医院管理论坛
醫院管理論罈
의원관이론단
HOSPITAL MANAGEMENT FORUM
2014年
5期
15-19
,共5页
失效模式与效应分析%根本原因分析法%数字化X线摄影%辐射风险
失效模式與效應分析%根本原因分析法%數字化X線攝影%輻射風險
실효모식여효응분석%근본원인분석법%수자화X선섭영%복사풍험
Failure mode and effect analysis%Root cause analysis%Digital radiography%Radiation risk
目的分析放射科数字化X线摄影(Digital Radiography，DR)检查流程缺陷及废弃影像形成的根本原因，探讨相应的对策以加强受检者DR辐射风险的管理。方法综合利用失效模式与效应分析(Failure Mode and Effect Analysis，FMEA)和根本原因分析法(Root Cause Analysis，RCA)对放射科DR检查流程及DR机器上存储的废弃影像形成原因进行分析，并制订针对性的整改措施，比较实施整改措施前后的DR废弃影像发生率和风险优先顺序值(Risk Priority Number，RPN)变化。结果与应用FMEA与RCA前比较，实施整改措施后DR废弃影像发生率由0.95%降低为0.29%，差异具有统计学意义（χ2=265.5，P<0.05）；风险优先值(RPN)下降明显，其中流程5中检查部位图像模糊的RPN值比整改前降低了62.50%。结论综合利用FMEA与RCA对放射科DR的辐射风险进行科学管理，能够有效降低DR废弃影像发生率和操作流程的风险优先值，大大减少受检者可能受到的潜在电离辐射危险。
目的分析放射科數字化X線攝影(Digital Radiography，DR)檢查流程缺陷及廢棄影像形成的根本原因，探討相應的對策以加彊受檢者DR輻射風險的管理。方法綜閤利用失效模式與效應分析(Failure Mode and Effect Analysis，FMEA)和根本原因分析法(Root Cause Analysis，RCA)對放射科DR檢查流程及DR機器上存儲的廢棄影像形成原因進行分析，併製訂針對性的整改措施，比較實施整改措施前後的DR廢棄影像髮生率和風險優先順序值(Risk Priority Number，RPN)變化。結果與應用FMEA與RCA前比較，實施整改措施後DR廢棄影像髮生率由0.95%降低為0.29%，差異具有統計學意義（χ2=265.5，P<0.05）；風險優先值(RPN)下降明顯，其中流程5中檢查部位圖像模糊的RPN值比整改前降低瞭62.50%。結論綜閤利用FMEA與RCA對放射科DR的輻射風險進行科學管理，能夠有效降低DR廢棄影像髮生率和操作流程的風險優先值，大大減少受檢者可能受到的潛在電離輻射危險。
목적분석방사과수자화X선섭영(Digital Radiography，DR)검사류정결함급폐기영상형성적근본원인，탐토상응적대책이가강수검자DR복사풍험적관리。방법종합이용실효모식여효응분석(Failure Mode and Effect Analysis，FMEA)화근본원인분석법(Root Cause Analysis，RCA)대방사과DR검사류정급DR궤기상존저적폐기영상형성원인진행분석，병제정침대성적정개조시，비교실시정개조시전후적DR폐기영상발생솔화풍험우선순서치(Risk Priority Number，RPN)변화。결과여응용FMEA여RCA전비교，실시정개조시후DR폐기영상발생솔유0.95%강저위0.29%，차이구유통계학의의（χ2=265.5，P<0.05）；풍험우선치(RPN)하강명현，기중류정5중검사부위도상모호적RPN치비정개전강저료62.50%。결론종합이용FMEA여RCA대방사과DR적복사풍험진행과학관리，능구유효강저DR폐기영상발생솔화조작류정적풍험우선치，대대감소수검자가능수도적잠재전리복사위험。
Objective To analyze the defect of examining flow in the digital radiography of the radiology department and root causes of failure images, and explore the corresponding measures to ensure the radiation safety of the subjects.Methods The failure mode and effect analysis and root cause analysis were used to analyze the examining flow and the cause of failure images stored on the DR machine before making corresponding corrective measures. Compare the incidence of failure images and the risk priority number after implementing the corrective measures.Results The incidence of the failure images reduced to 0.29% from 0.95% after implementing FMEA and RCA with statistically significant difference (x2=265.5, P<0.05). The risk priority number declined significantly, especially for the fifth examining flow, it reduced by 62.50%.Conclusion The management on the radiation safety of the digital radiography with the application of FMEA and RCA can effectively reduce the incidence of failure images and the risk priority number in the examining flow, which could decrease the potential risk of ionizing radiation on the subjects.
