基于危害分析与关键控制点体系的消化内镜病理标本管理模式研究
Research on the Management Model of Digestive Endoscopic Pathological Specimens Based on Hazard Analysis and Critical Control Point System

目的：本研究基于危害分析与关键控制点(HACCP)理论，探讨消化内镜病理标本管理模式。方法：采用非同期前后对照设计，选取2019年11月~2020年3月7315例消化内镜病理标本作为对照组，采用常规病理标本管理；另选取2020年4月~2020年8月7839份镜病理标本作为观察组，采用HACCP管理方法，包括潜在危害分析、确定关键控制点、确定关键限值、建立监控程序、纠偏行动、自我验证和记录程序。比较两组内镜病理标本不合格发生率、内镜室与病理科医护人员对内镜病理标本管理的满意度。结果：观察组内镜病理标本不合格发生率低于对照组，差异有统计学意义(P < 0.05)；内镜室及病理科医护人员对观察组的内镜病理标本管理满意度高于对照组，差异有统计学意义(P < 0.05)。结论：基于HACCP管理模式，通过将预防和控制重点前移，实现内镜病理标本精准高效管理，能有效降低内镜病理标本不合格率，提高内镜病理标本管理医护人员满意度。
Objective: This study is based on the Hazard Analysis and Critical Control Points (HACCP) theory to explore the management mode of digestive endoscopy pathological specimens. Method: A non synchronous pre-and-post control design was adopted, and 7315 digestive endoscopy pathological specimens from November 2019 to March 2020 were selected as the control group. Routine pathological specimen management was used; In addition, 7839 pathological specimens from April 2020 to August 2020 were selected as the observation group, and the HACCP management method was adopted, including potential hazard analysis, determination of key control points, determination of critical limits, establishment of monitoring procedures, corrective actions, self verification, and recording procedures. Compare the incidence of unqualified endoscopic pathological specimens and the satisfaction of medical staff in the endoscopic room and pathology department with the management of endoscopic pathological specimens between the two groups. Result: The incidence of unqualified endoscopic pathological specimens in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05); The satisfaction level of endoscopic pathology specimen management among medical staff in the endoscopy room and the pathology department was higher in the observation group than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: Based on the HACCP management model, by shifting the focus of prevention and control forward, precise and efficient management of endoscopic pathological specimens can be achieved, which can effectively reduce the unqualified rate of endoscopic pathological specimens and improve the satisfaction of medical staff in endoscopic pathological specimen management.