The Department of Hospital Infection Control and Public Health, Sichuan Cancer Hospital, Chengdu, China.
Sci Rep. 2024 Nov 19;14(1):28564. doi: 10.1038/s41598-024-80282-9.
In the context of advancing medical procedures, postoperative infections in cancer patients, particularly those involving multidrug-resistant organisms, have become a significant clinical concern. This study aims to comprehensively and systematically evaluate the effectiveness of infection prevention and control for multidrug-resistant organisms (MDROs) in postoperative cancer patients using Failure Mode and Effects Analysis (FMEA). This study was conducted in a tertiary A-level cancer specialty hospital in China, employing Failure Mode and Effects Analysis (FMEA) to assess the risks of hospital infections. Intervention measures were implemented for high-risk and medium-high-risk factors. Through the hospital's infection information system, data on patients who underwent surgical treatment from 2017 to 2022 were extracted. Data from 2017 to 2019 served as the control group, and data from 2020 to 2022 as the intervention group, to compare the changes in hospital infection incidence and MDRO infection incidence before and after the intervention. Categorical data were described in terms of frequency and percentage. The chi-square test was utilized for statistical inference to assess the differences in infection rates before and after the intervention. Prior to the intervention (2017-2019), the incidence rate of hospital infections was 1.66%, which decreased to 1.22% after the intervention (2020-2022), showing a statistically significant difference (χ = 48.83, P < 0.001). The incidence rate of MDRO infections also decreased from 1.808‰ before the intervention to 1.136‰ after the intervention, with a statistically significant difference (χ = 11.417, P = 0.001). This study confirms the effectiveness of the FMEA method in preventing and controlling MDRO infections in postoperative cancer patients. It highlights the practicality and value of widespread adoption of this method, particularly in the context of the COVID-19 pandemic.
在推进医疗程序的背景下，癌症患者术后感染，特别是涉及多药耐药菌的感染，已成为一个重大的临床关注点。本研究旨在使用失效模式与效应分析（FMEA）全面系统地评估癌症患者术后多药耐药菌（MDRO）感染预防与控制的效果。本研究在中国一家三级 A 级癌症专科医院进行，采用失效模式与效应分析（FMEA）评估医院感染的风险。对高风险和中高风险因素实施干预措施。通过医院感染信息系统，提取 2017 年至 2022 年接受手术治疗的患者数据。2017 年至 2019 年的数据作为对照组，2020 年至 2022 年的数据作为干预组，比较干预前后医院感染发生率和 MDRO 感染发生率的变化。分类数据以频率和百分比表示。采用卡方检验进行统计推断，以评估干预前后感染率的差异。干预前（2017-2019 年），医院感染发生率为 1.66%，干预后（2020-2022 年）降至 1.22%，差异有统计学意义（χ²=48.83，P<0.001）。MDRO 感染的发生率也从干预前的 1.808‰降至干预后的 1.136‰，差异有统计学意义（χ²=11.417，P=0.001）。本研究证实了失效模式与效应分析（FMEA）方法在预防和控制癌症患者术后 MDRO 感染中的有效性。它强调了该方法在实践中的实用性和价值，特别是在 COVID-19 大流行的背景下。
