| 史瑀,殷翠香,穆金智,等.失效模式与效应分析在重症监护室医院感染中的应用[J].安徽医药,2019,23(6):1115-1118. |
| 失效模式与效应分析在重症监护室医院感染中的应用 |
| Application offailure mode and effect analysis in ICU nosocomial infection |
| 投稿时间：2017-08-07 |
| DOI： |
| 中文关键词: 失效模式与效应分析 重症监护室 医院感染 风险评估 |
| 英文关键词: Failure mode and effect analysis Intensive care unit Nosocomial infection Risk assessment |
| 基金项目: |
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| 摘要点击次数: 1916 |
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| 中文摘要: |
| 目的研究失效模式与效应分析(FMEA)在重症监护室(ICU)医院感染风险管理中应用的可行性,并讨论应用FMEA进行ICU医院感染风险管理的意义。方法 选取内蒙古林业总医院2015年1月和2016年12月在职的院感管理人员和ICU医院感染监控小组成员,利用FMEA进行医院感染风险评估,并针对得出的高风险因素提出改进措施,同时比较控制措施实施前后的医院感染改善情况。结果 风险评估控制措施实施后FMEA得分较实施前各风险因素得分均有所下降,差异有统计学意义(均P＜0.001)。导尿管相关尿路感染率(CAUTI)0.65%较实施前2.46%有较大降低(χ2=4.898,P=0.027),医院感染率8.46%较实施前13.65%有较大降低,差异有统计学意义(χ2=6.230,P=0.013)；呼吸机相关肺炎(VAP)、中心静脉置管相关血流感染率(CLABSI)以及手术部位相关感染率(SSI)较实施前有所降低,但差异无统计学意义(P＞0.05)。结论 FMEA方法的使用可以指导院感科找出关键风险事件,有效地反映出院感管理中的薄弱环节,降低ICU医院感染的发生,体现了持续改进的思想。 |
| 英文摘要: |
| ObjectiveTo explore the feasibility of the application of failure mode and effect analysis (FMEA) in risk management of nosocomial infection in intensive care unit (ICU),and to discuss the significance of applying FMEA to risk management of ICU hospital infection.Methods Administrators of nosocomial infection department and ICU nosocomial infection monitoring team members who worked at Inner Mongolia Forestry General Hospital from January 2015 to December 2016 were enrolled in the study.FMEA was used for hospital infection risk assessment,and then improvement measures were put forward for high-risk factors.Meanwhile,comparison was made of the improvement of nosocomial infection before and after the intervention.Results After the implementation of risk assessment control measures,FMEA scores were decreased in comparison with the scores of respective risk factors before the implementation,and the differences were statistically significant (all P<0.001).Catheter-associated urinary tract infection (CAUTI) rate after the implementation was significantly lower than that before the implementation (0.65% vs. 2.46%,χ2=4.898,P=0.027);nosocomial infection rate after the implementation was significantly lower than that before the implementation (8.46% vs. 13.65%,χ2=6.230,P=0.013).Rates of ventilator-associated pneumonia (VAP),central line-associated bloodstream infection (CLABSI) and surgical site infection (SSI) after the implementation were lower than those before the implementation,but the differences were not statistically significant (P>0.05).Conclusion FMEA can help the nosocomial infection managers identify the key risk events,effectively reflect the weaknesses in nosocomial infection control,and reduce the incidence of the ICU nosocomial infections,thus reflecting the idea of continuous improvement. |
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