Risk Assessment Based On Failure Mode And Effects Analysis In Nosocomial Infection Control Of Children's Hospital

Objective: FMEA,which was used in engineering supervision,was utilized to control nosocomial infection in this thesis.1,To discuss application of risk assessment based on FMEA in the field of nosocomial infection occurred in children's hospital.2,To make "Scale of risk assessment related to nosocomial infection" and to find out departments that are at high risk.3,To take measures on high risk factors to reduce nosocomial infection risk and to assess intervention effect according to appropriate measures.4,To establish systemized way of evaluating risk of nosocomial infection in children's hospital.Methods: Based on FMEA,we collected information on 54634 hospitalized patients,including 975 infected cases,and strived to know the status of nosocomial infection in children's hospital.Via brain storming and reference researching,departments of high risk were figured out.Possible high risk factors of nosocomial infection were considered through literature review and group discussing.RPN was calculated to assure actual high risk factors of nosocomial infection,and contribute to intervention(risk management).To cope with these actual high risk factors,patients hospitalized in 2017 were selected as intervented subjects.Risk factor management wad used among intervented patients.Effect of risk factor management was observed by comparing nosocomial infection rate between intervented grouo and control group.Results: 1,Nosocomial infection rate of Children's Hospital from 2015 to 2017 was 1.84%,1.83%,1.53% respectively.Prevalence of Nosocomial infection rate from 2015 to 2017 was 3.05%,3.97%,3.41%.Most patients suffered from upper respiratory infection,followed by lower respiratory infection,gastrointestinal infection and Blood system infection.2,Departments that were at high risk were Department of children hematology,NICU,PICU,Department of pediatric respiratory medicine,Department of pediatric surgery.3,High risk factors in high risk departments should be focused including Ward management and key population monitoring of Children hematology.VAP,CLABSI,CAUTI,Hand hygiene of NICU.Ward disinfection and medical textile management in Department of rehabilitation.Seperation of severe pneumonia and serious infection patients.Aseptic technique,type III and type IV of surgical site in Department of pediatric surgery.Aseptic technique and Asthmatic bronchitis patients management in Department of pediatric respiratory medicine.4,In both intervented and control group,main infected site were respiratory system,blood system,gastric system.Infection rate in intervented group was significantly low compared with control group.(1.83% versus 1.53%,?2=7.17,p<0.05)Conclusion: Risk assessment based on FMEA could contribute to locate high risk factors and help to reduce nosocomial infection risk.