失效模式与效应分析在预防血液透析患者中心静脉长期导管相关性感染中的应用
| 作者: |
1黄峥,
1杜文婷,
1职晶晶,
2丁娟
1 郑州大学第一附属医院心内科，郑州 450000 2 郑州大学第一附属医院质控处，郑州 450000 |
| 通讯: |
丁娟
Email: dingjuan241@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.05.022 |
| 基金: | 河南省重点研发与推广专项 (182102310404)；河南省卫生与计划生育委员会省部共建项目 (SBGJ2018004)。 |
摘要
目的：探讨失效模式与效应分析(failure mode and effect analysis，FMEA)在预防血液透析患者中心静脉长期导管相关性感染中的作用。方法：选取2017年4月至12月及2018年1月至10月在郑州大学第一附属医院血液净化中心经中心静脉长期置管进行血液透析的238例患者为研究对象。基于FMEA管理模式，组建团队设定目标、制作流程图、找出潜在失效模式、计算优先风险数值(risk priority number，RPN)，根据最高风险优先处理的原则制定改善措施及操作规范。结果：实验组实施失效模式后的RPN值明显下降，导管相关性感染的发生率显著降低，差异具有统计学意义(P<0.05)。实验组发生中心静脉长期导管相关性感染的危险性为对照组的0.323倍。结论：应用FMEA模式能有效降低血液透析患者中心静脉长期导管相关性感染的发生率。
关键词：
FMEA模式；中心静脉导管；导管相关性感染
Effect of failure mode and effect analysis on prevention of central venous catheter related infection
CorrespondingAuthor: DING Juan Email: dingjuan241@163.com
DOI: 10.3978/j.issn.2095-6959.2019.05.022
Foundation: This work was supported by the Key R&D and Promotion Program in Henan Province (182102310404), and Provincial and Ministerial Co-construction Projects in Henan Province (SBGJ2018004)
Abstract
Objective: To explore effect of failure mode and effect analysis (FMEA) on prevention of central venous catheter infection. Methods: A total of 238 patients obtained hemodialysis via central venous catheter in Hemodialysis Centre of First Affiliated Hospital of Zhengzhou University from Apr to Dec 2017 and Jan to Oct 2018 were seleted. To cope with the central venous catheter related infection, we firstly formed a team with the FMEA skills and set a goal, then made flow chart program and found potential risk, and the prior risk index was calculated finally. According to the principle of the highest risks of prior resolution the amendatory measure and implementation methods were formulated. Results: Since FMEA was taken in intervention group, the risk priority number (RPN) values and central venous catheter related infection rate decreased markedly, the difference between the two was statistically significant (P<0.05). The rate of central venous catheter-related infection of intervention group is 0.323 times of the control group. Conclusion: The application of failure mode and effect analysis can effectively reduce the central venous catheter-related infection.
Keywords：
failure mode and effect ananlysis; central venous catheter; catheter-related infection