Homauni Abbas, Zargar Balaye Jame Sanaz, Hazrati Ebrahim, Markazi-Moghaddam Nader
Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management and Economics, School of Medicine, AJA University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2020 Aug;49(8):1422-1431. doi: 10.18502/ijph.v49i8.3865.
It is of paramount importance to reduce the probability of clinical risks to improve the quality of health care services, make the relationship between service providers and patients more effective, enhance patient satisfaction, and decrease the rate of complaints regarding medical errors in hospitals. This study aimed at detecting potential and unacceptable risks occurring in the hospital ICUs.
In this systematic review, all studies examining the risk assessment of ICUs in hospitals using Failure Mode and Effect Analysis method were reviewed. Google scholar, PubMed, Scopus, SID, Magiran and Web of Science databases were searched to find relevant articles published from 1980 to 2019.
The most frequent failures detected in the reviewed articles consisted of high risk of infection inwards for medical and nursing operations, high infection rates inwards for medical devices' operation within the unit, and early discharge. Moreover, the processes through which potential high-risk Failures were examined in these studies were injection or prescription process, suction process, the process of inserting or removing endotracheal tubes, the process of transferring patients from the operation room to the unit or vice versa, pressure ulcers, and processes related to the medical devices' operation.
There are many possible reasons for failure occurring throughout these processes, and the failure modes occurring in these processes are more probable to cause serious damages to patients, have high repeatability with low probability of failure detection as the failures cannot be discovered by the personnel.
降低临床风险的可能性对于提高医疗服务质量、使服务提供者与患者之间的关系更有效、提高患者满意度以及降低医院医疗差错投诉率至关重要。本研究旨在检测医院重症监护病房（ICU）中潜在的不可接受风险。
在这项系统评价中，对所有使用失效模式与效应分析方法检查医院ICU风险评估的研究进行了综述。检索了谷歌学术、PubMed、Scopus、SID、Magiran和科学网数据库，以查找1980年至2019年发表的相关文章。
在综述文章中检测到的最常见故障包括医疗和护理操作的院内感染高风险、单位内医疗设备操作的院内感染率高以及早期出院。此外，这些研究中检查潜在高风险故障的过程包括注射或处方过程、抽吸过程、气管插管插入或拔除过程、患者从手术室转入该单位或反之的过程、压疮以及与医疗设备操作相关的过程。
在这些过程中发生故障有许多可能的原因，并且这些过程中发生的故障模式更有可能对患者造成严重损害，具有高重复性且故障检测概率低，因为这些故障无法被工作人员发现。
