基于概率犹豫模糊集的麻醉设备安全运行风险评估模型构建与应用价值研究

Research on construction and application value of risk assessment model for safe operation of anesthesia equipment based on hesitant probabilistic fuzzy set

目的:基于概率犹豫模糊集(HPFS)构建麻醉设备安全运行风险评估模型,探讨其在麻醉设备安全运行风险控制管理中的应用价值。方法:以全生命周期安全和管理安全为重要风险评估维度,构建麻醉设备安全运行风险指标体系,采用HPFS和层次-优劣解距离法进行风险量化分析,制定安全自查和风险控制处理策略。选取2020年7月至2023年6月北京市通州区妇幼保健院收治的150例外科手术患者,按照麻醉设备管理模式不同,将其分为对照组和观察组,每组75例。在手术治疗中共使用16台麻醉设备,对照组患者手术治疗期间使用的10台麻醉机采用常规风险控制模式,观察组使用的12台麻醉机(含对照组中使用的6台和新增6台)采用风险评估控制模式。对比两组患者围术期内麻醉设备相关风险事件发生率、麻醉医护人员对潜在安全风险知晓率和麻醉设备故障率。结果:观察组患者围术期发生麻醉设备操作不当、麻醉用量不合理、相关感染和记录缺失风险事件例数分别为4例(占5.3%)、0例(占0%)、1例(占1.3%)和1例(占1.3%),发生率低于对照组,差异有统计学意义(x^(2)=4.478、4.110、6.857、4.754;P<0.05);观察组麻醉设备操作的医护人员安全管理理论知识、安全使用、管理意识和故障判定能力平均评分分别为(96.27±3.93)分、(94.31±2.69)分、(91.82±1.94)分和(84.97±4.36)分,均高于对照组,差异有统计学意义(t=5.176、5.322、5.541、5.942;P<0.05);两组设备操作设置、麻醉气路、麻深监测、阈值报警及其他故障的总次数分别为90、37、25、316和125次,观察组的故障发生率分别为30%(27/90)、35%(13/37)、28%(7/25)、22%(69/316)和39%(49/125),低于对照组,差异有统计学差异(x^(2)=28.800、6.541、9.680、200.532、11.664;P<0.05)。结论:基于HPFS的风险评估模式,能够降低麻醉设备相关风险事件发生率,提升麻醉医护人员安全风险控制意识,改善麻醉设备临床运行质量。

Objective:To construct a risk assessment model based on hesitant probabilistic fuzzy set(HPFS)and to explore its application value in the risk control and management of safe operation of anesthesia equipment.Methods:Taking the whole life cycle safety and management safety as the important risk assessment dimensions,the risk index system of safe operation of anesthesia equipment was constructed,HPFS and hierarchical-superior-inferior solution distance method were used to realize the quantitative analysis of risks,and the safety self-inspection and risk control treatment strategies were formulated.A total of 150 surgical patients and 16 anesthesia equipment used in surgery used in the operation were selected from July 2020 to June 2023 in Tongzhou District Maternal and Child Health Hospital,and into control group and observation group according to different management modes of anesthetic equipment,with 75 cases in each group.The 10 anesthesia machines used during the surgical treatment of the control group adopted the conventional risk control mode,and the 12 anesthesia machines used in the observation group(including 6 in the control group and the 6 newly added ones)adopted the risk assessment control mode.The incidence of perioperative anesthesia equipment-related risk events,the awareness rate of anesthesia medical staff about potential safety risks,and the failure rate of anesthesia equipment were compared between the two groups.Results:The number of perioperative risk events of improper operation of anesthesia equipment,unreasonable dosage of anesthesia,associated infection and missing records in the observation group were 4 cases(5.3%),0 cases(0%),1 case(1.3%)and 1 case(1.3%),respectively,which was lower than that in the control group,the difference was statistically significant(x^(2)=4.478,4.110,6.857,4.754;P<0.05).The average scores of theoretical knowledge of safety management,safe use,management awareness and fault judgment ability of medical staff operating anesthesia equipment in the observation group were(96.27±3.93)points,(94.31±2.69)points,(91.82±1.94)points and(84.97±4.36)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=5.176,5.322,5.541,5.942;P<0.05).The total number of equipment operation setting,anesthetic gas path,anesthesia depth monitoring,threshold alarm and other faults in the two groups were 90,37,25,316 and 125,respectively,and the failure incidence rates in the observation group were 30%(27/90),35%(13/37),28%(7/25),22%(69/316)and 39%(49/125),respectively,which were lower than those in the control group,the difference was statistically significant(x^(2)=28.800,6.541,9.680,200.532,11.664;P<0.05).Conclusion:The risk assessment model based on HPFS can reduce the incidence of risk events related to anesthesia equipment,enhance the awareness of safety risk control of anesthesia medical staff,and improve the quality of clinical operation of anesthesia equipment.