医疗失效模式与效应分析在降低儿科病房噪声污染中的应用研究

Application of health care failure mode and effects analysis to reduce the paediatric wards noise pollution

目的应用医疗失效模式与效应分析管理模式减少儿科病房声音分贝,降低噪声污染,以期提高护理人员抗噪声风险意识及严谨的工作态度,保证医护人员及患儿身心健康,保持良好的医疗环境。方法采用方便抽样法发放噪声调查问卷并使用噪音仪器进行监测,获得病房噪音产生重点来源、重点时段、重点地段,随后进入医疗失效模式与效应分析实施阶段,列出儿科病房工作流程,然后对流程进行分析,算出危急值,对危急值较高的项目制订并实施整改措施,采用噪声调查问卷进行评价。结果实施医疗失效模式与效应分析管理模式后,危急值明显降低,患儿及家属认为受噪声干扰程度非常严重的人数由38人降低至29人(χ2值为21.82,P<0.05),对控制噪声管理非常满意的人数由18人上升至30人(χ2值为36.28,P<0.05),噪声重点地段强度、噪声来源强度、各时段强度明显改善且差异有统计学意义(P<0.05)。结论医疗失效模式与效应分析管理作为一种质量管理模式,可降低病房噪声污染,提高患者满意度,保证医护人员及患儿身心健康,塑造良好的医疗环境。

Objective To use the methods of Health Care Failure Mode and Effects Analysis to reduce the paediatric wards noise pollution,Ensure the physical and mental health of medical staff and children,and maintain a good medical environment.Methods The sampling method is adopted,noise investigation questionnaire was used in our study and we use the noise instrument to monitor the sound,and the focus source,the key time period and the key section of the room noise are obtained,then the HFMEA is carried out,we listed the work flow of the pediatric ward,and the flow is analyzed and discussed,calculate the Risk Priority Number(RPN).Then,some improvement measures were carried out aimed at the failure mode,the noise survey questionnaire were used for evaluation.Results After the implemented the HFMEA,The RPN value was significantly decreased(P<0.05).the degree of noise interference of children and their families decreased from 38 to 29,the difference was statistically significant(χ2 value was 21.82,P<0.05),and the satisfaction with control noise was improved from 18 to 30,the difference was statistically significant(χ2 value was 36.28,P<0.05).The intensity of noise key areas,The intensity of noise source and intensity in each period of the day were significantly improved and the difference was statistically significant(P<0.05),and the critical value was significantly decreased.Conclusion Applying HFMEA can reduce ward noise pollution,improve patient satisfaction,ensure the physical and mental health of medical staff and children,and create a good medical environment.