Zhang Q P, Wang X T, Lu J Q, Shi F J, Jia L, Jin J W, Feng Q L, Cai Y
The First Hospital of Jiaxing, Jiaxing 314000, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Mar 20;39(3):189-192. doi: 10.3760/cma.j.cn121094-20200224-00082.
To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection. Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared. Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant (<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ(2)=996.55, <0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ(2)=11.49, <0.01) . FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.
探讨失效模式与效应分析(FMEA)在医院感染管理中的作用,为有效预防和控制医院感染提供参考。采用FMEA对2020年1月医院感染的高风险事件进行识别、分析、评估并筛选,确定了手卫生依从性和血源性职业暴露这两个医院层面的重点改进项目。采取风险控制及干预措施后,比较改进前后效果。除激励机制欠缺、医护团队沟通不足外,实施FMEA前后手卫生依从性及血源性职业暴露风险优先系数差异有统计学意义(<0.05)。实施FMEA后,手卫生依从率为74.92%(79375/105953),显著高于实施FMEA前的68.40%(58361/85328),差异有统计学意义(χ(2)=996.55,<0.01)。实施FMEA后血源性职业暴露发生率为3.85%(80/2080),低于实施FMEA前的6.16%(123/1998),差异有统计学意义(χ(2)=11.49,<0.01)。FMEA在医院感染管理中效果良好,能前瞻性地识别和评估医院感染风险,从而有效控制风险。