Yang Suqing, Yang Lingfei, Chuang Yen-Ching, Asihaer Gulidanna, Lin Xiaonan
Customer Service Center, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.
Institute of Public Health and Emergency Management, Taizhou University, Taizhou, Zhejiang, China.
BMC Oral Health. 2025 Jan 8;25(1):45. doi: 10.1186/s12903-024-05321-3.
To perform risk assessment and analysis of potential infection during stomatology workflow in a hospital in the context of a major infectious disease outbreak, and to determine the key failure modes and measures to prevent and control infection.
Following the Failure Modes and Effects Analysis (FMEA) method based on the stomatology workflow, the opinions of 30 domain-experts in related fields were collected through questionnaires to determine all potential failure modes in the severity (S), occurrence (O), and detectability (D) dimensions. The group score was then integrated through the median method and the risk priority number (RPN) was obtained. Finally, combined with expert experience, a score above 100 was considered to define a key potential failure mode. The data collection period for this study was from August to September 2023.
The key failure modes identified were "Patient concealed epidemiological history (A) (RPN: 149.6; Rank: 1)," "At the pre-examination door, safe distancing cannot be practiced due to the large number of visitors (A) (RPN: 147; Rank: 2)," "The patient does not cooperate in checking the health code or itinerary code (A) (RPN: 128, Rank: 3)," "The patient provides a non-personal health code or itinerary code (A) (RPN:121.5; Rank: 4)," "Pre-examination personnel did not strictly implement the inquiry of epidemiological history (A) (RPN: 120; Rank: 5)," and "The patient did not wear a mask according to the specification (A) (RPN:108.0; Rank: 6)". The key risk area was "Before diagnosis and treatment (A)".
Insufficient records of patient epidemiological history may increase the spread of COVID-19 in the oral diagnosis and treatment environment. High-density areas where patients gather are prone to become sources of infection. Finally, improper use of personal protective equipment increases the risk of cross-infection with COVID-19. However, in the face of the potential spread of major infectious diseases in the future, the government and hospitals need to build a more comprehensive epidemiological notification system to provide the population with early action trajectories and warning reports.
在重大传染病暴发背景下，对某医院口腔诊疗工作流程中潜在感染进行风险评估与分析，确定关键失效模式及感染防控措施。
遵循基于口腔诊疗工作流程的失效模式与效应分析（FMEA）方法，通过问卷调查收集30名相关领域专家意见，确定所有潜在失效模式在严重度（S）、发生度（O）和探测度（D）维度的情况。然后通过中位数法整合小组评分，得出风险优先数（RPN）。最后，结合专家经验，将评分高于100分的定义为关键潜在失效模式。本研究的数据收集期为2023年8月至9月。
确定的关键失效模式为“患者隐瞒流行病学史（A）（RPN：149.6；排名：1）”“在预检门口，因就诊人数多无法保持安全距离（A）（RPN：147；排名：2）”“患者不配合查验健康码或行程码（A）（RPN：128，排名：3）”“患者提供非本人健康码或行程码（A）（RPN：121.5；排名：4）”“预检人员未严格落实流行病学史询问（A）（RPN：120；排名：5）”“患者未按规范佩戴口罩（A）（RPN：108.0；排名：6）”。关键风险区域为“诊疗前（A）”。
患者流行病学史记录不全可能增加新冠病毒在口腔诊疗环境中的传播。患者聚集的高密度区域易成为感染源。最后，个人防护用品使用不当增加了新冠病毒交叉感染风险。然而，面对未来重大传染病的潜在传播，政府和医院需要建立更全面的流行病学通报系统，为民众提供早期行动轨迹和预警报告。
