医疗失效模式与效应分析在援塞抗疫医疗队员风险管理中的应用

摘要

Objective To investigate the application effects of the healthcare failure mode and effects analysis ( HFMEA) system on reducing infection risks of EVD for healthcare workers ( from Suzhou) in Chinese Medical Team in Sierra Leone. Methods Based on the requirement to use HFMEA system, the EVD exposure risks management team was set up to analyze the failure mode and causes of potential risks of EVD exposure, to calculate the Risk Priority Number ( RPN ) , and to take measures to solve priority issues. Results After administration of HFMEA, number of healthcare workers qualified for hand hygiene compliance, personal protective equipment ( PPE) donning and doffing, and epidemiological knowledge mastery was higher, compared to the number before HFMEA administration (χ2 =39. 30,47. 70;P<0. 01). During the two months in Sierra Leone and the 21-day medical observation period, none was infected with EVD. Positive assessment was given by 87. 0% of the healthcare workers. Conclusions Usage of HFMEA to evaluate RPN risks for healthcare workers in Chinese Medical Team, focuses on infection control management, revision and improvement of work processes and contingency plans, and assists team members to adapt to new circumstance, which can reduce the risks of EVD exposure for healthcare workers of Chinese Medical Team.%目的：探讨医疗失效模式与效应分析( HFMEA)在降低中国(江苏)援塞抗疫医疗队员感染埃博拉病毒病风险的应用效果。方法应用HFMEA的方法,成立埃博拉风险管理小组,针对有可能感染埃博拉病毒病的风险进行失效模式及潜在风险原因分析,计算优先风险指数( RPN),对需优先解决的问题进行措施改进。结果实施HFMEA管理后,手卫生依从率97.8%、个人防护装备穿脱正确率100%、埃博拉流行病学知识掌握率91.3%,均高于 HFMEA管理前,差异有统计学意义(χ2值分别为39.30,47.70；P<0.01)；在援塞2个月期间及结束后直至医疗队员21 d医学观察期满,无一人感染埃博拉病毒病；87.0%的医疗人员对HFMEA管理有正面评价。结论应用HFMEA评估援塞医疗队员风险的RPN,加强感染控制管理,完善工作流程和应急预案,促进队员尽快适应新环境等措施,可以有效预防医疗队员感染埃博拉病毒病风险。