基于FMEA法探讨重症肝病病房多重耐药菌感染的风险评估及干预  

Assessment and Intervention of Multi-Drug-Resistant Organism Infections in Intensive Care Unit for Severe Liver Disease Based on FMEA Method

作　　者：何彩玲 HE Cailing(Department of Infection Control,Mengchao Hospital of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学孟超肝胆医院感染管理科,福州350001

出　　处：《中国医药指南》2024年第1期48-51,共4页Guide of China Medicine

基　　金：福州市科技计划社会发展项目(2021-S-238)。

摘　　要：目的探讨失效模式与效应分析法(FMEA)在重症肝病病房多重耐药菌感染防控中的应用及效果。方法选取2021年1月至2022年12月于福建医科大学孟超肝胆医院重症肝病病房住院患者作为研究对象,以2021年1月至12月FMEA法干预前入住重症肝病病房的患者1225例为对照组,以2022年1月至12月FMEA法干预后入住重症肝病病房的患者1385例为研究组。组建FMEA小组并绘制重症肝病病房防控多重耐药菌医院感染流程图,基于多重耐药菌检出率、种类及药敏结果,寻找潜在失效模式,分析关键风险因素,进行风险处置,对FMEA法干预前后重症肝病病房多重耐药菌感染发生率进行比较。结果FMEA法干预前重症肝病病房多重耐药菌感染发生率为2.20%(27/1225),干预后发生率为1.15%(16/1385)。FMEA法能降低肝病重症病房多重耐药菌感染发生率(P<0.05)。干预后耐甲氧西林金黄色葡萄球菌发生率由0.65%降至0.07%。结论FMEA法可指导医院感染管理科和肝病重症病房发现多重耐药菌感染防控中的高危因素,为优化医院风险管理流程提供依据。Objective To explore the application and effect of Failure Mode and Effect Analysis(FMEA)in preventing and controlling multi-drug-resistant strains in the intensive care unit of liver diseases.Methods Patients who were hospitalized in the critical liver disease ward of Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2021 to December 2022 were selected as the study subjects,1225 patients who were admitted to the critical liver disease ward before the intervention of the FMEA method from January 2021 to December 2021,and1385 patients who were admitted to the critical liver disease ward after the intervention of the FMEA method from January 2022 to December 2022.The FMEA team was formed and aflow chart was drawn for the prevention and control of multi-resistant bacteria hospital infections in the intensive liver disease ward.Based on the detection rate,species and drug sensitivity results of multi-resistant bacteria,we searched for potential failure modes,analyzed the key risk factors,performed risk treatment,and compared the incidence of multi-resistant bacteria infections in the intensive liver disease ward before and after the intervention of the FMEA method.Results The incidence of multi-resistant bacterial infections in critical liver disease ward was 2.20%(27/1225),before the intervention of FMEA method and 1.15%(16/1385)after the intervention.FMEA method reduced the incidence of multi-resistant bacterial infections in the critical liver disease ward(P<0.05).After intervention,the incidence of methicillin-resistant Staphylococcus aureus decreased from 0.65%to 0.07%.Conclusions FMEA can guide the infection management department and the ICU in identifying high-risk factors for multi-drug-resistant strains in the prevention and control of multi-drug-resistant strains in the ICU of liver diseases,and providing basis for optimizing hospital risk management processes.

关 键 词：FMEA法 重症肝病 多重耐药菌 风险评估 

分 类 号：R575[医药卫生—消化系统] R446.5[医药卫生—内科学]