失效模式用于中心手术室医院感染风险管理的实践  

Risk management of healthcare-associated infection in central operating room based on failure mode and effect analysis

作　　者：赵会杰[1] 王力红[1] 赵霞[1] 刘婷[1] 马文晖[1] 韩叙[1] 王允琮 ZHAO Hui-jie;WANG Li-hong;ZHAO Xia;LIU Ting;MA Wen-hui;HAN Xu;WANG Yun-cong(Xuan Wu Hospital Capital Medical University,Beijing100053,China)

机构地区：[1]首都医科大学宣武医院,北京100053

出　　处：《中国消毒学杂志》2023年第5期361-365,共5页Chinese Journal of Disinfection

基　　金：北京市属医院科研培育计划基金资助项目(PG2019018)。

摘　　要：目的研究失效模式与效应分析法(FMEA)用于中心手术室全流程医院感染风险管理的效果,优化手术室医院感染管理策略。方法采用头脑风暴法、文献Meta分析法查找中心手术室医院感染的重点风险点,依据重点风险点对医院感染影响的严重度(S)等级、发生率(O)等级、可探测度(D)等级3个维度进行定量分析及评分,计算风险优先系数RPN值,针对RPN值>125的风险点采取干预措施进行风险控制,并对风险控制效果进行评价。结果从建筑布局及设施不规范、环境控制不合理、物品管理不合格、人员管理不符合要求及操作管理不规范等5方面筛出49个风险点,对其中9个RPN值>125的重点风险点采取控制措施。经过风险控制,重点风险点RPN值均<125,9项失效模式总体RPN值由1578降至666,下降率为57.8%,风险控制效果良好。结论应用失效模式与效应分析法可有效控制中心手术室重点风险。Objective To investigate the effect of failure mode and effect analysis(FMEA)on risk of nosocomial infection in the whole process of the central operating room,so as to optimize the management strategy of nosocomial infection in the central operating room.Methods The key risk points of hospital infection prevention and control were found by using brainstorming and literature meta-analysis.Quantitative analysis and scoring were conducted according to the three dimensions of severity(S),frekuencyof occurrence(O)and likelihood of Detection(D)of the impact of key risk points on nosocomial infection,and the scores of the three dimensions were calculated for the risk points.The risk control measures were taken for the risk points with RPN>125,and the risk control effect was evaluated.Results From five aspects:non-standard building layout and facilities,unreasonable environmental control,unqualified goods management,unqualified personnel management and non-standard operation management,49 risk points were screened,and 9 key risk points whose RPN>125 were treated with control measures.After that,the RPN of all key risk points were<125,and the overall RPN value decreased from 1578 to 666,with a decrease rate of 57.8%.Conclusion FMEA has a good risk control effect on nosocomial infection in key risk points of the central operating room..

关 键 词：中心手术室 失效模式与效应分析法 医院感染风险 

分 类 号：R184[医药卫生—流行病学]