实施医疗失效模式与效应分析对骨科髓腔扩大器清洗质量的影响  

Impact of Health Failure Mode and Effect Analysis on the Cleaning Effect of Orthopedic Medullary Cavity Expander

作　　者：庄姗 ZHUANG Shan(Disinfection Supply Center,Jinjiang Municipal Hospital/Shanghai Sixth People's Hospital Fujian,Jinjiang Fujian 362200,China)

机构地区：[1]晋江市医院/上海市第六人民医院福建医院消毒供应中心,福建晋江362200

出　　处：《中国卫生标准管理》2025年第5期176-179,共4页China Health Standard Management

摘　　要：目的探究医疗失效模式与效应分析(health failure mode and effect analysis,HFMEA)对骨科髓腔扩大器清洗效果的影响。方法回顾性分析2022年7月—2023年10月晋江市医院消毒供应中心清洗的骨科髓腔扩大器共406根,其中2022年7月—2023年2月HFMEA实施前消毒供应中心清洗的骨科髓腔扩大器共205根,2023年3—10月HFMEA实施后消毒供应中心清洗的骨科髓腔扩大器共201根。比较HFMEA实施前后风险优先系数(risk priority number,RPN)评分、器械清洗效果。结果实施后,清洗机清洗方式不适合管腔器械、清洗后有污渍、清洗液不易灌满管腔、清洗槽内液体温度过高、装载过大过密、器械装载不恰当、术后预处理不当等主要失效模式的RPN评分分别为(42.15±7.21)分、(36.13±5.42)分、(39.06±5.38)分、(35.11±4.18)分、(33.08±5.17)分、(44.05±5.20)分、(38.12±4.19)分,低于实施前的(145.38±15.22)分、(139.36±14.55)分、(151.30±16.51)分、(149.14±15.25)分、(144.31±14.24)分、(152.41±16.32)分、(159.35±17.22)分,差异均有统计学意义(P<0.05);实施后,器械清洗合格率为88.78%(182/205),高于实施前的95.02%(191/201),差异有统计学意义(P<0.05)。结论应用HFMEA有助于分析骨科髓腔扩大器清洗流程的失效模式及原因,确定风险因素并加以改进,促使器械清洗过程更为规范,以提高清洗质量。Objective To explore the effect of health failure mode and effect analysis(HFMEA)on the cleaning efficiency of orthopedic medullary cavity expander.Methods A retrospective analysis was conducted on 406 orthopedic pulp expanders cleaned by the disinfection supply center of Jinjiang Municipal Hospital from July 2022 to October 2023.Among them,205 orthopedic pulp expanders were cleaned by the disinfection supply center before the implementation of HFMEA from July 2022 to February 2023,and 201 orthopedic pulp expanders were cleaned by the disinfection supply center after the implementation of HFMEA from March to October 2023. The risk priority number (RPN) score, instrument cleaning effectiveness were compared before and after the implementation of HFMEA. Results After implementation, the RPN scores for the main failure modes of the cleaning machine, such as unsuitable cleaning methods for luminal instruments, stains after cleaning, difficulty filling the luminal with cleaning solution, high liquid temperature in the cleaning tank, excessive and dense loading, improper instrument loading, and improper postoperative pretreatment, were (42.15±7.21) points, (36.13±5.42) points, (39.06±5.38) points, (35.11±4.18) points, (33.08±5.17) points, (44.05±5.20) points, and (38.12±4.19) points, respectively, lower than the before implementation scores of (145.38±15.22) points, (139.36±14.55) points, and (151.30±16.51) points, (149.14±15.25) points, (144.31±14.24) points, (152.41±16.32) points, and (159.35±17.22) points, and the differences were statistically significant (P < 0.05). The qualified rate of instrument cleaning after implementation was 95.02%, which was higher than before implementation (88.78%), with statistical significance (P < 0.05). Conclusion The application of HFMEA is helpful in analyzing the failure modes and causes of the cleaning process of orthopedic medullary cavity expanders, identifying risk factors and making improvements, promoting a more standardized instrument cleaning process, improvi

关 键 词：骨科髓腔扩大器 医疗失效模式与效应分析 风险优先系数 清洗质量 清洗合格率 风险因素 

分 类 号：R472[医药卫生—护理学]