| Objective:Discusses the effect of failure mode and effect analysis in improving clinical nurses’ execution of the standard prevention, for hospitals to improve the nurse standard prevention are enforced, to reduce nurses’ occupational exposure risk, to provide theoretical basis and practice guidance, to provide references for further scientific researches. Methods:Do a questionnaire survey in a grade A tertiary comprehensive hospital in Taiyuan City. The survey is directed at 125 clinical nurses from emergency department, ICU, operating room, neurology, neurosurgery, gynecology and oncology to understand the general data, occupational exposure, standard precautions compliance; Combine with the clinical observation results to truly understand the clinical nurses’ standard prevention status. Then according to FMEA implementation steps to determine the research topic is study the effect of FMEA in the implementation of nurses’ standard precaution; Choice 10 experts who have rich experience in clinical nursing or hospital infection management and team them up; Then those experts proceed “brainstorming” discussion and list all possibilities that may lead to the failure of standard prevention, analyze the cause of failure and the damage caused by the failure. Experts score every failure mode according to the discussion and calculate risk priority index. The higher the score, the greater the risks. Then give priority to develop the solution to high risk failure mode and use it for clinic, to evaluate the effect of application through the actual observation.Results:After the implementation of FMEA, the emergency department, ICU, operating room, neurology, neurosurgery, department of gynaecology, oncology nurses’ standard prevention are enforced increased significantly, by 50.07%, 55.80%, 55.13% and 55.80%, 53.80%, 54.66%, 53.80% to 54.66%, 95.50%, 94.85%, 90.35%, 91.07%, 91.01%, 91.07%; nurses use of protective equipment behavior increased significantly, isolation gown, protective clothing, goggles and protective face screen from 50% separately increase to the utilization rate of 61.31%, 86.48%, 72.65%, 61.31%; the RPN value of standard prevention of failure mode decreased obviously, which did not perform hand hygiene, did not use gloves, mask, tube caps, protective clothing, protective clothing, goggles and protective face screen, overshoes, and is not properly deal with medical waste, not to prevent sharp instrument injury, is not properly treat the one-time items, did not report the occupational exposure of RPN reduction respectively by 101.32 points to 30.26 points, 119.65 points to 31.90 points, 99.95 points to 25.95 points, 59.75 points to 16.75 points, 80.10 points to 13.85 points, 53.65 points to 15.90 points, 53.65 points to 15.90 points, 109.85 points to 22.25 points, 58.40 points to 21.90 points, 49.75 points to 12.25 points, 118.80 points to 18.55 points, 74.35 points to 19.35 points, 128.10 points to 31.60 points, The difference compared before and after the implementation is statistically significant(P<0. 05). Conclusion:Application of FMEA can effectively improve the compliance of the use of protective equipment for the clinical nurses, the implementation rate of standard prevention, and to reduce the nurse occupational risk, and reduce the incidence of occupational exposure, ensure the safety of his career. |
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