失效模式与效应分析在消毒供应中心骨科外来器械清洗质量管理中的应用  

Application of failure mode and effect analysis in quality management of external instrument cleaning in orthopedics of central sterile supply department

作　　者：赵继春[1] ZHAO Ji-chun

机构地区：[1]广西河池市人民医院消毒供应中心,河池市547000

出　　处：《护理实践与研究》2018年第18期128-130,共3页Nursing Practice and Research

摘　　要：目的探讨失效模式与效应分析(FMEA)在消毒供应中心骨科外来器械清洗质量管理中的应用效果。方法 2017年7～12月我院消毒供应中心应用FMEA理论对骨科外来器械清洗过程中可能存在的失效模式进行风险分析,计算优先风险数值(RPN),对高RPN值的失效模式分析其影响成因,同时优化重塑清洗流程,制定改进措施,观察比较FMEA管理前后各高风险失效模式的RPN值变化及器械清洗合格率。结果器械清洗不彻底、手工刷洗不到位、未按清洗流程操作、器械丢失或损坏是骨科外来器械清洗过程中的高风险失效模式。实施FMEA管理后,各高风险失效模式的RPN得分均低于管理前,管理后器械清洗合格率高于管理前,差异均有统计学意义(P <0. 05)。结论消毒供应中心在骨科外来器械清洗过程中应用FMEA进行管理,并采取相应措施干预,能提高骨科外来器械的清洗质量。Objective Objective：To explore the application effect of failure mode and effect analysis（FMEA）in quality management of external instrument cleaning in orthopedics of central sterile supply department. Methods To analyze the risks of possible failure modes during process of orthopedic external instrument cleaning by applying FMEA theory in our hospital＇s central sterile supply department from July 2017 to December 2017. The risk priority number（RPN）was calculated and the causes of the failure modes with high RPN were analyzed. Meanwhile, remodeling cleaning process in the department was optimized and the improvement measures were developed. Before and after the application of FMEA management, RPN value change of each high-risk failure mode and the instrument cleaning pass rates were observed and compared. Results Incomplete cleaning of the instrument, unqualified manual brushing, failure to follow the cleaning process, as well as loss or damage of the instrument are the high-risk failure modes in the cleaning process of orthopedic external instruments. After the implementation of FMEA management, the RPN scores of each high-risk failure mode were lower than those before the management, and the qualified rate of instrument cleaning was higher than that before the management. The difference was statistically significant（ P 〈0.05）. Conclusion Applying FMEA for management in the external instrument cleaning process of orthopedics in central sterile supply department and taking corresponding measures to intervene can improve the cleaning quality of orthopedic external instruments.

关 键 词：失效模式与效应分析 消毒供应中心 骨科 外来器械 清洗质量 

分 类 号：R472.1[医药卫生—护理学]