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1、American Society for Healthcare Central Service Professionals of the American Hospital Association 美国医院联合会医疗中心服务专业美国协会 Training Manual for Health Care Central Service Technicians 医疗中央服务技术员培训手册Training Manual for Health Care Central Service Technicians 医疗中央服务技术员培训手册3THE CENTRAL SERVICE DEPARTMENT (CS
2、D) is the department within a health care facility in which medical/surgical supplies and equipment, both sterile and nonsterile，are cleaned，prepared，processed，sterilized，stored，and issued for patient care 中央服务部门(CSD)是对医疗/手术用品及设备（无菌及有菌的）进行清洁、准备、加工、灭菌、贮藏并分发到 病人护理使用的一个机构。 Until the 1940s，medical/surgi
3、cal supplies were, for the most part，processed and maintained in the departments and patient care areas in which they were to be usedUnder this system，there was considerable duplication of effort and equipment，and it was difficult to maintain consistently high standards of sterilization technique an
4、d product quality through out the health care facility. Sterilization processing was “everybodys business but no ones responsibility”(Perkins，1983) 直到 20 世纪 40 年代，大多数情况下都是在使用医疗/手术用品的各部门和病人护理区域对其进行处理和维护。 在这一体制下，要进行大量重复工作，也需要多个设备，而且很难在整个医疗机构一直维持灭菌技术和产品质 量的高标准。灭菌处理是“每个人的事，但无人负责”( Perkins，1983)。 As the
5、number and variety of surgical procedures grew and the types of medical devices，equipment，and supplies proliferated，it became apparent that centralized processing was needed for efficiency, economy, and patient safetyThe work of scientists W.B. Underwood and John JPerkins was instrumental in encoura
6、ging health care facilities to establish a separate and distinct department，the central service department，with specialized expertise and direct responsibility for providing clean and sterile medicalsurgical supplies and equipment to patient care areas 由于手术操作、医疗设备数量和类型的增长，设备和用品激增，出于对效率、经济及病人安全的考虑，显然
7、需 要进行集中处理。科学家 W.B. Underwood 和 John JPerkins 的工作有助于鼓励医疗机构建立独立的、独特的 不同部门中央服务部，具备专门的技术，直接负责向病人护理区域提供清洁的和无菌的医疗/手术用品。This chapter provides an overview of the organizational structure，objectives，and functions of the CSD and an introduction to the responsibilities of CSD technicians 本章概述了 CSD 的组织结构、目标及职能，
8、介绍了 CSD 技术员的责任。 Organizational Structure 组织结构组织结构 The health care field of sterile processing and distribution has commonly been known as either central service or central supply, although neither of these names accurately reflects the functions or duties of the people who work in this field. A numb
9、er of other names are also used to refer to the department that performs these functions. Among these names are central processing，central sterile, supply processing and distribution，and sterile processing and distributionWhatever the department is called，the functions performed by the staff include
10、 the following：(1) cleaning, decontamination，processing(inspection，assembling, and packaging)，and 无菌处理和分配医疗领域已经普遍被称为中央服务或中央供应，虽然这些名字未能准确反映这一领域工作人的 功能和职责。一些其他名字也用来指称履行这些职能的部门。如中央处理、中央消毒、用品加工和分配、无菌 加工和分配。无论部门的名字是什么，其人员的职能包括：(1)清洁、净化、加工（检查、装配及包装） ，以及4sterilization of reusable patient care supplies and
11、equipment, and (2) distribution of these supplies and equipment to the units that use them. 可重复使用病人护理用品及设备的消毒； (2)将这些物资和设备分配到其使用单位。 Other logistical services may also be part of the CSD, such as mailroom, linen, and patient transport. Regardless of how the department is structured, any or all of the
12、se functions may be included in the services provided. Some of these functions may be performed by other departments. 其他后勤服务也可成为 CSD 的一部分，如收发室、织物、病人运输。无论部门如何构成，所提供的服务中都可 能包括全部或部分这些功能。其中一些可能由其他部门承担。 Not only are the functions performed by the central service department different from one health care
13、facility to another, but the organizational reporting structure varies also. For example, in many facilities the CSD reports to materials management, in others it reports to surgery, and in still others, to fiscal services, nursing, pharmacy, infection control, or administration. Some facilities hav
14、e the cleaning, decontamination, processing, and sterilization functions report to one department and distribution to another department. 对不同医疗机构而言，不仅是中央服务部的职能不同，而且组织的汇报结构也不同。例如,许多机构中 CSD 向 物料管理部门报告，而有些机构向外科报告，还有一些向财务服务、护理、药房、感染控制或行政部门报告。 某些机构向一个部门报告有关清洁、消毒、加工及灭菌职能，而向另一部门报告有关分配的功能。 Every health care
15、 facility is organized into divisions and departments, each with a defined scope of activities and an organizational structure of its own. Managers are placed in charge of each of the departments, and their authority relationships are defined. Figure 1.1 shows one type of organizational structure fo
16、r a health care facility. Figure 1.2 shows an example of an organizational structure for a large CSD. 每个医疗机构都由区域和部门组成，每个区域和部门都有明确的活动范围和自身的组织结构。管理者负责各个 部门，其权力关系是规定好的。 图 1.1 显示了一种医疗机构的组织结构。图 1.2 展现了一个大型 CSD 的组织结 构的示例。 Objectives and Functions 目标及功能目标及功能 In general, central service provides the health care facility with services in the areas of supply processing and distribution. The distribution area is responsible for the delivery of supplies to designate
