非传统安全视角下军队中心医院科室生物安全管理等级研究

Research on the biosecurity management levels for departments of military central hospital from the perspective of nontraditional security

目的提出一套适用于军队中心医院主要科室的生物安全管理等级.方法采用头脑风暴结合德尔菲流程设定科室生物安全构成的要素;通过失效模式与影响分析计算各科室的生物安全风险优先指数(RPN);使用文献计量结合层次分析法评估生物安全风险要素的风险概率、严重性和可监测性;采用单因素方差分析对比不同类型科室生物安全风险的差异.结果评估了38个科室的医院感染、生物材质和生物技术管理风险的RPN值及其综合RPN值;综合RPN在4.19~0.18之间,中位数为2.47,综合RPN值最高的5个科室为传染科、医学检验科、消毒供应科、呼吸内科和老年病科;专科类科室RPN值显著低于内科类、外科类科室.据此提出Ⅰ—Ⅴ级生物安全管理等级,其中,Ⅰ级(最低级)9个、Ⅱ级6个、Ⅲ级12个、Ⅳ级7个、Ⅴ级(最高级)4个.结论本文得出的RPN值及生物安全管理等级有助于卫勤机关科学配置生物安全管控资源,提高管控绩效,为制订相关管理标准奠定基础.

Objective To establish a set of biosecurity management levels for the main departments of military central hospital.Methods Brainstorming combined with Delphi process were used to set the indicators of the departments biosecurity.Biosecurity risk priority numbers(RPNs)were calculated through failure mode and effect analysis.Bibliometrics combined with analytical hierarchy process were used to assess the probability,severity and detection difficulty of biosecurity risks.Oneway analysis of variance was used to compare the differences in biosecurity risks of different types of departments.Results The RPNs of management risks of nosocomial infection,biomaterial and biotechnology in 38 departments and their synthesized RPNs were evaluated.The synthesized RPNs ranged from 4.19 to 0.18,with a median of 2.47,and the top 5 departments of synthesized RPNs were department of infection diseases,medical laboratory,sterile supply center,respiratory medicine and gerontology department.RPNs values of specialized departments were significantly lower than those of internal medicine and surgical departments.Thus,five biosecurity management levels(I to V)were proposed.The numbers of level I(the lowest level)to level V(the highest level)were 9,6,12,7 and 4,respectively.Conclusion The RPNs and the biosecurity management levels obtained in this study are helpful for the authority of military medical service to scientifically allocate biosecurity control resources,enhance biosecurity management performance,and make a foundation for the formulation of relevant management standards.