不同管理模式对降低中国医务人员职业暴露发生率效果的网状Meta分析OA

Objective To systematically evaluate the effect of different management modes on reducing the inci-dence of bloodborne occupational exposure among medical staff in Chinese medical institutions.Methods Literature on the effect of different management modes on the incidence of occupational exposure among medical staff were retrieved from China National Knowledge Infrastructure(CNKI),Wanfang Data,and PubMed.Search period was from database inception to February 25,2025.The Newcastle-Ottawa scale(NOS)was used to assess the quality of the studies,R software was used for Meta-analysis and Stata software for network Meta-analysis.Results A total of 31 observational studies involving 7 active management modes were included in analysis.Network Meta-analysis results showed that compared with conventional management,7 active management modes(reduction/readiness/response/recovery[4R]crisis management mode,failure mode and effect analysis[FMEA],plan-do-check-action[PDCA]cycle management method,quality control circle[QCC],Six Sigma method,soft/hard/envi-ronment/litigant[SHEL]accident analysis method,and root cause analysis[RCA])could all reduce the risk of occupational exposure among medical staff(all P<0.05).However,there were no statistically significant diffe-rences among 7 active management modes.The probability ranking indicated that FMEA had the highest likelihood of being the optimal mode(75.3%).FMEA was optimal in the nurse and mixed professional subgroups,while PDCA was optimal in the nursing interns subgroup.Conclusion Active management modes such as PDCA are superior to conventional management in reducing the risk of occupational exposure,with FMEA being the most effective method.The optimal management mode may vary with personnel category and should be flexibly applied in practice.