Risk assessment of neonatology nosocomial infection based on hazard vulnerability analysis / 中华医院管理杂志

ABSTRACT

Objective:To assess the nosocomial infection risk events of neonatology experienced by a hospital, for identifying those events deserving high priority in infection prevention and control and critical rooms of improvement, hence minimizing such risks of the hospital.Methods:The hazard vulnerability analysis was called into play, along with literature review and clinical practices, while the hazard vulnerability analysis team of neonatology of the hospital preliminarily screened the indexes in brainstorming method. Then the individual indexes from such screening evaluated by means of questionnaires, and the risk evaluation index system for neonatal infection prevention and control was formed in combination with the risk value evaluation table of Kaiser model. On such basis, an evaluation questionnaire for the prevention and control was developed.In May 2020, the team members scored the possibility and severity of these risk indexes in the form of questionnaire, calculated the hazard risk value, and divided the risk zones by matrix analysis.Results:The risk assessment index system of neonatology was composed of 11 management indexes, 20 implementation indexes and 7 outcome indexes. The top 5 indexes of hazard risk value were incorrect hand hygiene method(39.20%), inadequate cleaning and disinfection of environmental object surface(39.04%), the formula was not used immediately when ready(38.19%), nosocomial infection outbreak(38.02%), and low hand hygiene compliance(37.99%). The indexes with high severity and low readiness include three indexes related to formula feeding and three indexes related to cleaning and disinfection of object surface. The matrix analysis results showed that there were 9 indexes in the high-risk zone, 7 indexes in the medium risk zone and 22 in the low-risk zone.Conclusions:This study identified risk management events in hospital infection management in neonatology by means of hazard vulnerability analysis. The neonatology administrators are recommended to prioritize indexes in the high risk zone, make a root cause analysis of those indexes of high risk value and low readiness and take intervention measures in time, hence reducing the incidence of nosocomial infection and avoiding the outbreak of nosocomial infection.