失效模式和效应分析在眼科医院医护人员手卫生依从性的应用

The application of failure mode and effect analysis to improve the hand hygiene compliance of medical staffin eye hospital

目的探讨应用失效模式与效应分析方法在眼科医院医护人员手卫生依从性危险因素分析中的应用。方法于2016年1月，对温州医科大学附属眼视光医院10个科室共325名医护人员进行调查，运用失效模式与效应分析（FMEA）风险管理方法，组建质控团队，分析眼科医院医护人员手卫生依从性的危险因素，确定高风险因子。结果与实施失效模式与效应分析前比较，实施后医护人员手卫生知识知晓率明显提高，差异有统计学意义（P〈0．01），洗手方法的正确率和5项手卫生执行率均明显提高，差异有统计学意义（P〈0．05），FMEA实施前后全院洗手液与快速手消毒剂总使用量从13292ml提高到28390ml，手卫生合格率明显提高，差异有统计学意义（P〈0．05）。结论应用FMEA有助于系统分析手卫生失效的原因，指导制定改进措施，可有效提高医护人员的手卫生依从性，从而降低院内感染。

Objective To discuss the application of failure mode and effect analysis to improve the hand hygiene compliance of medical staff in eye hospital. Methods To form failure mode and effect analysis （FMEA） quality control team. By using FMEA method of risk management, to analyze the risk factors of hand hygiene compliance of medical staff in eye hospital. By performing analysis, to determine the high risk factor, develop and implement the improvement measures to reduce the risk of these factors. Results the awareness rate of hand hygiene knowledge was increased significantly after the implementation of failure mode and effect analysis（P〈0.01 ）, the correct rate of hand-washing method, and the implementing rate of 5 hand hygiene were increased significantly （P〈0.05）. After the implementation of FMEA, the usage amount of hand washing liquid and quick hand disinfectant was increased from 13 292 ml to 28 390 ml, and difference of the hand hygiene qualification rate was statistically significant （P〈0.05）. Conclusion The application of FMEA contributes to analyze the causes of hand hygiene failure, and guide the development of improvement measures, which can effectively improve the hand hygiene compliance of medical staff, thereby reducing nosocomial infection.