失效模式和效果分析模式提高医院保洁人员标准预防依从性的效果  

Effect of failure mode and effects analysis on enhancing compliance with standard precautions among hospital cleaning personnel

作　　者：李兰兰 龚忆华 陈泳欣 郑纯翠 易石坚[2] Li Lanlan;Gong Yihua;Chen Yongxin;Zheng Chuncui;Yi Shijian(Department of Infection Control,Fuyong People's Hospital,Bao'an District,Shenzhen 518103,China;South China Hospital Affiliated to Shenzhen University,Shenzhen 518111,China;Department of Intensive Care Medicine,Fuyong People's Hospital,Bao'an District,Shenzhen 518103,China)

机构地区：[1]深圳市宝安区福永人民医院院感科,广东深圳518103 [2]深圳大学附属华南医院,广东深圳518111 [3]深圳市宝安区福永人民医院重症医学科,广东深圳518103

出　　处：《中华卫生应急电子杂志》2024年第5期277-280,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：深圳市宝安区科技计划基础研究项目(医疗卫生类)(2021JD280)。

摘　　要：目的应用失效模式和效应分析(FMEA)理论,识别导致保洁人员标准预防依从性低的主要原因,并制定相应的干预措施以提高依从性。方法通过组建FMEA课题小组,对医院保洁人员的标准预防依从性现状进行系统分析。小组制定评分标准并计算风险优先指数(RPN),以识别高风险因素。根据高风险优先处理原则,重新设计和优化标准预防流程,并提出针对性干预措施。结果FMEA干预显著提高了保洁人员的标准预防依从性。在洗手和消毒时机掌握、正确佩戴手套、防护用品合理使用、环境处理及职业暴露应对方面,依从性评分均显著提高(P<0.001)。改进措施有效降低了风险优先数(RPN),医院ICU感染发生率从12.53%降至1.88%(P<0.001)。结论首次引入FMEA模式改善保洁人员标准预防依从性,并从创新视角评估了干预效果,该研究具有重要的实践应用意义和推广价值。Objective To identifies the primary factors contributing to the low compliance of cleaning personnel with standard precautions,and devises corresponding intervention measures to enhance compliance by applying failure mode and effects analysis(FMEA)theory.Methods An FMEA project team was assembled to systematically analyze the compliance status of cleaning staff with standard precautions.The team established scoring criteria and calculated the risk priority number(RPN)to identify high-risk factors.Based on the principle of prioritizing high-risk interventions,the standard precaution processes were redesigned and optimized,with targeted interventions proposed.Results The FMEA intervention significantly improved the compliance of cleaning personnel with standard preventive measures.Compliance scores for handwashing and disinfection timing,proper glove wearing,appropriate use of personal protective equipment,environmental management,and handling of occupational exposure all showed significant increases(P<0.001).The implemented improvement measures effectively reduced the RPN,leading to a decline in the infection rate in the hospital ICU from 12.53%to 1.88%(P<0.001).Conclusion The introduction of the FMEA model to improve compliance with standard precautions among cleaning staff is innovative and provides valuable insights for intervention effectiveness,with important practical significance and potential for broader application.

关 键 词：失效模式与效应分析 标准预防 依从性 保洁人员 医院感染控制 

分 类 号：R47[医药卫生—护理学]