FMEA模式在综合医院流感流行季院感风险防控中的应用  

An application of fmea model in nosocomial infection prevention during seasonal influenza epidemic

作　　者：王颖[1] 怀晴雨 邓茜月 应娇茜[1] WANG Ying;HUAI Qingyu;DENG Qianyue;YING Jiaoqian(China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院,北京100029 [2]北京中医药大学管理学院,北京100029

出　　处：《现代医院》2022年第1期147-151,共5页Modern Hospitals

摘　　要：目的 探讨在流感流行季期间,失效模式与效应分析(FMEA)在综合医院风险防控中的应用效果。方法采取回顾性干预对照研究,于2017/2018年度按照FMEA的步骤和方法对我院流感风险进行评估和应对,组建多学科团队,建立了包括人、机、料、法、环五个风险点的FMEA模式,发现三个可能的失效点:环、人和法,其RPN值分别为27分、18分和12分,并据此制定了相应的应急方案,根据实际情况加以落实。分析和比较干预前后流感流行季不良事件的发生情况等。结果 我院2017/2018年度累计上报流感病例751例,占既往三年上报总量的91. 6%,不同流行季流感发病情况存在统计学差异(χ^(2)=1 329. 894,P <0. 001)。其中感染疾病科上报流感病例472例、呼吸与危重症科152例、其他内科103例和外科24例分别占同时段相应科室就诊人数的2. 14%、0. 56%、0. 05%和0. 01%,不同科室流感发病情况存在统计学差异(χ^(2)=5 082. 992,P <0. 001);我院2017/2018年度流感病例的危重症比(4. 12%)高于某传染病专科医院同期流感病例的危重症比(0. 17%),差异有高度统计学意义(χ^(2)=172. 033,P <0. 001);2017/2018年度未发生院感暴发、医疗事故以及其他不良事件。结论 将FMEA应用于综合医院流感流行季院感风险防控中是有效的、可行的,达到了院感风险防控的目的,为院感防控提供了具有借鉴意义的管理途径。Objective To explore the application of Failure Model&Effects Analysis(FMEA)in general hospital risk prevention and control during seasonal influenza epidemic season.Methods A retrospective intervention control study was conducted.According to the steps and methods of FMEA,we established a multidisciplinary team to evaluate and deal with the risk of influenza in our hospital during the 2017/2018 influenza epidemic in Beijing.Through an evaluation of human,machine,material,method and environment,potential failures in environment,human and method factors were identified,and the scores of RPN were 27,18 and 12.The corresponding emergency plan is formulated and implemented according to the actual situation.The occurrence of adverse events in influenza epidemic season before and after intervention was analyzed and compared.Results In the 2017/2018 epidemic,751 influenza cases were identified in our hospital,accounting for 91.6%of the total amount reported in the past three years.There were statistically significant differences in different epidemics(χ^(2)=1329.894,P<0.001).Among them,472 of influenza cases were reported from infectious disease department,152 cases from department of respiration and critically department,103 from internal medicine and 24 from surgery.They accounted for 2.14%,0.56%,0.05%and 0.01%of the corresponding departments’outpatient visits.There were statistically significant differences in the incidence of influenza in different departments(χ^(2)=5082.992,P<0.001).The critical illness ratio of influenza cases in our hospital in 2017/2018(4.12%)was higher than that of influenza cases in an infectious disease hospital in the same period(0.17%),and the difference was highly statistically significant(χ^(2)=172.033,P<0.001).There was no nosocomial outbreak,medical accident and other adverse events in 2017/2018.Conclusion The application of FMEA in the prevention and control of nosocomial risk in influenza epidemic season in general hospitals is effective and feasible,achieves the purpose of nosoc

关 键 词：FMEA 综合医院 流感 院感风险防控 

分 类 号：R197[医药卫生—卫生事业管理]