失效模式与效应分析在眼科手术术前消毒流程中的应用  

Application of Failure Mode and Effect Analysis in the Disinfection Process before Ophthalmic Surgery

作　　者：归纯漪 席淑新 华玮 

机构地区：[1]复旦大学附属眼耳鼻喉科医院护理部,上海200031

出　　处：《解放军护理杂志》2017年第21期53-57,共5页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨失效模式与效应分析(failure mode and effects analysis,FMEA)在眼科手术术前消毒流程中的应用效果。方法便利抽样法选取2016年3-4月在复旦大学附属眼耳鼻喉科医院住院眼科手术患者299例为对照组,采用传统的眼科手术术前消毒流程,并采用FMEA对眼科手术术前消毒流程进行分析,查找每个环节中可能存在的风险;针对用物准备、操作者准备、消毒方法等关键环节实施改革。便利抽样法选择2016年7-8月的住院眼科手术患者303例为观察组,根据FMEA特定流程组织实施改良后的眼科手术术前消毒流程。比较两组患者手术术前消毒流程危险系数(risk priority number,RPN)、术后感染发生率、消毒操作前消毒者手卫生执行合格率、手培养合格率等。结果眼科手术术前消毒流程RPN由改进前的1895降至342,但术后感染发生率的差异无统计学意义(P>0.05);观察组消毒操作前消毒者手卫生执行合格率、手培养合格率显著提高,与对照组相比,差异均有统计学意义(均P<0.01)。结论运用FMEA对眼科手术术前消毒流程进行风险管理,有助于规范相关工作流程,降低术后感染发生可能风险,有利于眼科手术工作质量的持续改进。Objective To discuss the application effect of failure mode and effect analysis （FEMA） in the disinfection process before ophthalmic surgery.Methods By convenience sampling, 299 cases from March to April 2016 were selected as control group and received failure mode and effect analysis （FMEA） to ana- lyze the preoperative disinfection process of ophthalmic surgery to find out the possible risks in each link, especially on the key links such as the preparation of the objects, the preparation of the operator and the method of disinfection. The other 303 cases from July to August 2016 were selected as observation group. The risk priority number （RPN）, postoperative infection rate, hand hygiene execution pass rate of the oper- ator and the qualified rate of hand hygiene were compared.Results The RPN of the disinfection process before ophthalmic surgery was reduced from 1895 before improvement to 342, and the incidence of postop- erative infection showed no difference （P^0.05）. The hand hygiene execution pass rate of the operator and the qualified rate of hand hygiene was significantly improved in observation group （all P ~0.01）. Conclu- sion The use of FMEA in the preoperative disinfection process of ophthalmic surgery risk management which helps to regulate the relevant work processes can reduce the risk of postoperative infection. It is con- ducive to continuous improvement of eye surgery quality.

关 键 词：失效模式与效应分析 眼科 手术消毒 护理风险 护理管理 

分 类 号：R197.323[医药卫生—卫生事业管理]