Study On Nosocomial Infection Risk Management Scheme In Tuberculosis Ward Based On Failure Mode And Effect Analysis

Objective:To explore the application of FMEA method in nosocomial infection management of tuberculosis ward.1.Developing "Nosocomial Infection Management Risk Assessment Scale" Based on FMEA method in tuberculosis Ward;2.To develop management interventions for nosocomial infection management risk control in tuberculosis wards and conduct preliminary validation.Methods:In this study,risk assessment of nosocomial infection management in tuberculosis ward of a tertiary Class A infectious disease hospital in Kunming,Yunnan Province was conducted based on FMEA method.Through the establishment of a risk assessment expert team,the use of brainstorming,literature analysis and other methods to sort out the process,determine the tuberculosis ward "nososoal infection management risk assessment scale",calculate its risk priority coefficient(RPN)to obtain high risk items,discuss and develop management intervention measures for nososoal infection management risk control in the tuberculosis ward,and conduct preliminary verification to evaluate its intervention effect.Results:1.In this study,risk identification was carried out from the aspects of patient management,personnel management,hand hygiene,environmental management,medical equipment management,invasive operation infection control and building layout,and 21 potential failure modes were identified by consensus,and their RPN values were calculated.According to RPN value,five high-risk items need to be improved first,that is,(1)patients with excessive basic diseases and low immune function;(2)High-frequency contact surfaces of ventilators and other medical equipment are not strictly cleaned and disinfected;(3)Sputum management is not standard;(4)Simplified hand hygiene procedures or no time to attend to;(5)Medical staff and cleaning staff have insufficient cognition of hospital sense knowledge.2.Evaluation of intervention effect: the RPN values of the five high-risk items decreased from 74.78,71.21,67.82,64.34,61.86 before intervention to 56.31、16.63、20.63、21.70、21.14 after intervention,and the RPN values all decreased,with statistical significance(P<0.05).The qualified rates of hygienic hand disinfection,surface cleaning and disinfection of medical equipment and air cleaning and disinfection were respectively increased from 87.23%,86.82% and 88.29% before intervention to 94.56%,94.83% and 96.84% after intervention,and the qualified rates were all increased,the difference was statistically significant(P<0.001).Conclusion:1.The risk points of nosocomial infection management in tuberculosis ward can be determined by using FMEA method.2.Based on the FMEA method,the management intervention measures for the management risk control of tuberculosis ward nosocomial infection have a good effect on the prevention and control of tuberculosis ward nosocomial infection.