陈萍, 刘勇, 王燕, 段晓菲, 陈岚, 林华. 医疗失效模式与效应分析方法在降低医务人员锐器处置环节职业暴露风险中应用[J]. 职业卫生与应急救援, 2020, 38(1): 11-14. DOI: 10.16369/j.oher.issn.1007-1326.2020.01.003
引用本文: 陈萍, 刘勇, 王燕, 段晓菲, 陈岚, 林华. 医疗失效模式与效应分析方法在降低医务人员锐器处置环节职业暴露风险中应用[J]. 职业卫生与应急救援, 2020, 38(1): 11-14. DOI: 10.16369/j.oher.issn.1007-1326.2020.01.003
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CHEN Ping, LIU Yong, WANG Yan, DUAN Xiaofei, CHEN Lan, LIN Hua. Application of failure mode and effect analysis method to reduce medical staff's occupational exposure risk during sharps instrument disposal[J]. Occupational Health and Emergency Rescue, 2020, 38(1): 11-14. DOI: 10.16369/j.oher.issn.1007-1326.2020.01.003
Citation: CHEN Ping, LIU Yong, WANG Yan, DUAN Xiaofei, CHEN Lan, LIN Hua. Application of failure mode and effect analysis method to reduce medical staff's occupational exposure risk during sharps instrument disposal[J]. Occupational Health and Emergency Rescue, 2020, 38(1): 11-14. DOI: 10.16369/j.oher.issn.1007-1326.2020.01.003
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医疗失效模式与效应分析方法在降低医务人员锐器处置环节职业暴露风险中应用

Application of failure mode and effect analysis method to reduce medical staff's occupational exposure risk during sharps instrument disposal

    摘要
  • 摘要:
    目的 应用医疗失效模式与效应分析（health care failure mode and effect analysis，HFMEA）方法对针刺伤中锐器处置环节进行干预，降低针刺伤发生率。
    方法 在职业暴露监测过程中，通过组建专业的HFMEA团队，分析锐器处置流程，找出潜在失效模式，计算风险优先数值（risk priority number，RPN）以及优先干预因素，针对高风险因素采取相应的改进措施并落实。
    结果 实施HFMEA管理模式前，排前三位的失效模式依次是：丢弃针头时手未拿捏针柄位置（A）；暂时盛装和整理锐器的容器未放置在合适的位置（B）；与同事之间配合不默契（C）。实施HFMEA管理模式后，"A"的RPN值从184.71降低到45.50，"B"的RPN值从177.13降低到52.18，"C"的RPN值从163.47降低到25.13，其他6个失效模式的RPN值也明显降低，前后评分差异均具有统计学意义（P < 0.01）；发生在锐器处置环节的利器伤发生率由干预前的1.94%（15例）下降到干预后的0.65%（5例），差异具有统计学意义（P < 0.05）。
    结论 HFMEA方法在锐器处置环节的应用，有助于减少针刺伤的发生。

     

    Abstract:
    Objective Health care failure mode and effect analysis (HFMEA) method was used to intervene needle stick injuries of medical staff during process of sharps disposal, to reduce occupational exposure risk due to needle injuries.
    Methods A professional HFMEA team was set up in the process of occupational exposure monitoring, to analyze the sharp disposal process, find out the potential failure mode, calculate the risk priority number (RPN) and preferred intervention factors, and take the corresponding measures against the high risk factors.
    Results The baseline survey showed that the failure modes in the top three (A, B, C) were as follows:staff's hands did not pinch the needle handles when discarding the needles(A); the containers for temporarily holding and sorting sharps instruments were not placed in the appropriate position(B); and the cooperation with colleagues was not tacit(C). After the implementation of HFMEA management mode, the RPN value of A, B and C decreased from 184.71 to 45.50, from 177.13 to 52.18 and from 163.47 to 25.13 respectively, while the RPN values of the other 6 failure modes were also significantly reduced(P < 0.01). The incidence of sharps injuries decreased from 1.94%(15 cases)before intervention to 0.65%(5 cases)after intervention(P < 0.05).
    Conclusion The application of HFMEA can help reduce the incidence of needle puncture during sharps disposal.

     

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