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目的探讨失效模式与效应分析(FMEA)法在医护人员血源性职业暴露风险管理中的应用效果。方法组建血源性职业暴露风险管理FMEA团队,利用“头脑风暴法”列出医护人员发生血源性职业暴露的失效模式,分析失效原因及后果,计算风险指数(RPN);针对最高风险指数进行优先处理,制定改进措施并组织实施。结果实施FMEA管理后,各项失效模式发生血源性职业暴露的风险明显降低,失效模式的RPN值平均下降了61.93%、权重系数下降了64.79%;医护人员血源性职业暴露的标准化发生率由0.075人次/人·年降至0.053人次/人·年(Z=3.235,P<0.05)。结论将FMEA应用于医护人员血源性职业暴露风险管理,能确定并细化血源性职业暴露的高风险环节,使制定的改进措施更具有针对性,从而降低发生职业暴露的风险。
Objective To explore the application of failure mode and effect analysis (FMEA) in the management of hemorrhagic occupational exposure in health care workers. Methods The FMEA team of blood-based occupational exposure risk management was established. The failure modes of blood-based occupational exposure of health care workers were listed by using “brainstorming method.” The failure causes and consequences were analyzed to calculate the risk index (RPN) Index prioritized, develop improvement measures and organize the implementation. Results After implementing FMEA management, the risk of blood-induced occupational exposure to various failure modes was significantly reduced. The RPN of failure mode decreased by an average of 61.93% and the weight coefficient decreased by 64.79%. The standardized incidence of blood-borne occupational exposure among medical staff From 0.075 person-years to 0.053 person-years (Z = 3.235, P <0.05). Conclusion The application of FMEA in the management of hemorrhagic occupational exposure to healthcare workers can identify and refine the high-risk aspects of blood-based occupational exposure and make the improvement measures more targeted so as to reduce the risk of occupational exposure.