基于风险检验的新生儿多功能床边监护仪安全风险评估及对策研究

Study on safety risk assessment and countermeasures of neonatal multifunctional bedside monitor

目的:基于风险检验(RBI)技术构建安全风险评估模型,探讨其在新生儿多功能床边监护仪管理中的应用价值。方法:选取医院2020-2021年临床在用的17台新生儿多功能床边监护仪,按照研究周期将2020年1-12月设备及管理数据纳入对照组,将2021年1-12月设备及管理数据纳入观察组,对照组采用经验评估模式;观察组采用RBI评估模式。从感染、电气、报警和性能筛选监护仪的一级和二级失效风险指标,通过失效概率数学模型预测不同设备的安全隐患和事故频率。对比两组设备感染控制质量及运行质量。通过调查问卷方式,对被调研者临床服务质量进行满意度调查。结果:观察组心电电极、血压袖带、血氧传感器和体温传感器清洁消毒合格率高于对照组,差异有统计学意义(x^(2)=8.243,x^(2)=12.452,x^(2)=10.676,x^(2)=4.626;P<0.05);观察组设备的异常报警、性能参数故障和电气安全隐患低于对照组,差异有统计学意义(x^(2)=5.549,x^(2)=6.298,x^(2)=9.257;P<0.05);被调研者对观察组的管理内容、管理方法、管理效果及科室人员间的协作水平满意度好于对照组,差异有统计学意义(t=3.380,t=4.600,t=3.116,t=3.058;P<0.05)。结论:RBI评估模型能够分析新生儿多功能床边监护仪的风险隐患和失效概率,降低设备相关感染发生率,提高设备运行质量和服务水平。

Objective:To construct a safety risk assessment model based on risk based inspection(RBI)technology and explore its application value in the management of neonatal multifunctional bedside monitor.Methods:A total of 17 neonatal multifunctional bedside monitors in clinical use were selected and divided into control group and observation group according to study period.The control group adopted empirical assessment mode.The observation group adopted RBI assessment mode to screen the primary and secondary failure risk indicators of the monitor from four aspects of infection,electrical,alarm and performance,and the potential safety hazards and accident frequencies of different equipment were predicted by failure probability mathematical model.The infection control quality,equipment operation quality and clinical service quality were compared between the two groups.Results:The qualification rate of clean disinfection of electrocardiographic electrode,blood pressure cuff,blood oxygen sensor and temperature sensor in the observation group was higher than that in the control group,the difference was statistically significant(x^(2)=8.243,x^(2)=12.452,x^(2)=10.676,x^(2)=4.626;P<0.05).The abnormal device alarm,performance parameter failure and electrical safety hazard in the observation group were lower than that in the control group,the difference was statistically significant(x^(2)=5.549,x^(2)=6.298,x^(2)=9.257;P<0.05).The respondents'satisfaction with the management content,management methods,management effects and the level of collaboration among department personnel of the observation group was better than that of the control group,the difference was statistically significant(t=3.380,t=4.600,t=3.116,t=3.058;P<0.05).Conclusion:The RBI assessment model can analyze the potential risks and failure probability of neonatal multifunctional bedside monitor,reduce the incidence of equipment associated infection,improve the operation quality and service level of the equipment.