中国感染控制杂志2026，Vol.25Issue(6)：867-872,6.DOI:10.12138/j.issn.1671-9638.20263252
动态医疗失效模式与效应分析方法在CLABSI防控中的应用
Application of dynamic healthcare failure mode and effect analysis method in the prevention and control of central line-associated bloodstream infection
摘要
Abstract
Objective To analyze the short-and long-term effects of dynamic healthcare failure mode and effect analysis(HFMEA)in reducing central line-associated bloodstream infection(CLABSI)by using a segmented regression model designed with interrupted time series analysis.Methods Hospitalized patients with indwelling central venous catheters in a tertiary first-class hospital in Hebei Province from June 2022 to May 2024 were selected as the research subjects.June 2023 was set as the intervention point,and the study was divided into two stages:pre-intervention stage(from June 2022 to May 2023)and post-intervention stage(from June 2023 to May 2024).Before intervention,conventional HFMEA method was applied to identify failure modes and assess hazard score.After intervention,the dynamic HFMEA method was implemented,and 2-4 key failure modes were dynamically determined monthly for cyclic improvement based on three criteria:hazard index,compliance rate,and controllabi-lity.The short-and long-term intervention effect on CLABSI incidence was analyzed using the Poisson segmented regression model designed with interrupted time series.Results The trend of CLABSI incidence before intervention was not statistically significant(β1=-0.002,P=0.388);after implementing improvements using dynamic HFMEA,the short-term intervention effect was not statistically significant(β2=-0.018,P=0.513),but the long-term intervention effect was statistically significant(β3=-0.009,P=0.025),and the average CLABSI incidence decreased by 0.011 ‰ every month after the intervention.Conclusion The dynamic HFMEA method can effectively reduce the incidence of CLABSI through progressive cyclic improvement,and the improvement effect is sustainable.关键词
医疗失效模式与效应分析/中央血管导管相关血流感染/改进科学/质量持续改进/多模式策略Key words
healthcare failure mode and effect analysis/central line-associated bloodstream infection/improve-ment science/quality continuous improvement/multimodal strategy分类
医药卫生引用本文复制引用
郭栩雯,张翔宇,刘雪芬,户培华,董毅,马凯芳,董梁..动态医疗失效模式与效应分析方法在CLABSI防控中的应用[J].中国感染控制杂志,2026,25(6):867-872,6.基金项目
河北省卫生健康委青年科技课题(20242371) （20242371）
