基于Kaiser模型的灾害脆弱性分析在ICU应急管理中的应用  

Application of hazard vulnerability analysis based on the Kaiser model in ICU emergency management

作　　者：王珍 李国民 张玲玲 徐文波 汪冰 袁冬 Wang Zhen;Li Guomin;Zhang Lingling;Xu Wenbo;Wang Bing;Yuan Dong(Department of Critical Care Medicine,the Affiliated Jintan Hospital,Jiangsu University,Changzhou 213200,China)

机构地区：[1]江苏大学附属金坛医院重症医学科,江苏常州213200

出　　处：《中华卫生应急电子杂志》2024年第6期354-358,共5页Chinese Journal of Hygiene Rescue(Electronic Edition)

摘　　要：目的基于Kaiser模型的重症医学科(ICU)灾害脆弱性分析(HVA)了解ICU面临的灾害事件的风险程度,为制定和完善ICU各项应急预案提供参考。方法2024年3月,根据Kaiser模型制作HVA标准化问卷表,由江苏大学附属金坛医院ICU的HVA小组对科室人员进行HVA问卷调查。调查表内容包含38件ICU灾害事件发生的可能性、发生后可能对科室产生的影响(人员伤害、财产损失、运营影响)及科室所采取的防范措施(应急准备、内部响应、外部响应)。采用Kaiser模型计算公式,计算每个潜在风险事件的相对风险值,根据相对风险值进行灾害风险事件相对风险度排序。结果共发放调查问卷表40份,回收率100%。相对风险值排名前十位的分别是:医院感染爆发(71.94%)、突发公卫事件(62.59%)、医疗纠纷/暴力伤医(54.06%)、呼吸机故障(53.13%)、医疗护理差错(48.34%)、气管插管困难或失败(43.84%)、患者非计划拔管(42.32%)、患者误吸(35.85%)、医用气体故障(31.84%)及医疗废物管理不当(28.26%)。结论基于Kaiser模型的ICU的高相对风险值的灾害风险事件,主要集中在人员类伤害和技术类事故。应依据高相对风险值事件制定和完善应急预案,以提高风险事件应对能力,确保ICU安全有序运行。Objective To understand the risk degree of hazard events faced by intensive care unit(ICU)by carrying out Kaiser model-based hazard vulnerability analysis(HVA),so as to provide reference for formulating and improving ICU emergency plans.Methods In March 2024,A standardized HVA questionnaire was established according to the Kaiser model,and HVA team of Jintan Hospital affiliated to Jiangsu University conducted HVA questionnaire survey among the department staff.The questionnaire included a comprehensive assessment of 38 potential ICU disaster events,their potential impact on the department(including personnel injuries,property losses,and operational disruptions),as well as the preventive measures implemented by the department(such as emergency preparedness,internal response protocols,and external response strategies).All survey data were entered into Excel 2019 for statistical analysis.The Kaiser model calculation formula was used to calculate the relative RISK value of each potential risk event,and the relative risk degree of disaster risk events was ranked according to the relative risk value.Results The total number of questionnaires distributed was 40,with a recovery rate of 100%.The top ten RISK values observed in the ICU were as follows:hospital infection outbreaks(71.94%),public health emergencies(62.59%),incidents of medical disputes/violence against doctors(54.06%),ventilator failure(53.13%),medical care error(48.34%),difficulty or failure of tracheal intubation(43.84%),patient unplanned extubation(42.32%),patient aspiration(35.85%),medical gas failure(31.84%)and improper management of medical waste(28.26%).Conclusion Disaster risk events with high relative risk values in ICU based on Kaiser model primarily revolve around personnel injuries and technical accidents,necessitating the formulation and enhancement of emergency plans to improve response capabilities towards such high relative risk events and ensure safe and orderly operations within the ICU.

关 键 词：灾害脆弱性分析 Kaiser模型 相对风险 应急管理 ICU 

分 类 号：R197.323[医药卫生—卫生事业管理]