心脏外科重症监护室设备安全风险的预见性分析与应对策略研究  

Predictive analysis and countermeasure research of equipment safety risk in cardiac surgery intensive care unit

作　　者：张尹红[1] 黄熠辉 许云东 胡萍 方奕海[2] ZHANG Yin-hong;HUANG Yi-hui;XU Yun-dong(Cardiovascular Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510282,China;不详)

机构地区：[1]南方医科大学珠江医院心血管外科,广东广州510282 [2]南方医科大学珠江医院设备科,广东广州510282

出　　处：《中国医学装备》2023年第12期170-175,共6页China Medical Equipment

基　　金：2022年度广东省医学科研基金指令性课题项目(C2022081)“基于循证决策的主动脉夹层术后自我健康管理模型的构建”。

摘　　要：目的:开展心脏外科重症监护室(ICU)设备安全风险的预见性分析,探讨安全风险应对管理策略的应用价值。方法:针对心脏外科ICU设备安全风险控制管理中的问题进行系统失效模式及后果分析(SFMEA),采用三角模糊软集评价信息融合算法进行安全风险等级评价,按优先级顺序不同开展分层管理。选取医院心脏外科ICU临床在用的89台医疗设备,根据管理模式不同分为对照组(79台)和观察组(82台,含对照组72台和新增加的10台),对照组设备采用经验性管理,观察组设备采用预见性管理。对比两组设备的系统稳定性、设备安全性和临床服务满意度。结果:观察组设备操作部件及功能、机械部件及功能、电气源路及功能、信号采集及处理和数据输出与存储发生失效平均占比分别为(1.49±1.02)%、(1.91±1.37)%、(2.21±1.16)%、(0.97±0.67)%和(0.61±0.43)%,均低于对照组,其差异有统计学意义(t=3.119,t=3.705,t=4.713,t=3.871,t=4.306;P<0.05);观察组常规检测设备、急救治疗设备、专用治疗设备及基础医疗设备的风险占比分别为7.69%(1/13)、10.53%(2/19)、0.00%(0/8)和11.90%(5/42),均低于对照组,其差异有统计学意义(χ^(2)=4.887,χ^(2)=4.039,χ^(2)=5.333,χ^(2)=4.082;P<0.05);医院相关工作人员对观察组设备临床服务质量的满意度为94.59%,高于对照组,其差异有统计学意义(χ^(2)=5.731,P<0.05)。结论:基于三角模糊软集评价信息融合算法的心脏外科ICU设备安全风险预见性分析与应对管理策略能够提高心脏外科ICU设备安全风险的预见性,提升医疗设备系统稳定性,改善医疗设备临床诊疗安全性,提高医疗设备管理满意度。Objective:To conduct a predictive analysis of the safety risks in cardiac surgery intensive care unit(ICU)equipment,and to explore the application value of safety risk countermeasure strategies.Methods:The system failure modes and effects analysis(SFMEA)of cardiac surgery ICU equipment was carried out from the main system,subsystem and component levels,and the safety risk level was evaluated by using the triangular fuzzy soft set evaluation information fusion algorithm.The hierarchical management was carried out according to the priority order.A total of 89 medical equipment in clinical use in cardiac surgery ICU of the hospital were selected and divided into control group(79 units)and observation group(82 units,including 72 units in the control group and 10 newly added units)according to different management modes.The equipment in the control group adopted experiential management,the equipment in the observation group adopted predictive management.The system stability,equipment safety and clinical service satisfaction of the two groups were compared.Results:The failure ratio of operating components and functions,mechanical components and functions,electrical source circuits and functions,signal acquisition and processing,data output and storage in the observation group were(1.49±1.02)%,(1.91±1.37)%,(2.21±1.16)%,(0.97±0.67)%and(0.61±0.43)%,respectively,which were lower than those in the control group,the difference was statistically significant(t=3.119,t=3.705,t=4.713,t=3.871,t=4.306;P<0.05).The risk ratios of routine testing equipment,emergency treatment equipment,special treatment equipment and basic medical equipment in the observation group were 7.69%(1/13),10.53%(2/19),0.00%(0/8)and 11.90%(5/42),respectively,which were lower than those in the control group,,the difference was statistically significant(χ^(2)=4.887,χ^(2)=4.039,χ^(2)=5.333,χ^(2)=4.082;P<0.05).The satisfaction of hospital staff on clinical service quality of equipment in observation group was 94.59%,which was higher than that in control

关 键 词：安全风险 预见性分析 三角模糊软集 信息融合 系统失效模式及后果分析(SFMEA) 

分 类 号：R197.39[医药卫生—卫生事业管理]