作　　者： (董美丽）; (吕润丽）; (邢艳芳）; (崔颖）; (迟俊涛）;

机构地区： 青岛大学附属烟台毓璜顶医院消毒供应中心,烟台264000

出　　处： 《中华现代护理杂志》 2017年第17期2279-2282,共4页

摘　　要： 目的 完善医用动力工具清洗流程,提升医用动力工具清洗质量.方法 2016年4月成立失效模式和效应分析法（FMEA）项目小组,运用FMEA对医用动力工具清洗流程进行分析,针对高风险因素给予干预,结合ATP生物荧光检测结果,完善医用动力工具清洗流程进行持续改进.对医用动力工具清洗流程进行风险评估,确定高风险因子,制定并实施改进措施,比较FMEA前（2016年3月）和改进后（2016年9月）医用动力工具清洗危险序数（RPN）控制效果和清洗效果.结果 FMEA实施前后医用动力工具清洗流程RPN由（218.17〈89.14）分降至（33.26〈9.54）分;清洗质量ATP生物荧光检测合格率由68.6%提升至98.5%,实施前后比较差异有统计学意义（χ2=22.94,P〈0.01）.结论 应用失效模式和效因分析能有效的控制医用动力工具清洗流程中风险因素,提升动力工具清洗质量,减少患者发生感染的机会. Objective To consummate the cleaning process of medical power tool so as to improve the quality of cleaning of medical power tool.Methods The failure mode and effect analysis（FMEA） project group was built up in April 2016. The cleaning process of medical power tool was analyzed with the method of FMEA. The intervention was carried out aiming at high risk factor. Besides, the cleaning process of medical power tool was consummated and improved continually combining the detection results of ATP bioluminescence assay. The risk assessment of the cleaning process of medical power tool was carried out to determine high risk factors and formulate as well as implement improvement measures. The control effect of risk priority number （RPN） of cleaning on medical power tool and cleaning effect were compared before （March 2016） and after （September 2016） FMEA.Results The RPN of the cleaning process of medical power tool decreased from （218.17〈89.14） before implementing FMEA to （33.26〈9.54） after implementing FMEA. The qualified rate of ATP bioluminescence assay in washing quality increased from 68.6% to 98.5% before and after implementation with a significant difference （χ2=22.94,P〈0.01）.Conclusions The application of FMEA can effectively control the risk factors of the cleaning process of medical power tool, improve the cleaning quality of power tool and reduce the opportunity for infection in patients.

关 键 词： 失效模式和效应分析 清洗 医用动力工具 管理