Experience sharing on constructing an emergency support management model for disinfection supply center manpower based on decision theory

Xianting Liu; Yan Yuan

doi:10.11910/j.issn.2791-2043.2023.2.06

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Experience sharing on constructing an emergency support management model for disinfection supply center manpower based on decision theory

MONOGRAPHIC STUDY | Updated：2023-07-14

- Experience sharing on constructing an emergency support management model for disinfection supply center manpower based on decision theory
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  Yichang Central People's Hospital, 443003, Yichang City, Hubei Province, China
  
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  Xianting Liu
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  Affiliation：
  Yichang Central People's Hospital, 443003, Yichang City, Hubei Province, China
  
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  Yan Yuan
  ,
- Sterile Supply Vol. 2, Issue 2, (2023)
- Affiliations：
  
  1.Yichang Central People's Hospital, 443003, Yichang City, Hubei Province, China
  2.Yichang Central People's Hospital, 443003, Yichang City, Hubei Province, China
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- DOI：10.11910/j.issn.2791-2043.2023.2.06
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Liu Xianting,Yuan Yan.Experience sharing on constructing an emergency support management model for disinfection supply center manpower based on decision theory[J].Sterile Supply,2023,02(02):95-102.
DOI：

Liu Xianting,Yuan Yan.Experience sharing on constructing an emergency support management model for disinfection supply center manpower based on decision theory[J].Sterile Supply,2023,02(02):95-102. DOI： 10.11910/j.issn.2791-2043.2023.2.06.

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Abstract

Objective

Based on decision theory, this study explores the management model of manpower support for independent disinfection supply centers in different hospital areas.

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Methods

In the event of a sudden shortage of manpower resources in Hospital A, the mode of deploying disinfection supply center staff from Hospital B to support Hospital A was implemented, adopting a multidisciplinary collaborative model to complete the job setting and management of the supported manpower resources, ensuring the normal operation of the disinfection supply center in Hospital A.

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Results

The disposal of reusable devices, equipment operation, and information traceability in Hospital B were all normal, and surgeries and clinical diagnosis and treatment were carried out as usual. The job setting of personnel was satisfactory.

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Conclusion

Based on decision theory, the management model of manpower support for independent disinfection supply centers in different hospital areas can ensure the timely and quality completion of the disposal of reusable devices, guarantee the supply of clinical frontlines, and reflect the emergency response capabilities of disinfection supply centers.

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Keywords

Decision theory; Disinfection supply center; Different hospital areas; Manpower support; Multidisciplinary collaboration

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The disinfection supply center is a key department for hospital infection management. This department is responsible for cleaning, disinfecting, and sterilizing reused devices, supplying safe and qualified sterile items and thus guaranteeing the medical safety of treatment and surgery. The reasonable allocated human resources and normal running of equipment is the basis for the operation of the disinfection supply center. Studies have found that there are some difficulties in human resource management in disinfection supply centers of Grade-A tertiary hospitals, such as insufficient staffing and inadequate staff structure^[

1-2]. In addition, unexpected emergencies, such as the COVID-19 pandemic, have resulted in that the independent hospital area’s disinfection supply center is locked into the “isolation”. In face of emergencies, hospitals need to have a multi-departmental approach in terms of personnel, funds, and supplies.

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Emergency management disposal should be a dynamic process that adapts to the situation, based on the features that emergencies themselves vary continually and are hard to foresee in advance^[

3-5]. This puts the management’s capacity to handle crises to the test. According to decision theory, decision-making is at the core of management and permeates the whole management process. Making decisions, or choosing what to do first and then how to execute it, is the initial stage in every organization. Its criteria are to substitute satisfactoriness for optimality^{[Reference 6-8

6-8]}. Decision theory can offer rational advice for handling crises. Crisis management may be more effectively organized using decision process theory, more effective using procedural and non-procedural principles, and more precise using the limited rationality and satisfaction of decision-making principles^{[Reference 9-10

9-10]}. Decision theory should thus be applied to help handle hospital emergencies.

译

The response to an unexpected big event in the disinfection supply center that left a significant shortfall in human resources to sustain the center’s regular operations is not well studied^[

5,11-12]. Therefore, the COVID pandemic led to a severe shortage of human resources in hospital area A’s disinfection supply center, which made it impossible for the facility to operate normally and prevented clinical care and surgery from being done. To create an emergency support management model for human resources in the disinfection supply center of various hospital locations, we explored and used new emergency management practices based on decision theory. The report is as follows.

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1 Construction of management model

1.1 Set up a model-building expert group

The expert group of model construction consists of ten staff, including the president in charge, director of the nursing department, hospital infection management section officer, staff of the information section, staff of the equipment department, manager of the general affairs department, head nurse of the disinfection supply center in hospital area A, head nurse of the disinfection supply center in hospital area B, and two backbones of the disinfection supply center in hospital area A. Among them, there are one chief physician, one chief nurse practitioner, two deputy chief nurse practitioners, and two nurse practitioners in charge. One is doctor, three are masters, and six are undergraduates.

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1.2 Construction of management model

In this study, the construction of the human resource emergency support management model for disinfection supply centers based on decision theory follows the four stages of the decision-making process (Figure 1). The multidisciplinary collaborative management implementation process is considered from the perspective of the construction of the human resource emergency support model for disinfection supply centers in various hospital areas. This process includes the establishment of a multidisciplinary collaborative human resource emergency management team, the unified deployment of human resources based on job requirements and professional competencies, the multi-departmental collaboration on the training of full-time and part-time staff in different positions, and the management of key quality aspects in four modules (Figure 2).

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Figure 1 Four stages of the decision-making process

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Figure 2 Emergency support model for human resources in disinfection supply centers in different hospital areas

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2 Application of management model

2.1 Data collection

2.1.1 Operation of disinfection supply center in hospital area A

(1) Human resources: during the COVID-19 pandemic from Nov. 2 to Nov. 6, 2022, the total number of beds in the establishment was 1800. The disinfection supply center had only three staff remaining, and the staff bed ratio was 2-3:100, which was seriously not in line with the standard. There were only two nurses and one assistant nurse remaining, and among the three staff members, there were no qualified sterilizers, no head nurse, or nurses in management positions. (2) Professional competency: all three staff members worked in the cleaning work area daily, and one assistant nurse was deployed to work in the clinical device packaging post. (3) The equipment and facilities of the disinfection supply center in hospital area A were intact, and the materials and consumables were sufficient.

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2.1.2 Operation of disinfection supply center in hospital area B

(1) The building layout, equipment and facilities, and human resources were in a fully saturated state corresponding to the workload. (2) To meet the new complex building’s operating room supply needs, B hospital area’s new disinfection supply center was being constructed, and the professional reserve of each specialized post was trained to provide support. (3) The equipment and facilities of the disinfection supply center in hospital area B were intact, and there were sufficient materials and consumables.

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2.2 Plan development

The dean in charge, the nursing department of hospital area A, and the head nurse of the disinfection supply center of hospital area B initially discussed and formulated a support plan. (1) The nursing department of hospital area A urgently deployed human resources throughout the hospital to recover reused devices to the disinfection supply center of hospital area B for cleaning, disinfection, packaging and sterilization disposal. (2) The nursing department of hospital area A urgently deployed human resources throughout the hospital to complete sorting, cleaning and disinfection packaging in the disinfection supply center of hospital area A and then transported the sterilization packages to the disinfection supply center of hospital area B for sterilization and disposal. (3) Deploy staff from the disinfection supply center in hospital area B to support the disposal of devices at the disinfection supply center in hospital area A. All processes were completed in hospital area A.

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2.3 Plan selection

It was decided to choose plan 3 to deploy staff from the disinfection supply center of hospital area B to support on-site device of hospital area A’s disinfection supply center for disposal and multidisciplinary collaboration. This was carried out in response to the aforementioned three plans and the staffing data gathered by the two hospital areas. (1) The hospital area B disinfection supply center’s building layout, equipment, and human resources corresponded to the workload in a completely saturated state, and they could not complete the entire process of disposal of large quantities of reused devices, and contaminated devices were easily spread during transportation, which was one of the reasons for rejecting plan 1. Besides, when there was heavy traffic, there was a concern that the demand for surgical equipment would not be satisfied. (2) Two arguments against plan 2. There were only three employees remaining in the hospital area, and none of them had any prior experience working in a decontamination environment. In addition, they were all undergoing on-the-job training for support personnel, which prevented them from categorizing, cleaning, and disinfecting tools and packaging.

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2.4 Implementation of the evaluation plan

2.4.1 Establish a multidisciplinary collaborative human resources emergency management team

2.4.1.1 Formation of a multidisciplinary collaborative management team A human resources emergency support management team for the disinfection supply center was established by the president in charge. It was composed of the nursing department, hospital infection control department, equipment department, information department, general affairs department in hospital area A, and nurse manager of disinfection supply center B.

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2.4.1.2 Division of responsibilities for multidisciplinary collaboration

(1) The president in charge took the lead in organizing a meeting of the human resources emergency management team of the disinfection supply center and resolved to deploy professional human resources in the disinfection supply center of hospital area B to support the disinfection supply center of hospital area A. (2) The nursing department of hospital area A conducted emergency human resources deployment in this hospital area to support the disinfection supply center, and coordinated to notify the clinical use of disposable sterile items to replace some of the reused sterile items. (3) The hospital infection management section of hospital area A instructed clinical departments qualified to dispose of medium to high-risk items to dispose of some of the reused sterile items themselves, and instructed clinical departments to cooperate with the disinfection supply center to transport and hand over reused devices, appliances and items at temporary centralized locations and times. (4) The equipment department of hospital area A deployed full-time personnel to the disinfection and supplied center to instruct support personnel to operate the equipment. (5) The information section of hospital area A deployed full-time personnel to the disinfection supply center to instruct the support personnel to use the traceability system of the disinfection supply center. (6) the general affairs department of hospital area A deployed part-time personnel to assist in the transportation of reused devices and logistical support. (7) The head nurse of the disinfection supply center in hospital area A formulated the temporary operation plan of the disinfection supply center; the head nurse of hospital area B deploys support staff on-site and manages key work sessions.

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2.4.2 Uniform deployment of human resources based on position requirements and competencies

2.4.2.1 Deploy professional and specialized staff of the disinfection supply center in hospital area B

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2.4.2.1.1 First phase

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The head nurse of hospital area B led the team and deployed two qualified sterilizers to operate the sterilization equipment on site under the supervision of the equipment department, operated the existing sterilization equipment effectively, and completed the entire process of device disposal if there was no sterilizer in hospital area A.

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2.4.2.1 2 Second phase

Deploy other 4 professional staff in hospital area B following the position requirements and the operation of the disinfection supply center of hospital area A. The positions were divided into three groups: two nurses with expertise in the lumpectomy device group, one person with expertise in foreign devices, and one person with expertise in the use of traceability systems and packaging of precision surgical devices.

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2.4.2.2 Deploy full-time and part-time personnel in hospital area A

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2.4.2.2.1 Deploy three full-time personnel in the disinfection supply center of hospital area A

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The head nurse of hospital area B set up and managed the positions according to the previous posting of the remaining three staff members in the disinfection supply center of hospital area A. The positions were set up as one person for clinical device inventory and retrospective system recovery and entry, one person to be responsible for and guide the support staff for clinical device packaging and distribution, and one person to be flexible and responsive to the needs of all support staff and to assist the head nurse of hospital area B in solving temporary work problems and difficulties.

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2.4.2.2 2 Deploy eleven full-time staff in other departments in hospital area A

The chief nurse of hospital area B assessed the professional competency of eleven full-time staff members deployed to support the whole hospital in hospital area A, combined with the job demand, and carried out the initial job setting. (1) Deploy seven staff members for the operating room. The positions were set up for one person mainly responsible for sorting and counting surgical devices, two persons to receive and deliver surgical devices and assist in manual cleaning of devices, one person to assist in manual cleaning and machine washing of surgical devices on the shelves, two persons to assist in cleaning and packaging of endoscopic devices, and one person to assist in the packaging of surgical devices. (2) Deploy one person from the former disinfection supply center in hospital area A to assist in packing clinical devices. (3) Deploy two clinical nurses to assist in the packaging of clinical devices. (4) Deploy one intern nurse who had interned in the disinfection supply center in hospital area A to assist in clinical device packaging.

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2.4.2.2 3 Deploy five part-time staff in other departments in hospital area A

the general affairs department deployed five third-party laborers for part-time support. (1) Four part-time laborers to receive and deliver clinical reuse devices, and the chief nurse of hospital area A to develop a schedule for receiving and delivering under each building and a fixed device handover location. (2) One clinical cleaning staff per part-time job to complete the cleaning work in the public area of the disinfection supply center in hospital area A.

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2.4.3 Train for full-time and part-time support staff by position

2.4.3.1 Six professional staff from hospital area B and three professional staff from hospital area A were responsible for the temporary training for the supporting personnel deployed from hospital area A while completing their duties. (1) The training was primarily responsible for and aided with the job obligations of the role, clear working hours, locations, and work assignments, according to the uniform deployment structure of the support staff. (2) Responsible for training workflow, including operating the traceability system, printing out-of-package identification, monitoring and registering. Responsible for the decontamination area instrument hand washing machine washing process, including checking and packaging sterilization area instrument inspection and maintenance, and packaging. Train other dispatchers on operating equipment under the guidance of the equipment department and the nurses in the A hospital area.

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2.4.4 Collaborate with functional departments

The information department and equipment department of hospital area A deployed full-time staff to the disinfection supply center. They instructed the support staff of hospital area B to operate the traceability system and equipment, and then taught to use the traceability system and equipment when training the support staff.

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2.4.5 Key quality threshold management

2.4.5.1 Establish temporary liaison and communication mechanism with clinical departments. (1) Clinical departments classified and sealed contaminated reused devices, and placed a list inside the container, which indicated the name, quantity, contact person and contact information of the device package and the department outside the container. (2) Hand over contaminated devices and receive sterile items at a fixed time and place. (3) In special cases, clinical departments delivered reused contaminated items to the disinfection supply center and picked them up on their own, and processed them centralizedly as much as possible to reduce unnecessary circulation.

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2.4.5.2 Supervise the implementation of personal protection in the decontamination area and daily cleaning and disinfection of the environment. (1) Professional personnel in hospital area B provided on-site guidance to support personnel in other departments in hospital area A on the personal dress code requirements for the decontamination area, demonstrated the operation on site, and checked whether the actual dressing and removal process were performed correctly. (2) Personnel in fixed positions implemented environmental object table cleaning and disinfection and register all items.

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2.4.5.3 Strictly check the quality of cleaning, dryness and functional inspection of devices on the packaging table. Three staff members from hospital area A stayed on site to supervise and check the support staff of other departments in hospital area A in batches, supervising and urging the packaging support staff to strictly implement the inspection and maintenance process of devices using the teaching of cleaning quality of non-standard devices on site so as to ensure the quality of cleaning, dryness and functional qualification of devices.

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2.4.5.4 Track and register daily cleaning, disinfection, and sterilization monitoring. The head nurse of hospital area B tracked the operation of cleaning and disinfection machines, and supervised the implementation of chemical disinfectant testing and registration, as well as all sterilization-related monitoring and records.

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3 Results

3.1 Statistics on the average daily surgical volume and human resources deployment in hospital area A

From November 2 to 6, 2022, the average daily surgical number in hospital area A was 50, with no delay or cancellation of device processing and a 100% sterilization pass rate. The human resources were well deployed, with no objection and 100% obedience to the arrangement.

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3.2 Equipment operation statistics

Two automatic cleaning and disinfection machines, three pressure steam sterilizers, two low-temperature hydrogen peroxide gas plasma sterilizers, and one ethylene oxide sterilizer are all in normal operation. The traceability system of the disinfection supply center is in normal operation.

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3.3 Comparison of the evaluation of human resources emergency support capabilities

Table 3 displays the findings of the comparison of pre- and post-application emergency response times, emergency staffing scores, and emergency training coverage scores for the evaluation of human resources emergency support capabilities. When P<0.05, the difference is statistically significant

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Table 3 Comparison of evaluation of human resources emergency support capabilities

Indicators	Pre-application	Post-application	P value
Emergency response time (minutes)	8.0±0.03	8.5±0.12	<0.05
Emergency staffing score	7.5±0.12	8.0±0.15	<0.05
Emergency training coverage score	8.5±0.22	9.5±0.21	<0.05

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4 Discussion

4.1 Decision theory applied to the emergency management of hospital disinfection supply center

Decision theory has been widely applied and studied in various aspects of social and economic management, military decision-making, and emergency decision-making^[

13-16]. As a subsystem of management, it provides managers with a systematic approach to analyzing and solving problems. Its four steps not only provide a referable theoretical basis for managers or decision makers to respond to emergencies but also lay the foundation for a good ending of the emergency response to the massive lack of human resources in the disinfection supply center in this study.

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4.2 Feasible management model for manpower support of independent disinfection supply centers in different hospital areas

As the key reusable item supplier and hospital-acquired essential department, the disinfection supply center requires practitioners with a high degree of professional knowledge and competence. However, a variety of factors, including working experience, hospital level, surgical cases, and centralized administration, affect the staff competency of the disinfection supply center^[

9-10]. The employees at disinfection supply centers also have varying degrees of education, and the majority of them lack the basis of prior medical training, which makes it difficult to execute the operating procedures. Long-term performance assessment systems and tiered theoretical operational training are required to increase their work capability. Due to the irreplaceable nature of disinfection supply center staff, a management model of delivering professional staff support from disinfection supply centers to various hospital areas should be utilized to prevent the expense of challenging job training and interfering with clinical treatment and surgery that would be necessary due to a significant lack of human resources.

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4.3 Improving emergency plans helps to respond to public emergencies

To guarantee timely supply, sterilization, and sterilization quality, the hospital disinfection supply center devised a variety of organizational divisions of labor and disposal procedures for emergencies. This provided reliable and secure medical protection for the clinical front line. In this emergency, the head nurse of hospital area A quickly devised a temporary operation work arrangement plan for the disinfection supply center, including the formulation of the building’s downward collection and delivery time and the arrangement table of the fixed device handover point, and clarified the temporary operation issues that needed to be addressed in the clinical departments. To guarantee that each position’s professional levels were appropriate and that the workflow went well, the head nurse of hospital area B coordinated the on-site scheduling and organization of temporary operating staff positions in hospital area A. These steps can assure the efficient operation of the disinfection supply center, the ability to respond to emergencies promptly, the effectiveness of the sterilization and disinfection process, and the security and dependability of the clinical front line.

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4.4 Multi-departmental and multi-disciplinary collaboration model helps response to disinfection supply center emergencies

The solution to the issues faced in disinfection supply centers in emergency mode, such as personnel deployment, professional use of specialized equipment, and use of information systems, is collaborative interaction across many disciplines and departments. According to studies^[

17-19], the application of a multi-disciplinary team (MDT) management model can result in comprehensive, enlightening, and scientific management and control of surgical devices in hospital disinfection supply centers, improve the quality of the supply of surgical devices and the service quality of the supply center, and thereby increase the department’s satisfaction. The combination of the operating room, disinfection supply center, equipment department, infection management department, etc. can improve the management and disposal of foreign devices, improve the quality of foreign device handling, facilitate the security of surgery, and prevent hospital infection.

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5 Conclusion

This study discusses the construction and practice of the emergency support management model for human resources in disinfection supply centers. The study suggests measures such as rapid formulation of response plans based on decision theory, multidisciplinary collaboration, assessment of existing staff’s professional competencies for unified deployment, scientific job setting, and strengthening of key link management in response to the lack of human resources in disinfection supply centers during the COVID-19 pandemic. The supply availability was essentially guaranteed.

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However, there are some inadequacies and deficiencies in this study. Firstly, the depth and scope of the comparative analysis in this study are constrained by the paucity of reporting on the emergencies of human resource scarcity in disinfection supply centers domestically and internationally. Second, this study only focuses on the unexpected human resource shortage the hospital experienced at the first time in the disinfection supply center of one hospital area under the COVID-19 pandemic. Since there had never been a case like this one before the study, it could not be repeatedly optimized and improved. Future studies can improve data collection and comparative analysis of pertinent events, enhance cross-disciplinary multidisciplinary collaboration, improve the emergency management system of the disinfection supply center, and improve the effectiveness and level of emergency disposal to address these deficiencies.

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References

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ZHAN R W, SHEN Y H, YUAN P H, et al. Optimization and effect evaluation of effective communication process between disinfection supply center and operating room[J]. China Plant Eng, 2023(7): 9-12. [Baidu Scholar]

DAI H H, ZHAO D. Research progress of human resource management of disinfection supply center[J]. World Latest Med Inf, 2017, 17(A4): 12-13. [Baidu Scholar]

GAO Min, HUANG Hao, ZHU Hong, et al. The construction of human resource efficiency evaluation index system of central sterile supply department[J]. Journal of Nurses Training, 2021, 36(06): 540-4. [Baidu Scholar]

GAO Y H, GUO C X, SUN X Y, et al. Careful and detailed management of human resources in central sterilization supply department: application and discussion[J]. Chin J Nosocomiology, 2011, 21(17): 3675-3676. [Baidu Scholar]

JIANG Z H, QU X W, LI Z, et al. Research progress of shared decision theory in vascular access selection of hemodialysis patients[J]. Chin Gen Pract Nurs, 2022, 20(15): 2059-2063. [Baidu Scholar]

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LI Yitao. Analysis of fuzzy decision theory[J]. Artists of China, 2018, (01): 210-1. [Baidu Scholar]

ZHOU Hui. Meta-Decision Theory: New Trends in the Development of Decision Theory[J]. Pioneering with Science & Technology Monthly, 2018, 31(11): 137-40. [Baidu Scholar]

ZHOU X Q. Application of management decision theory in real life—simon decision theory[J]. West Leather, 2017, 39(4): 126. [Baidu Scholar]

GUO L. Analysis and countermeasures of difficulties in nursing management of central sterilization supply department[J]. China Pract Med, 2010, 5(17): 261-262.(in Chinese) [Baidu Scholar]

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摘要

Abstract

Objective,2,Based on decision theory, this study explores the management model of manpower support for independent disinfection supply centers in different hospital areas.,Methods,2,In the event of a sudden shortage of manpower resources in Hospital A, the mode of deploying disinfection supply center staff from Hospital B to support Hospital A was implemented, adopting a multidisciplinary collaborative model to complete the job setting and management of the supported manpower resources, ensuring the normal operation of the disinfection supply center in Hospital A.,Results,2,The disposal of reusable devices, equipment operation, and information traceability in Hospital B were all normal, and surgeries and clinical diagnosis and treatment were carried out as usual. The job setting of personnel was satisfactory.,Conclusion,2,Based on decision theory, the management model of manpower support for independent disinfection supply centers in different hospital areas can ensure the timely and quality completion of the disposal of reusable devices, guarantee the supply of clinical frontlines, and reflect the emergency response capabilities of disinfection supply centers.

关键词

Keywords

Decision theoryDisinfection supply centerDifferent hospital areasManpower supportMultidisciplinary collaboration

references

ZHAN R W, SHEN Y H, YUAN P H, et al. Optimization and effect evaluation of effective communication process between disinfection supply center and operating room[J]. China Plant Eng, 2023(7): 9-12.

DAI H H, ZHAO D. Research progress of human resource management of disinfection supply center[J]. World Latest Med Inf, 2017, 17(A4): 12-13.

GAO Min, HUANG Hao, ZHU Hong, et al. The construction of human resource efficiency evaluation index system of central sterile supply department[J]. Journal of Nurses Training, 2021, 36(06): 540-4.

JIANG Z H, QU X W, LI Z, et al. Research progress of shared decision theory in vascular access selection of hemodialysis patients[J]. Chin Gen Pract Nurs, 2022, 20(15): 2059-2063.

Theory of decision making[J]. Management Observer, 2019, (36): 186.

LI Yitao. Analysis of fuzzy decision theory[J]. Artists of China, 2018, (01): 210-1.

ZHOU Hui. Meta-Decision Theory: New Trends in the Development of Decision Theory[J]. Pioneering with Science & Technology Monthly, 2018, 31(11): 137-40.

ZHOU X Q. Application of management decision theory in real life—simon decision theory[J]. West Leather, 2017, 39(4): 126.

GUO L. Analysis and countermeasures of difficulties in nursing management of central sterilization supply department[J]. China Pract Med, 2010, 5(17): 261-262.(in Chinese)

LAN L H. Human resource management of disinfection supply center in grass-roots hospitals under the new situation[J]. Chin Gen Pract Nurs, 2013, 11(10): 928-929.

LI M Y, REN J Y. Research on influencing factors of college students’ willingness to work and start a business in rural areas based on behavior decision theory[J]. Employ Guarant, 2023(1): 139-141.

TAN B J. The enlightenment of Simon’s decision theory on college students’ entrepreneurship[J]. J Qiqihar Ju Teach Coll, 2016(3): 96-97.

WANG Hang. The enlightenment of Simon’s decision theory on government crisis management[J]. Journal of Jiamusi Vocational Institute, 2017, (02): 456.

WANG Z L, WANG Y W, JIANG Y, et al. An improved signal modulation identification algorithm based on decision theory[J]. Radio Eng, 2014, 44(5): 30-33.

YAN Y P. Study on the intervention of detail management mode on the quality of infection control in disinfection supply center[J]. Heath EVERYONE, 2023(4): 111-113.

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