基于失效模式与效应分析在电外科手术器械烧伤的管理研究

A Study on the Management of Electrosurgical Instrument Burns Based on Failure Mode and Effect Analysis

目的探讨基于失效模式与效应分析(FMEA)在消毒供应中心(CSSD)电外科手术器械烧伤的管理研究。方法将2023年2-12月某三级甲等医院共1583件电外科手术器械分成对照组和实验组,2023年2-6月实施FMEA前的750件手术器械作为对照组,采用常规管理方法;2023年7-12月实施FMEA管理的833件手术器械作为实验组,在对照组常规管理基础上联合FMEA管理,比较实施FMEA前后两组电外科手术器械烧伤的失效模式风险优先数(RPN)及医护人员对CSSD电外科手术器械处理满意率;记录并比较电外科手术器械使用过程中两组患者皮肤烧伤或切口组织烧伤程度等不良反应发生情况。结果实验组电外科手术器械绝缘层磨损老化、回收不及时、回收防护不当、清洗操作不规范、带电器械未做绝缘检测的RPN值明显低于对照组(P<0.05);实施FMEA后手术室医护人员对电外科手术器械处理质量满意率明显高于实施FMEA前医护人员满意率(P<0.05)。实验组电外科手术器械使用过程中患者电外科烧伤发生率低于对照组(P<0.05)。结论应用FMEA对电外科手术器械处理缺陷进行前瞻性分析,可有效降低电外科手术器械管理中的烧伤风险,提升器械管理的效果及服务满意度。

Objective To study the management of electrosurgical instrument burns in the Central Sterile Supply Department(CSSD)based on failure mode and effect analysis(FMEA).Methods A total of 1583 electrosurgical devices collected in a tertiary hospital from February to December 2023 were included as the study objects,among which 750 devices from February to June 2023 before the implementation of FMEA were included in the control group(under conventional management),while 833 devices from July to December 2023 after the implementation of FMEA were included in the experimental group(under FMEA management in addition to conventional management).The risk priority number(RPN)of failure mode and the satisfaction of medical staff with the treatment of electrosurgical devices in the CSSD before and after the implementation of FMEA were compared between the two groups.The occurrence of adverse events such as skin burns or incision tissue burns during the use of electrosurgical devices was recorded and compared between the two groups.Results Compared with those in the control group,the electrosurgical instruments in the experimental group exhibited lower RPN values in insulation wear and aging,delayed recovery,improper protection of electrosurgical devices,irregular cleaning process and no insulation test of live devices(P<0.05).The satisfaction of medical staff with the quality of device treatment after the implementation of FMEA was significantly higher than that before the implementation of FMEA(P<0.05).The incidence of electrosurgical device burns in the after the implementation of FMEA was lower than that in the control group(P<0.05).Conclusion The prospective analysis of the treatment defects of electrosurgical devices based on FMEA can effectively reduce the risk of burn injury in electrosurgical device management,and improve the effect of device management and service satisfaction.