失效模式与效应分析在降低医院感染风险中的应用

来源 :中华劳动卫生职业病杂志 | 被引量 : 0次 | 上传用户:wudiscl
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目的:探讨失效模式与效应分析(FMEA)在医院感染管理中的应用效果,为有效预防和控制医院感染提供参考。方法:于2020年1月,运用FMEA进行医院感染风险识别、分析与评价,筛选出医院感染高风险事件,从中确定风险事件为手卫生依从性和血源性职业暴露2个院级优先级改进项目,进行风险控制与干预措施后,比较改进前后的效果。结果:除缺乏激励机制、医护团队间沟通不足等原因,FMEA实施前后的手卫生依从性和血源性职业暴露风险优先系数差异均有统计学意义(n P<0.05)。FMEA实施后手卫生依从性为74.92%(79 375/105 953),较FMEA实施前的68.40%(58 361/85 328)有明显提高,差异有统计学意义(χn 2=996.55,n P<0.01)。FMEA实施后血源性职业暴露发生率为3.85%(80/2 080),低于FMEA实施前的6.16%(123/1 998),差异有统计学意义(χn 2=11.49,n P<0.01)。n 结论:FMEA在医院感染管理中有良好的效果,可前瞻性识别和评估医院感染风险,从而对风险进行有效控制。“,”Objective:To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection.Methods:Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared.Results:Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant (n P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χn 2=996.55, n P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χn 2=11.49, n P<0.01) .n Conclusion:FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.
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