失效模式与效应分析在采集血标本流程改造中的应用

Process Re-engineering in Clinical Blood Specimens Collection Using Failure Mode and Effects Analysis

目的预防采集血标本操作中护理差错的发生。方法采用失效模式与效应分析(failure mode and effects analysis,FMEA)评估现有的采集血标本流程,分析可能出现的失效模式,计算风险优先级数(risk priority numbers,RPN)值,找出差错高发环节,并以此为依据对流程进行改造。结果通过流程改造前后护理差错发生率的对比,差错总发生率由0.15%下降至0.03%,差异具统计学意义(P<0.05)。结论应用FMEA对采集血标本流程进行改造可以减少护理差错的发生。

Objective To prevent possible errors during the process of clinical blood specimens collection. Methods Failure mode and effects analysis （FMEA） was employed to appraise and re-engineer the present process of blood specimens collection. High risk possibility of errors in the blood specimens collection process was initially figured out by analysis of the past failure modes and by calculating the risk priority numbers （RPN） according to the severity and likelihood of the failures. The process was then re-designed based on the above analysis results and the new procedures were implemented. Results Overall rate of errors reduced to 0.03% after the re-engineering of the blood specimens collection process from 0.15% before the modification of the blood specimens collection process, with statistically significant difference （P 〈0.05）. Conclusions Process e-engineering using failure mode and effects analysis can efficiently prevent error occurrence in clinical blood specimens collection.