- 期刊
運用失效模式與效應分析降低病房多重抗藥性菌株照護流程的風險係數
Applying Healthcare Failure Mode and Effect Analysis to the Risk Factor of the Care Process of Multiple Drug Resistant Strains in the Ward
摘要
多重抗藥菌株照護是重要及不容許院內感染發生，運用失效模式與效應分析（Failure Mode and Effects Analysis, FMEA），評估本院住院中病人，多重抗藥性菌株照護流程失效模式：隔離床位運用不周全、缺乏多重抗藥性菌株照護指引、執行手部衛生正確率低、環境清潔未落實等，經專案小組收集相關資料後，整理出以危害風險指數（RPN）大於100分潛在失效項目擬定對策，包括：調整隔離床位運用效能、隔離不害怕之多重抗藥性菌株照護指引、推動手部衛生稽核之蟲蟲拜拜辦法、專人環境清潔我最行等策略，以降低本院住院中病人多重抗藥菌株交叉感染風險為本專案目的。結果：危害風險指數由1415下降至366，改善成效達74.1%；鎖床由266床／月降低為157床／月（40.0%）；手部衛生不正確率由14.7%降低為2.0%；住院中多重抗藥性菌株感染環境清潔不正確率28.4%降低為10.8%。
並列摘要
Multidrug-resistant organisms care is important and no hospital infections are allowed, Using Failure Mode and Effects Analysis, assessment of patients in our hospital, Failure modes of the multidrug-resistant organisms care process: incomplete use of isolation beds, lack of care guidelines for multidrug-resistant organisms, low accuracy in implementing hand hygiene, and unimplemented environmental cleanliness, etc. After the task team collected relevant information, the hazard risk index (RPN) Proposed countermeasures for potential failure items greater than 100 points, including: adjusting the efficiency of the isolation bed, the guidelines for the care of multi-drug resistant strains that are not afraid of isolation, the worm worship method for promoting hand hygiene audits, and the best way to clean the environment by dedicated personnel to reduce The risk of cross-infection of multidrug-resistant organisms in hospitalized patients in this hospital is the purpose of this project. Result: The hazard risk index decreased from 1415 to 366, and the improvement effect reached 74.1%; the locked bed was reduced from 266 beds/ month to 157 beds/month (40.0%) ; the incorrect hand hygiene rate was reduced from 14.7% to 2.0%; in hospital The rate of incorrect cleaning of the multidrug-resistant organisms infected environment was reduced from 28.4% to 10.8%.
延伸閱讀
- 楊惠茹、戴金英、邱鈴惠（2022）。降低加護病房多重抗藥性菌株感染密度之專案。秀傳醫學雜誌，21(2)，1-11。https://doi.org/10.30185/SCMJ.202212_21(2).0001
- 陳淑玲、黃秋玲、黃惠芳（2012）。運用失效模式及效應分析降低重症加護病房火災疏散流程的風險優先係數。南臺灣醫學雜誌，8(1)，10-19。https://doi.org/10.6726/MJST.201206_8(1).0002
- 林汭蓁、李彩緣、黃詠青、李秋香（2015）。降低某加護病房多重抗藥性鮑氏不動桿菌感染率成效專案。安泰醫護雜誌，21(2)，1-15。https://www.airitilibrary.com/Article/Detail?DocID=18111955-201512-201512010006-201512010006-1-15
- 江玉婷、戴筠臻、陳郁芬、朱育瑧、王筱珮（2021）。Project to Reduce Cases of Drug-Resistant Strain Colonization in the Intensive Care Unit Using a Chlorhexidine Gluconate Bath。護理雜誌，68(5)，74-82。https://doi.org/10.6224/JN.202110_68(5).10
- 林淑甄、張蕙茹、張雅涵、黃小容（2017）。Improving Compliance with Multi-Drug Resistant Organism Infection Control in Long-Term Care Facilities With Team Resource Management。醫務管理期刊，18(3)，252-267。https://doi.org/10.6174/JHM2017.18(3).252