Application research of tracking methodology combined with FMEA in hand hygiene management for nosocomial infection prevention and control
Objective To investigate the application effect of tracking methodology combined with failure mode and effect analysis(FMEA)in hand hygiene management for nosocomial infection prevention and control in the post-epidemic era.Methods A hand hygiene management tracking and inspection team was set up to track and inspect the hand hygiene management process using tracking methods such as data review,on-site interviews,and field inspections.A total of 100 cases of medical personnel who were directly involved in patient diagnosis and treatment operations in Guangdong Second TCM Hospital from January 2022 to June 2023 were selected and were divided into a control group(from January 2022 to September 2022,pre-implementation)and an observation group(from October 2022 to June 2023,post-implementation)with 50 cases in each group.In the control group,there were 31 males and 19 females,aged(31.88±4.56)years,with working duration of(4.72±1.73)years.In the observation group,there were 29 males and 21 females,aged(30.24±6.08)years,with working duration of(4.84±1.63)years.FMEA was applied to carry out risk assessment,and thereafter corresponding interventions were carried out.A hand hygiene tracking and inspection team was established to determine the tracking and inspection process.The members of the inspection team conducted the assessment and inspection on the hand hygiene condition according to the process and recorded the problems found in the inspection.The control group was conducted by means of no intervention and no training before the inspection and random check.The observation group first conducted intensive on-site hand hygiene knowledge training(the training contents included hand hygiene facility requirements,hand hygiene principles,5 opportunities for hand washing,hand hygiene and nosocomial infection related knowledge,and watching seven-step washing manipulation video,etc.),and then assessed the members after the training.The differences in hand hygiene compliance,correct rate of hand hygiene,awareness rate of hand hygiene knowledge,and qualification rate of hand hygiene disinfection effect monitoring were compared between the two groups.t test and x2 test were used.Results Hand hygiene assessment,hand hygiene practices,and hand hygiene training were important failure mode risk factors for hand hygiene management.In the control group,the compliance rates of the medical staff before contact with patients,after contact with patients,after contact with body fluids/blood,after contact with surrounding environment,and before aseptic manipulation were 64.0％(32/50),72.0％(36/50),84.0％(42/50),58.0％(29/50),and 80.0％(40/50),and those in the observation group were 72.0％(36/50),82.0％(41/50),100.0％(50/50),90.0％(45/50),and 100.0％(50/50);there were statistically significant differences in the compliance rate between the two groups after contact with body fluids/blood,after contact with surrounding environment,and before aseptic manipulation(x2=8.696,P=0.003;x2=13.306,P=0.001;x2=11.111,P=0.001).The correct rate of hand hygiene,awareness rate of hand hygiene knowledge,and qualification rate of hand hygiene disinfection effect monitoring in the control group were 74.0％(37/50),80.0％(40/50),and 82.0％(41/50),and those in the observation group were 98.0％(49/50),100.0％(50/50),and 98.0％(49/50),with statistically significant differences(,x2=11.960,P=0.001;x2=11.111,P=0.001;x2=7.111,P=0.008).Conclusion The application of tracking methodology combined with FMEA can effectively enhance the efficiency of hand hygiene management,warranting further promotion and implementation.
万方数据
维普
