中国感染控制杂志2026，Vol.25Issue(8)：1233-1241,9.DOI:10.12138/j.issn.1671-9638.20264237
FMEA联合PDCA循环管理在重症监护病房多重耐药菌防控中的应用
Application of FMEA combined with PDCA cycle management in the prevention and control of multidrug-resistant organism in intensive care unit
摘要
Abstract
Objective To explore the application effect of failure mode and effect analysis(FMEA)combined with PDCA cycle management on reducing multidrug-resistant organism(MDRO)associated infection in the intensive care unit(ICU).Methods A quasi-experimental study with before-after control was carried out.Patients admitted to the ICU from March to December 2023 were assigned to the control group(n=171),and those hospitalized between March and December 2024 served as the intervention group(n=162).FMEA was adopted to identify high-risk links,with risk priority number(RPN)≥18 defined as the threshold for high-risk items.Rectification strategies were formulated for high-risk factors,and continuous quality improvement was implemented via the PDCA cycle.Risk reassessment and dynamic scheme adjustment were performed quarterly.Infection-related core indicators and process quality indicators were compared between the two groups.Results The top two high-risk factors included poor compliance and incorrect operation of hand hygiene(mean RPN=22.42)and nonstandard use of protective equipment for patients colonized or infected with MDROs(mean RPN=19.27),both exceeding the high-risk cut-off(RPN≥18).After intervention,their RPN values decreased by 45.45%and 66.06%,respectively.The overall nosocomial infection incidence dropped from 11.11%to 3.09%(OR=0.26,P=0.005).The MDRO-related healthcare-associated infection incidence per 1 000 patient days decreased from 3.95‰ to 0.89‰(IRR=0.23,P=0.005).The pathogenic specimen submission rate prior to therapeutic antibiotic administration rose from 89.26%to 97.62%(P=0.009).Conclusion The integrated management strategy combining FMEA and the PDCA cycle can systematically identify and intervene in weak points of MDRO prevention in the ICU,and effectively lower the risk of MDRO nosocomial infection,which deserves clinical promotion.关键词
多重耐药菌/失效模式与效应分析/PDCA循环/医院感染/重症监护病房Key words
multidrug-resistant organisms/failure mode and effects analysis/PDCA cycle/nosocomial infection/intensive care unit分类
医药卫生引用本文复制引用
李艳菊,白娜娜,陈永欢..FMEA联合PDCA循环管理在重症监护病房多重耐药菌防控中的应用[J].中国感染控制杂志,2026,25(8):1233-1241,9.基金项目
北京市大兴区中西医结合医院院级基金资助项目(DXZXYZ202415) （DXZXYZ202415）
