摘要
目的分析失效模式与效应分析(FMEA)模式对妇产科住院患者医院感染的防控效果。方法自2013年其院内成立FMEA团队,根据FMEA模式对妇产科患者医院感染的主要原因进行分析,计算高风险指数(RPN),进行评估,并制定实施改进方案并评估效果,选取2013年1月-2015年12月医院妇产科诊断并进行院内手术和治疗的患者4926例作为实验组,实施根据FMEA模式改进后的护理管理模式,分析方案实施后妇产科患者医院感染率,2010年1月-2012年12月住院妇产科患者4336例作为对照组,比较两组患者的感染率、RPN。结果对照组和实验组的感染致病菌无明显差异,感染比例对照组高于实验组;两组患者的感染部位均主要发生在泌尿道、呼吸道、消化道,总体感染率对照组为14.21%高于实验组的8.85%,差异有统计学意义(P<0.05);统计对照组的RPN值,应用FMEA模式后,实验组的实施改进措施后RPN(RPN=12,12,12,8,8,18)低于对照组(RPN=24,36,18,24,12,36),住院妇产科患者的医院感染率由14.21%下降至8.85%,差异有统计学意义(P<0.05)。结论应用FMEA模式对于妇产科患者医院感染的防控效果进行评估并实施改进方案,能降低妇产科患者院内的感染率,对于住院妇产科患者院内感染有着良好的预防控制效果,能够有效地规避风险,有助于医院提供更好的护理管理服务。
OBJECTIVE To explore the effect of failure mode and effect analysis（FMEA）on prevention and treatment of nosocomial infections in inpatients of obstetrics and gynecology department.METHODS The FMEA team was established in 2013.According to the FMEA model,the main causes of nosocomial infections in inpatients of obstetrics and gynecology department were analyzed.The high risk index（RPN）was calculated and evaluated,the improvement plan was established and implemented,and the effect was evaluated.The patients of obstetrics and gynecology department diagnosed,hospitalized and treated in our hospital from Jan.2013 to Dec.2015 were selected as the experimental group,and the nursing management model was improved according to the FMEA model.After the implementation of the program,the nosocomial infections rate of obstetrics and gynecology patients was analyzed.The nosocomial infection in inpatients of obstetrics and department from Jan.2010 to Dec.2012 were selected as a control,and the infection rate and RPN between the two groups of patients were compared.RESULTS There was no significant difference in the infection pathogens between control group and experimental group.The infection rate in control group was higher than that in experimental group.The infection sites of the two groups were mainly in the urinary tract,respiratory tract and digestive tract,and the overall infection rate of control group was 14.21% ,which was significantly higher than that of experimental group（8.85% ）,（P〈0.05）.The RPN value of experimental group（RPN=12,12,12,8,8,18）was lower than that of control group（RPN=24,36,18,24,12,36）after the FMEA model was applied in the experimental group.The nosocomial infection rate of the obstetrics and gynecology patients significantly decreased from 14.21% to 8.85% （P〈0.05）.CONCLUSION Application of FMEA model for the prevention and treatment of nosocomial infections in obstetrics and gynecology patients to assess and implement the improvement program,can reduce the nosocomial infection rate of patients of obstetrics and gynecology department,and has a good prevention and control effect on the nosocomial infection rate of patients of obstetrics and gynecology department,which can effective avoid risks and help hospitals provide better care management services.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4206-4209,共4页
Chinese Journal of Nosocomiology
关键词
FMEA模式
妇产科
医院感染
高风险指数
预防控制效果
FMEA mode
Obstetrics and gynecology department
Nosocomial infection
High risk index
Prevention and control effect
