失效模式及效应分析在控制ICU呼吸机相关性肺炎中的应用  

Application of FMEA in controlling ventilator-associated pneumonia in ICU

作　　者：冯雁[1] 姚小红[2] 周朝阳[3] 

机构地区：[1]长沙市中心医院护理部,湖南长沙410004 [2]长沙市中心医院院感科,湖南长沙410004 [3]长沙市中心医院ICU,湖南长沙410004

出　　处：《中华医院感染学杂志》2011年第3期448-450,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨使用失效模式和效应分析(FMEA)方法对减少ICU呼吸机相关性肺炎(VAP)发生的作用。方法将2008年入住ICU患者设为对照组,仅落实医院相关医院感染制度防范VAP发生,2009年入住ICU患者设为试验组,将失效原因列为医院感染的高风险因子,分別是呼吸机管理及应用、吸痰操作规范程度、手卫生落实、病房管理与病床周转率等,针对每一项风险进行FMEA管理,于2009年1月开始实施。结果 2008年VAP发生率为40.12%,2009年的VAP发生率为19.27%,两年比较差异有统计学意义(P<0.01),2009年每季度VAP发生率呈下降趋势,发生率最低为第四季度,仅为8.69%。结论 ICU应用FMEA能有效控制VAP发生。OBJECTIVE To explore the application of reducing ventilator-associated pneumonia in ICU,based on the method of using Failure Mode and Effect Analysis（FMEA）.METHODS The patients entered ICU in 2008 as the control group,only implement regulations of the hospital infection and prevent occurring of ventilator-associated pneumonia.Set patients entered ICU in 2009 as the experimental group,the failure causes of following items were considered as the high-risk factors of resulting in hospital infection,including the management and application of breathing machine,the degree of specifications in suction operating,the implementation of hand hygiene,the ward management and bed turnover rate.FMEA risk management had been adopted for each one as above from January 2009.RESULTS The incidence rate of ventilator-associated pneumonia in 2008 was 40.12%,Relatively,it was 19.27% occurred in 2009,and the difference was statistically significant（P0.05）.Each quarter of 2009,the incidence of ventilator-associated pneumonia was in a downward trend,the lowest rate was only 8.69% occurred in the fourth quarter.CONCLUSION Ventilator-associated pneumonia in ICU can be controlled effectively by using of FMEA.

关 键 词：失效模式和效应分析 重症监护 呼吸机相关性肺炎 管理 

分 类 号：R181.32[医药卫生—流行病学]