FMEA风险评估法在脊柱术后切口医院感染防控中的实践  

Risk assessment of wound infection after spinal surgery based on FMEA

作　　者：肖瑜[1] 黄菊[1] 胡洁芬 刘慧楹 邓凯升 李亮[1] XIAO Yu;HUANG Ju;HU Jiefen;LIU Huiying;DENG Kaisheng;LI Liang(Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528401,China)

机构地区：[1]中山市中医院,广东中山528401

出　　处：《现代医院》2023年第7期1045-1047,1052,共4页Modern Hospitals

摘　　要：目的通过失效模式与效应分析法(FMEA)筛选出脊柱术后切口医院感染的高危因素,以此为依据在临床科室中进行管理控制,并比对FMEA管理前后患者医院感染发生率的差异,为医院感染的防控提供参考依据。方法选取2017年7月-2020年6月于广州中医药大学附属中山中医院接受脊柱手术的患者作为FMEA管理前组,2020年7月-2021年11月进行脊柱手术的患者作为FMEA管理后组。应用FMEA筛选脊柱术后切口感染的高危因素,于2020年7月开始落实干预措施,采用χ2检验,比较干预前后患者术后切口的医院感染发生率的差异。结果研究纳入FMEA管理前组患者2399例,FMEA管理后组患者1717例,样本总量共4116例。FMEA干预前患者脊柱术后切口感染发生率为1.4%,干预后脊柱术后切口感染发生率为0.5%,差异有统计学意义(χ2=18.76,P<0.05)。结论应用FMEA法干预可以有效降低患者脊柱术后切口感染发生率。Objective This study aims to detect high-risk factors through risk assessment to provide a reference for the prevention and control of incision infection after spinal surgery.Methods Brainstorming was used to identify 15 potential risks.Failure Mode and Effect Analysis(FMEA)was adopted to detect high-risk factors for incision infection after spinal surgery,implement improvement measures,and compare the effects before and after intervention.Results The selected high-risk events were as follows:①The medical-nursing cooperation system and procedures were not in place,and abnormalities of the surgical port were not found timely;②The drainage tube was indwelled for a long time;3.The aseptic operation was not standardized.The postoperative spine infection rate before intervention was 1.4%,and the postoperative spine infection rate after intervention was 0.5%.In addition,the effect was better than the expected target.Before and after intervention,the difference was statistically significant(P<0.05).Conclusion The application of FMEA method can effectively reduce the incidence of incision infection after spinal surgery.

关 键 词：FMEA 脊柱术后 切口感染 医院感染 

分 类 号：P473[天文地球—大气科学及气象学] R197[医药卫生—卫生事业管理]