动态医疗失效模式与效应分析方法在CLABSI防控中的应用OA

Objective To analyze the short-and long-term effects of dynamic healthcare failure mode and effect analysis(HFMEA)in reducing central line-associated bloodstream infection(CLABSI)by using a segmented regression model designed with interrupted time series analysis.Methods Hospitalized patients with indwelling central venous catheters in a tertiary first-class hospital in Hebei Province from June 2022 to May 2024 were selected as the research subjects.June 2023 was set as the intervention point,and the study was divided into two stages:pre-intervention stage(from June 2022 to May 2023)and post-intervention stage(from June 2023 to May 2024).Before intervention,conventional HFMEA method was applied to identify failure modes and assess hazard score.After intervention,the dynamic HFMEA method was implemented,and 2-4 key failure modes were dynamically determined monthly for cyclic improvement based on three criteria:hazard index,compliance rate,and controllabi-lity.The short-and long-term intervention effect on CLABSI incidence was analyzed using the Poisson segmented regression model designed with interrupted time series.Results The trend of CLABSI incidence before intervention was not statistically significant(β1=-0.002,P=0.388);after implementing improvements using dynamic HFMEA,the short-term intervention effect was not statistically significant(β2=-0.018,P=0.513),but the long-term intervention effect was statistically significant(β3=-0.009,P=0.025),and the average CLABSI incidence decreased by 0.011 ‰ every month after the intervention.Conclusion The dynamic HFMEA method can effectively reduce the incidence of CLABSI through progressive cyclic improvement,and the improvement effect is sustainable.