FMEA模式预测风险度及预防ICU导管相关性血源感染的临床研究  

Clinical significance of FMEA model in the prevention of ICU catheter related blood source infection

作　　者：王海艳[1] 孙光英 陈熙[1] Wang Hai-yan;Sun Guang-ying;Chen Xi(Department of Infection,Infectious Disease Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院感染性疾病中心感染科

出　　处：《湖南师范大学学报（医学版）》2019年第5期54-58,共5页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨FMEA模式在预防ICU导管相关性血源感染(CRBSI)中的临床意义.方法:本研究采用回顾性临床研究方法,2014年7月~2014年12月ICU收入的85例符合静脉置管要求的患者设为对照组;将2015年1月~2015年6月ICU收入的85例符合静脉置管要求的患者设为观察组.对照组中心静脉置管后给予常规PDCA模式管理,观察组在此基础上实施防控CRBSI的失效模式与绩效分析管理(FMEA)风险防范管理.将对照组CRBSI失效模式调查结果的RPN分数进行排序,统计RPN分值位于前十位的失效模式.参考RPN分数统计结果在观察组预防CRBSI方面采取相应的改善措施,比较改善前后的执行率.统计CRBSI感染率.结果:通过统计对照组RPN分值前十位的失效模式,对相应管理措施提出明显改善.经统计,观察组对相关管理措施执行率方面明显优于对照组,CRBSI感染率明显低于对照组(1.18% vs 9.14%).结论:FMEA作为成熟的风险管理工具,为ICU中心静脉置管患者CRBSI的合理防治提供了科学而有效的保障,可以作为临床防治CIBSI的策略和管理方法.Objective To explore the clinical significance of FMEA model in the prevention of ICU catheter related blood source infection(CRBSI). Methods In this study, a retrospective clinical study was conducted, and 85 patients with ICU income from July 2014 to December 2014 were set as control group. The 85 patients who met the requirements of ICU from January 2015 to June 2015 were set up as observation group. In the control group, the central venous catheter was administered to the conventional PDCA model, and the observation group implemented the failure mode of CRBSI and the Failure Mode and Effect Analysis(FMEA). The RPN scores of the control group CRBSI failure mode were sorted. Statistical RPN is located in the top 10 failure mode. The statistical results of RPN scores were used to prevent CRBSI in the observation group, and corresponding improvement measures were taken to compare the implementation rate before and after the improvement. Statistics of CRBSI infection rate. Results The failure mode of the top ten of RPN in the control group was analyzed, and the corresponding management measures were improved obviously. Statistically, the observation group was significantly superior to the control group in the implementation rate of related management measures, and the CRBSI infection rate was significantly lower than the control group(1.18% vs.9.14%). Conclusion As a mature risk management tool, FMEA provides a scientific and effective guarantee for the rational prevention and control of CRBSI in ICU central venous catheter patients, and can be used as a strategy and management method for clinical prevention and control of CIBSI.

关 键 词：经外周静脉置入中心静脉导管 风险管理 失效模式与绩效分析管理 导管相关性血流感染 

分 类 号：R473.6[医药卫生—护理学]