ObjectiveThis study aimed to develop and implement a safety chain management system for the Central Sterile Supply Department (CSSD) based on the Swiss Cheese Model.MethodsBased on literature analysis and case studies, a safety chain management system was developed by integrating the multi-layer defense concept of the Swiss Cheese Model into CSSD management. The system encompassed ten key components related to processes, equipment, personnel, and supervision. To evaluate its effectiveness, comparisons were made before and after the intervention in terms of instrument cleaning efficacy, standardized acceptance rate of high-risk instruments, sterilization qualification rate, and adverse event reporting rate.ResultsFollowing the intervention, the qualified rate of instrument cleaning increased from 99.74% to 99.94% (P<0.001), the standardized acceptance rate of high-risk instruments rose from 99.6% to 99.81% (P<0.001), and the sterilization qualification rate improved from 99.56% to 99.90%. Notably, the number of sterilization process interruptions caused by incomplete instrument drying decreased from 4 to 1, positive biological monitoring results declined from 2 to 1, wet packages were reduced by 2 cases, and cycle interruptions due to equipment failure decreased by 3. In addition, the adverse event reporting rate increased markedly from 24.49% to 75.00% (P<0.001).ConclusionThe proposed safety chain management system effectively reduces the risk of healthcare-associated infections and improves the quality of instrument reprocessing in the CSSD. It also offers a novel theoretical framework and practical guidance for advancing safety management practices in the CSSD.
Che et al. (Mon,) studied this question.