基于FMEA的外科医师、手术室护士和麻醉师劳动强度影响因素分析  

Analysis of influencing factors of labor intensity among surgeons,operating room nurses and anesthesiologists based on FMEA

作　　者：张海悦 马尚寅 高关心 苑艺 李媛媛 刘嘉吉 ZHANG Hai-yue;MA Shang-yin;GAO Guan-xin;YUAN Yi;LI Yuan-yuan;LIU Jia-ji(Department of Quality Management,Inner Mongolia People's Hospital,Hohhot Inner Mongolia,010017,China)

机构地区：[1]内蒙古自治区人民医院质量管理处,内蒙古呼和浩特010017

出　　处：《职业与健康》2020年第8期1014-1017,1021,共5页Occupation and Health

基　　金：内蒙古自治区自然科学基金项目(2017MS0710);内蒙古自治区人民医院院内基金项目(2016005)。

摘　　要：目的了解外科医师、手术室护士和麻醉师的劳动强度影响因素,针对外科医师、手术室护士和麻醉师管理提出改进建议,以有效降低人员劳动强度。方法2018年11-12月,选择内蒙古自治区2家大型三级甲等综合医院的外科医师、手术室护士和麻醉师为调查对象,运用失效模式和效应分析法(FMEA)及Kruskal-Wallis H检验,对比分析外科医师、手术室护士和麻醉师的劳动强度影响因素。结果外科医师、手术室护士和麻醉师3类人群对临时安排手术、突发急诊手术和手术室因素导致开台延迟等诸多因素导致的劳动强度的感知,差异均有统计学意义(均P<0.05)。外科医师的劳动强度主要来自于急诊手术[风险优先指数(RPN)的M(P25,P75)为315.0(150.0,448.0)]、突然增加的手术工作量[RPN=240.0(126.0,400.0)]。手术室护士的劳动强度主要来自于原有的工作计划被打乱[RPN=280.0(213.0,360.0)]及工作带来的疲惫感[RPN=224.0(128.0,384.0)]。手术室麻醉师的劳动强度主要来自于突发紧急工作[RPN=210.0(148.5,327.0)]与缺乏足够的休息[RPN=216.0(117.0,336.0)]。结论应提升外科医师与麻醉师急诊急救能力,建立手术室护士连续性排班模式与层级管理机制,加强人员执业安全保障。Objective To understand the influencing factors of labor intensity of surgeons,operating room nurses and anesthesiologists,and to put forward improvement suggestions for the management of surgeons,operating room nurses and anesthesiologists,so as to effectively reduce the labor intensity of personnel.Methods The surgeons,operating room nurses,and anesthesiologists from two large size tertiary comprehensive hospital in Inner Mongolia Autonomous Region were selected as investigators from November to December 2018,using Failure Mode and Effects Analysis(FMEA)and Kruskal-Wallis H test to analyze the influencing factors of labor intensity among surgeons,operating room nurses and anesthesiologists.Results The differences of perception of labor intensity caused by various factors such as temporary surgery,sudden emergency surgery,and operating room factors caused delays of surgeons,operating room nurses and anesthesiologists were statistically significant(all P<0.05).The labor intensity of surgeons mainly came from emergency surgery[RPN=315.0(150.0,448.0)]and the sudden increase in surgical workload[RPN=240.0(126.0,400.0)].The labor intensity of the operating room nurses mainly came from the disruption of the original work plan[RPN=280.0(213.0,360.0)]and fatigue caused by work[RPN=224.0(128.0,384.0)].The labor intensity of the anesthesiologists mainly came from the lack of enough rest[RPN=216.0(117.0,336.0)]and sudden emergency work[RPN=210.0(148.5,327.0)].Conclusion The emergency and first-aid capacity of surgeons and anesthesiologists should be improved,and the continuous scheduling mode and hierarchical management mechanism of operating room nurses should be established to improve the occupational safety of personnel.

关 键 词：失效模式和效应分析法 手术 劳动强度 影响因素 

分 类 号：R181.31[医药卫生—流行病学]