基于FMEA法医院感染预防与控制风险评估.docVIP

基于FMEA法医院感染预防与控制风险评估 　　[摘要] 目的 通过风险评估筛选出高风险的医院感染事件，据此制订年度工作计划和防控措施。 方法 院感科专职人员和临床医院感染监控小组成员采用FMEA法进行风险评估，针对高风险因素提出改进措施并落实，比较FMEA前后的效果。 结果 筛选出的高风险事件为多重耐药菌感染和血源性病原体暴露，院感科和医院感染监控小组评估的高风险事件排序不同。进行FMEA后，实习生、清洁工和护工多重耐药菌知识知晓率有所提高（P 0.05），多重耐药菌各项隔离措施落实情况明显好转（P 0.05），职业暴露发生率由2.37%下降至1.31%（P 0.05）。结论 FMEA法可指导院感科在全程管理中抓住关键风险事件，较真实地反映感控中的薄弱环节，有效避免霍桑效应，体现了持续改进的思想。 　　[关键词] 失效模式与效应分析；医院感染；预防与控制；风险评估 　　[中图分类号] R197 [文献标识码] A [文章编号] 1673-7210（2016）02（a）-0156-04 　　Risk assessment of nosocomial infection prevention and control based on FMEA 　　HUANG Ju YANG Jiane ΧIAO Yu HUANG Shaojun 　　Department of Hospital Infection Management， Zhongshan Hospital Affiliated to Guangzhou Traditional Chinese Medicine University， Guangdong Province， Zhongshan 528401， China 　　[Abstract] Objective According to risk assessment， screen out the high risk of nosocomial infection， and develop annual work plan and prevention and control measures. Methods FMEA method was used by nosocomial infection managers and monitoring team members to evaluate the risk. Improvement measures for high-risk factors were proposed and implemented， then the effect before and after FMEA was compared. Results The high risk events were multi drug resistant bacteria infection and bloodborne pathogen exposure， the ordering of high risk event evaluation of hospital infection-control department and hospital infection monitoring group was different. Compared with before FMEA， after FMEA， awareness rate of multi-resistant bacteria knowledge in interns， cleaners and nursing workers increased （P 0.05）， the implementation of multi-resistant bacteria isolation measures significantly improved （P 0.05）， occupational exposure rate decreased from 2.37% to 1.31% （P 0.05）. Conclusion FMEA can guide the nosocomial infection managers to grasp the key event in the whole processing management， truly reflect the weak link of control， effectively avoid the Hawthorne effect， reflect the idea of continuous improvement. 　　[Key words] Failure