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基于风险评估与监测的生物安全管理:来自中国一家临床实验室的观点

Biosafety Management Based Upon Risk Assessment and Monitoring: Perspectives from a Clinical Laboratory, China.

作者信息

Diao Qizhi, Long Yongpei, Yang Fangyu, Nong Cuihui, Tang Huamiao, Zhou Xiangmin, Zhu Guoqiang, Ding Qiang

机构信息

Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, People's Republic of China.

Department of Laboratory Medicine, The People's Hospital of Jianyang City, Sichuan, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2024 Sep 26;17:2291-2303. doi: 10.2147/RMHP.S476005. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

Inadequate risk assessment and a lack of risk monitoring are common deficiencies in clinical laboratory, and are also the main causes of biosafety incidents. Therefore, we summarized the experience of implementing adequate risk assessment and maintaining risk monitoring, and established a procedure for continuously improving biosafety management.

METHODS

Learning from our laboratory's experience in implementing risk assessment, risk response, and risk monitoring before and during the COVID-19 epidemic, we summarized the procedures for fully identifying risks, accurately evaluating risks, maintaining risk monitoring, establishing and regular reviewing safety indicators. On this basis, we established a system for continuously improving biosafety management through risk monitoring and reviewing safety indicator.

RESULTS

We identified a total of 30 unacceptable risks prior to the COVID-19 pandemic, and developed and implemented appropriate risk control measures. After risk control, residual risks were acceptable, and no biosafety incidents have occurred. During the COVID-19 pandemic, after multiple risk monitoring, we identified ten new risks, three ineffective risk control measures, and multiple control measures for excessive protection. Then, we timely adjusted risk control measures to avoid laboratory personnel infection and excessive protection. Meanwhile, We established eight safety indicators and identified two improvement opportunities through regular reviews.

CONCLUSION

Adequate risk identification and accurate risk assessment are particularly important for effectively controlling biosafety risks. Biosafety management should be continuously improved to deal with ineffective and excessive protection caused by various changes in experimental activities. Continuous improvement of biosafety management can be achieved through risk monitoring, regular review of safety indicators, and management reviews. This study will help laboratory managers to fully and accurately assess risks, as well as update risks and their control measures through risk monitoring, and the continuous improvement procedure established in the study has certain reference value for laboratories to effectively respond to emerging infectious diseases and avoid excessive protection.

摘要

背景与目的

临床实验室中风险评估不足和缺乏风险监测是常见缺陷,也是生物安全事故的主要原因。因此,我们总结了实施充分风险评估和维持风险监测的经验,并建立了持续改进生物安全管理的程序。

方法

借鉴本实验室在新冠疫情前后实施风险评估、风险应对和风险监测的经验,我们总结了全面识别风险、准确评估风险、维持风险监测、建立并定期审查安全指标的程序。在此基础上,我们建立了通过风险监测和审查安全指标来持续改进生物安全管理的体系。

结果

在新冠疫情大流行之前,我们共识别出30项不可接受风险,并制定和实施了适当的风险控制措施。风险控制后,残余风险可接受,未发生生物安全事故。在新冠疫情大流行期间,经过多次风险监测,我们识别出10项新风险、3项无效风险控制措施以及多项过度防护控制措施。然后,我们及时调整风险控制措施,以避免实验室人员感染和过度防护。同时,我们建立了8项安全指标,并通过定期审查确定了2个改进机会。

结论

充分的风险识别和准确的风险评估对于有效控制生物安全风险尤为重要。生物安全管理应持续改进,以应对实验活动各种变化导致的无效和过度防护。通过风险监测、定期审查安全指标和管理评审可实现生物安全管理的持续改进。本研究将有助于实验室管理人员全面准确地评估风险,并通过风险监测更新风险及其控制措施,研究中建立的持续改进程序对实验室有效应对新发传染病和避免过度防护具有一定的参考价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8c5/11444055/c3faa79c7b5e/RMHP-17-2291-g0001.jpg

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