall's coefficients of concordance were 0.168 and 0.210, respectively (P < .05). Conclusion: Evidence-based nursing-sensitive quality indicators for the CSSD were established.

Background: Wet pack after steam sterilization of medical devices in healthcare facilities are unacceptable. Purpose: To retrieve, evaluate and integrate the best evidence related to wet pack management. Methods: We searched the JBI, Up To Date, BMJ, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Cochrane library, PubMed, Guideline International Network (GIN), AORN Journal, and other databases using the pyramid “ 6S” model for guidelines, expert consensus, systematic reviews, evidence summaries, decisions, recommended practices, and technical reports on wet pack management. The period of the literature search is from the establishment of the database to January 2024. Two researchers evaluated the literature quality independently, and evidence was extracted from the literature that met the quality standards. AGREE II assessment system, Cochrane bias risk assessment, and JBI Evidence-Based Health care center authenticity assessment were used as the literature evaluation criteria and the JBI 2014 edition evidence pre-grading system for intervention studies. For all types of research, the literature quality and evidence level was evaluated, extracted, and summarized according to the theme. Results: Based on the inclusion criteria, seven pieces of literature were selected, including three guidelines, three randomized controlled trials, and consensus from an expert. Twenty pieces of evidence were obtained from seven different aspects: device packaging stage, loading stage, sterilization stage, unloading and cooling stage, distribution stage, wet package evaluation and analysis, and personnel training. Conclusion: This study summarizes the best evidence on wet pack management and can provide a reference for staff practices in disinfection supply centers to reduce the incidence of wet packs.

Purpose This study explores the application effects of medical failure mode and the analysis of device packaging quality defects. Methods In this study, a total of 183,642 equipment kits were assembled in our hospital from January to June 2020. Using medical failure mode and effect analysis methods, we retrospectively analyzed and evaluated the device packaging process. Besides, we used a decision tree model to determine the strategies that need to be acted upon and formulate improvement plans. We also selected a total of 1,90,231 assembly equipment packages in our hospital from July to December 2020, implemented the improved plan for packaging quality control, and compared medical failure modes, including the incidence of equipment packaging defects before and after the application of effective analysis. Results Before implementing medical failure mode and effect analysis, 1,83,642 equipment packages were assembled, 98 defects occurred, with a defect rate of 0.053%. However, after implementing medical failure mode and effect analysis to improve the packaging process, 1,90,231 device packages were assembled, 22 defects occurred, and the defect rate was 0.012%. The results showed that the packaging quality defects of the disinfection supply center were significantly reduced (χ²=50.822, P=0.001). Conclusion Using the medical failure mode and effect analysis method to control device packaging defects can effectively reduce the rate of device packaging quality defects, ensuring patient safety.

Background: Because of conflicts with work schedule of central sterile supply department (CSSD), surgical instruments might not be immediately cleaned or sterilized by CSSD staff members after use. If surgical instruments are not kept appropriately moist, tarnish or rusting may occur on the instruments, which will not only affect cleaning quality, but also shorten the normal service life of the instruments. Nurses’ perception towards their behaviours for keeping surgical instruments moist has been rarely studied. We aimed to use the health belief model to analyse nurses’ perception towards their behaviours for keeping surgical instruments moist. Methods: The survey utilising a general information questionnaire, and a self-designed nurses’ perception-behaviour scale for keeping surgical instruments moist was conducted with 360 nurses from the West China Second University Hospital, Sichuan University. Data was gathered with cluster sampling, and analysed in SPSS20.0. Results: Total score of nurses’ perception-behaviour scale for keeping surgical instruments moist was 139.93±15.145, among which mean score for perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and self-efficacy was 4.49±0.57, 4.62±0.48, 4.57±0.52, 3.47±0.94 and 4.16±0.66, respectively. Single factor analysis showed that score of nurses’ perception-behaviour scale for keeping surgical instruments moist varied with age, length of service and job title, with a statistically significant difference (P < 0.05). Multivariable linear regression analysis showed that length of service was the main factor affecting nurses’ perception towards their behaviours for keeping surgical instruments moist. Conclusion: Nurses should be offered intensive training on keeping surgical instruments moist due to their inadequate perception on it. However, an increase in knowledge does not necessarily bring behavior change. The nurses’ change in health beliefs and behaviours must be based upon developing the right attitude. As a result, they could realize the benefits of keeping surgical instruments moist, identify the barriers, and finally obtain the solutions.

Background Because of conflicts with work schedule of central sterile supply department (CSSD), surgical instruments might not be immediately cleaned or sterilized by CSSD staff members after use. If surgical instruments are not kept appropriately moist, tarnish or rusting may occur on the instruments, which will not only affect cleaning quality, but also shorten the normal service life of the instruments. Nurses’ perception towards their behaviours for keeping surgical instruments moist has been rarely studied. We aimed to use the health belief model to analyse nurses’ perception towards their behaviours for keeping surgical instruments moist. Methods The survey which utilised a questionnaire regarding respondent’s general information and a self-designed nurses’ perception-behaviour scale for keeping surgical instruments moist was conducted with 360 nurses from the West China Second University Hospital, Sichuan University. Data was gathered with cluster sampling, and analysed in SPSS20.0. T-test, variance analysis and multivariable linear regression analysis were performed. Results Total score of nurses’ perception-behaviour scale for keeping surgical instruments moist was 139.93 ± 15.145, among which mean score for perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and self-efficacy was 4.49 ± 0.57, 4.62 ± 0.48, 4.57 ± 0.52, 3.47 ± 0.94 and 4.16 ± 0.66, respectively. Single factor analysis showed that score of nurses’ perception-behaviour scale for keeping surgical instruments moist varied with age, length of service, and job title, with a statistically significant difference (P < 0.05). Multivariable linear regression analysis showed that length of service was the main factor affecting nurses’ perception towards their behaviours for keeping surgical instruments moist. Conclusion Nurses should be offered intensive training on keeping surgical instruments moist due to their inadequate perception on it. However, an increase in knowledge does not necessarily bring behavior change. The nurses’ change in health beliefs and behaviours must be based upon developing the right attitude. As a result, they could realise the benefits of keeping surgical instruments moist, identify the barriers, and finally obtain the solutions.