FMEA在多药耐药菌医院感染控制中的应用  

Application of FMEA in the control of nosocomial infection caused by multi-drug resistant bacteria

作　　者：陈旭曼 陈雪茹 谭细兰[2] 钟晓祝 CHEN Xu-man;CHEN Xue-ru;TAN Xi-lan;ZHONG Xiao-zhu(Shenzhen Hospital of Southern Medical University,Shenzhen,Guangdong 5181o0,China;不详)

机构地区：[1]南方医科大学深圳医院感染管理科,广东深圳518100 [2]南方医科大学珠江医院感染管理科,广东广州510282

出　　处：《中华医院感染学杂志》2024年第8期1248-1252,共5页Chinese Journal of Nosocomiology

基　　金：广东省基础与应用基础研究基金资助项目(2019A1515111063)。

摘　　要：目的探讨失效模式和效应分析(FMEA)方法,在多药耐药菌(MDRO)医院感染管理中的应用。方法应用FMEA方法,对南方医科大学深圳医院重症医学科(ICU)住院患者MDRO医院感染进行全流程风险评估,对风险失效模式风险优先数(RPN)高的流程实施改进措施,评价改进措施实施前、后RPN降低率及MDRO医院感染发生率。结果风险失效模式风险优先数(RPN)排列前4位分别是:床单元清洁消毒、气管插管、查体及过程监测;对这4项流程实施改进后RPN值分别下降了82.00%、85.94%、77.50%、87.50%;MDRO医院感染发生率由改进前的4.20%降至改进后的2.20%,改进前后差异有统计学意义(P<0.05)。结论运用FMEA质量改进工具能有效降低多药耐药菌感染风险,MDRO医院感染发生率下降。OBJECTIVE To explore the application of failure mode and effect analysis(FMEA)in hospital infection management of multidrug-resistant organism(MDRO).METHODS By using the FMEA method,a full-process risk assessment was conducted on the inpatients with MDRO in the intensive care unit(ICU)of Shenzhen Hospi-tal of Southern Medical University.Improvement measures were implemented for processes with high-risk priority number(RPN)of risk failure modes.The incidence of MDRO infection and the reduction of RPN before and after the implementation of improvement measures were evaluated.RESULTS The top four priority number of risk fail-ure modes(RPN)were bed unit cleaning and disinfection,tracheal intubation,physical examination and course monitoring.With the improvements to these four processes,the RPN values decreased by 82.00%,85.94%,77.50%,and 87.50%respectively.The incidence of hospital infection with MDRO decreased from 4.20%to 2.20%,with a statistically significant difference before and after improvement(P<0.05).CONCLUSION The use of FMEA improvement tools can effectively reduce the risk of multidrug-resistant bacterial infections,and the incidence of MDRO hospital infections significantly reduce.

关 键 词：失效模式和效应分析 多药耐药菌 医院感染 清洁消毒 防控措施 

分 类 号：R181.32[医药卫生—流行病学]