目的:在标准的COVID-19疫情防控措施范围内,明确计算机断层扫描(CT)检查过程中的关键感染过程和危险因素。旨在减轻医院交叉感染的发生。
方法:病例医院组建了一个由30名CT检查专家组成的团队。根据CT检查过程,从严重性(S)的角度评估潜在的故障模式,发生概率(O),和可检测性(D);然后结合相应的风险预防措施。最后,根据风险优先数(RPN)和专家分析确定关键感染过程和危险因素。
结果:通过RPN的应用和进一步分析,确定了四个关键的潜在感染过程,包括“CT申请表(A1),在CT患者(B2)的扫描过程中,\“\”CT室和物体处置(C2),“和”医疗废物(垃圾)处理(C3)“。此外,还确定了八个关键风险因素,包括\“清洁人员不正常佩戴口罩(C32),“\”护士没有选择静脉井,导致外周静脉外渗以增强CT(B25),\"\"病人找不到CT室(A13),“\”患者已获得CT申请表,但不知道程序(A12),患者身体不适,无法继续进行CT扫描(B24),\"\"辅助人员(或技术人员)对灭菌和消毒标准(C21)没有很好的掌握,\"\"辅助人员(或技术人员)不彻底消毒CT机(C22),“和”清洁人员缺乏COVID-19预防和控制(C33)的知识。”
结论:医院可以通过各种渠道宣传CT检查的注意事项,降低CT检查失败的发生率。医院的清洁服务通常是外包的,从事这些服务的员工的教育背景普遍不高。因此,在培训和沟通过程中,更有必要提供一系列与其理解水平相一致的范围和培训计划。本研究开发的模型有效地识别了关键的感染预防过程和关键的风险因素,加强医务人员和患者的安全。这对重大传染病的潜在流行具有重要的研究意义。
OBJECTIVE: To identify the key infection processes and risk factors in Computed Tomography (CT) examination process within the standard prevention and control measures for the COVID-19 epidemic, aiming to mitigate cross-infection occurrences in the hospital.
METHODS: The case hospital has assembled a team of 30 experts specialized in CT examination. Based on the CT examination process, the potential failure modes were assessed from the perspective of severity (S), occurrence probability (O), and detectability (D); they were then combined with corresponding risk prevention measures. Finally, key infection processes and risk factors were identified according to the risk priority number (RPN) and expert analysis.
RESULTS: Through the application of RPN and further analysis, four key potential infection processes were identified, including \"CT request form (A1),\" \"during the scan of CT patient (B2),\" \"CT room and objects disposal (C2),\" and \"medical waste (garbage) disposal (C3)\". In addition, eight key risk factors were also identified, including \"cleaning personnel does not wear masks normatively (C32),\" \"nurse does not select the vein well, resulting in extravasation of the peripheral vein for enhanced CT (B25),\" \"patient cannot find the CT room (A13),\" \"patient has obtained a CT request form but does not know the procedure (A12),\" \"patient is too unwell to continue with the CT scan (B24),\" \"auxiliary staff (or technician) does not have a good grasp of the sterilization and disinfection standards (C21),\" \"auxiliary staff (or technician) does not sterilize the CT machine thoroughly (C22),\" and \"cleaning personnel lacks of knowledge of COVID-19 prevention and control (C33)\".
CONCLUSIONS: Hospitals can publicize the precautions regarding CT examination through various channels, reducing the incidence of CT examination failure. Hospitals\' cleaning services are usually outsourced, and the educational background of the staff employed in these services is generally not high. Therefore, during training and communication, it is more necessary to provide a series of scope and training programs that are aligned with their understanding level. The model developed in this study effectively identifies the key infection prevention process and critical risk factors, enhancing the safety of medical staff and patients. This has significant research implications for the potential epidemic of major infectious diseases.