Effect of HFMEA in prevention of catheter-related bloodstream infections in artificial liver support system therapy

doi:10.3760/cma.j.cn441417-20240729-02033

Abstract

Abstract:

Objective　To analyze the effect of healthcare failure mode and effect analysis (HFMEA) in the prevention of catheter-related bloodstream infections in artificial liver therapy. Methods　The patients taking artificial liver therapy at Third Hospital, Sun Yat-sen University from January 2022 to December 2023 were selected for the non-randomized controlled trial. According to the admission time, the patients were divided into a control group (283 cases), treated from January two December 2022, and an observation group, treated from January to December 2023. There were 283 males and 55 females in the control group; they were (49.35±11.52) years old. There were 323 males and 66 females in the observation group; they were (47.90±12.94) years old. The control group took routine nursing care for artificial liver catheters. The observation group were managed with HFMEA. The risk priority numbers (RPN) of the healthcare failure mode of catheter-related bloodstream infections, incidence rates of catheter-related bloodstream infections, and scores of catheter maintenance theory and operation of the nursing staff were compared between two groups by t test. Results　The RPN of the healthcare failure mode of catheter-related bloodstream infections and incidence rate of catheter-related bloodstream infections in the observation group were lower than those in the control group [1 592 vs. 3 980 and 0.083‰ (1/11 984) vs. 0.418‰ (5/11 952)]. The scores of the nursing staff's theoretical and operational assessments were higher after than before the application of HFMEA (85.28±4.94 vs. 75.56±9.72 and 94.24±2.19 vs. 84.24±2.19 ), with statistical differences (t=6.490 and 23.506; both P<0.05). Conclusion　The application of HFMEA can prospectively foresee the high-risk failure links that are prone to artificial liver catheter-related bloodstream infections, reduce the occurrence of artificial liver catheter-related bloodstream infections, and improve the nursing staff's catheter maintenance ability.

Key words:

Artificial Liver Support System, Catheterization, Infection, Healthcare failure mode and effect analysis

摘要：

目的　探讨医疗失效模式与效应分析（HFMEA）预防人工肝支持系统（ALSS）导管相关血流感染的效果。方法　选取中山大学附属第三医院2022年1月至2023年12月行ALSS治疗的患者进行非随机对照试验，根据入院时间分成对照组（2022年1月至12月）和观察组（2023年1月至12月）。对照组338例，男283例，女55例，年龄（49.35±11.52）岁，采用ALSS导管常规护理。观察组389例，男323例，女66例，年龄（47.90±12.94）岁，应用HFMEA管理。两组均护理7 d。比较护理后两组患者ALSS导管相关血流感染失效模式风险系数（RPN）和发生率，实施HFMEA项目管理前、后科室护理人员ALSS导管维护理论和操作考核成绩。统计学方法采用t检验。结果　护理后，观察组患者ALSS导管相关血流感染失效模式RPN与发生率均较对照组低［1 592分比3 980分、0.083‰（1/11 984）比0.418‰（5/11 952）］。实施HFMEA项目管理后，护理人员理论考核、操作考核成绩均高于实施前［（85.28±4.94）分比（75.56±9.72）分、（94.24±2.19）分比（84.24±2.19）分］，差异均有统计学意义（t=6.490、23.506，均P<0.05）。结论　应用HFMEA可前瞻性预见易导致ALSS治疗患者导管相关血流感染的高风险失效环节，降低导管相关血流感染事件发生率，提高护理人员导管维护能力。

关键词:

人工肝支持系统, 置管, 感染, 医疗失效模式与效应分析

Ouyang Shan, He Na, Wang Juan, Zheng Lihua, Zheng Zimei, Li Lili.

Effect of HFMEA in prevention of catheter-related bloodstream infections in artificial liver support system therapy [J]. International Medicine and Health Guidance News, 2025, 31(2): 340-344.

欧阳姗何娜王娟郑丽花郑子梅李莉莉.

基于HFMEA预防人工肝支持系统导管相关血流感染的效果评价 [J]. 国际医药卫生导报, 2025, 31(2): 340-344.

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