摘要
目的 系统评价失效模式与效应分析(FMEA)在预防重症监护病房(ICU)获得性感染中的有效性。方法 2名研究人员独立检索外文数据库和中文数据库相关文献,检索截止时间为2022年7月15日,根据纳入和排除标准独立筛选文献、提取数据和评估总体质量,并应用RevMan 5.4软件对纳入文献的预防效果进行Meta分析。结果 共纳入了19篇文献。Meta分析结果显示,运用FMEA方法降低了ICU患者呼吸机相关肺炎发病率[OR=0.40,95%CI(0.31~0.51),P<0.01]、导尿管相关尿路感染发病率[OR=0.29,95%CI(0.17~0.51),P<0.01]、中央血管导管相关血流感染发病率[OR=0.28,95%CI(0.18~0.46),P<0.01]、多重耐药菌感染发生率[OR=0.46,95%CI(0.37~0.58),P<0.01]、ICU医院感染发病率[OR=0.46,95%CI(0.37~0.59),P<0.01],提高了ICU患者及家属满意度[OR=2.34,95%CI(1.72~3.17),P<0.01]。结论 FMEA能有效预防ICU获得性感染,提高医院感染管理质量。
Objective To systematically evaluate the effectiveness of failure mode and effect analysis(FMEA)in the prevention of intensive care unit(ICU)-acquired infection.Methods Two researchers independently searched relevant literatures from foreign and Chinese databases,with a search deadline of July 15,2022.Independent screening of literatures,extraction of data and evaluation on overall quality were performed according to inclusion and exclusion criteria.RevMan 5.4 software was used to conduct Meta-analysis on the preventive effect of the included literatures.Results A total of 19 literatures were included in analysis.Meta-analysis results showed that application of FMEA method reduced the incidences of ventilator-associated pneumonia(OR=0.40,95%CI[0.31-0.51],P<0.01),catheter-associated urinary tract infection(OR=0.29,95%CI[0.17-0.51],P<0.01),central line-associated bloodstream infection(OR=0.28,95%CI[0.18-0.46],P<0.01),and multidrug-resistant organism infection(OR=0.46,95%CI[0.37-0.58],P<0.01)in ICU patients,as well as incidence of healthcare-associated infection(HAI)in ICU(OR=0.46,95%CI[0.37-0.59],P<0.01),and significantly improved the satisfaction of ICU patients and their families(OR=2.34,95%CI[1.72-3.17],P<0.01).Conclusion FMEA can effectively prevent ICU-acquired infection and improve the quality of HAI management.
作者
郭玲玲
吴晓英
GUO Ling-ling;WU Xiao-ying(Department of Healthcare-associated Infection Control,The Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2024年第3期336-343,共8页
Chinese Journal of Infection Control
关键词
失效模式与效应分析
ICU获得性感染
多重耐药菌感染
META分析
医院感染
failure mode and effect analysis
ICU-acquired infection
multidrug-resistant organism infection
Meta-analysis
healthcare-associated infection
