失效模式与效应分析在消毒供应中心硬式内镜器械全流程管理中的应用

Application of failure mode and effect analysis in the whole process management of hard endoscopic instruments in the disinfection and suppy center

目的探讨失效模式与效应分析(FMEA)应用于消毒供应中心硬式内镜器械全流程管理中的效果。方法2022年1月将FMEA应用于某医院硬式内镜处理流程中,组建FMEA小组,对存在的失效模式进行汇总分析,提出相应的整改措施,比较FMEA实施前后硬式内镜处理全流程中的风险优先数(RPN)和工作人员工作质量。结果FMEA实施后,硬式内镜器械交接错误、器械丢失、清洗不彻底、器械组配错误、器械损坏、灭菌失败、漏登记等失效模式RPN值均显著降低(P<0.01)。FMEA实施后器械清洗、检查包装、器械灭菌合格率均显著高于FMEA实施前(P<0.01),器械损坏率低于实施前(P<0.01)。结论FMEA能够发现硬式内镜在处理全流程中潜在的问题,提高管理质量。

Objective To explore the effect of Failure Mode and Effect Analysis(FMEA)in the whole process management of rigid endoscopic instruments in disinfection supply center.Methods In January,2022,FMEA was applied to the rigid endoscope treatment process in a hospital,and a FMEA team was established.The existing failure modes were summarized and analyzed,and the corresponding rectification measures were put forward.The risk priority number(RPN)in the whole process of rigid endoscopic treatment before and after FMEA implementation and the work quality of staff were compared.Results After the implementation of FMEA,the failure mode RPN values of rigid endoscope,such as instrument handover error,instrument loss,incomplete cleaning,the device group equipped with errors,instrument damage,sterilization failure and missed registration,were significantly reduced(P<0.05).After the implementation of FMEA,the qualified rates of equipment cleaning,inspection and packaging,and equipment sterilization were significantly higher than those before the implementation of FMEA(P<0.01).The damage rate of rigid endoscopic instruments was lower than that before implementation(P<0.01).Conclusion FMEA can find the potential problems in the whole process of rigid endoscopy,and improve the management quality.