Identification of key potential risk areas and key potential failure modes in hemodialysis rooms by the FMEA method following routine prevention and control of the COVID-19 pandemic
Yingying Ruan
Hemodialysis Room, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorQijun Hong
Hemodialysis Room, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorLili Feng
Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorChing-Wen Chien
Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, China
Search for more papers by this authorCorresponding Author
Kai Sun
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorCorresponding Author
Yen-Ching Chuang
Institute of Public Health and Emergency Management, Taizhou University, Taizhou, Zhejiang, China
Business College, Taizhou University, Taizhou, Zhejiang, China
Key Laboratory of evidence-based Radiology of Taizhou, Linhai, Zhejiang, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorCorresponding Author
Fuqin Tang
Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorYingying Ruan
Hemodialysis Room, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorQijun Hong
Hemodialysis Room, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorLili Feng
Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Search for more papers by this authorChing-Wen Chien
Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, China
Search for more papers by this authorCorresponding Author
Kai Sun
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorCorresponding Author
Yen-Ching Chuang
Institute of Public Health and Emergency Management, Taizhou University, Taizhou, Zhejiang, China
Business College, Taizhou University, Taizhou, Zhejiang, China
Key Laboratory of evidence-based Radiology of Taizhou, Linhai, Zhejiang, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorCorresponding Author
Fuqin Tang
Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
Correspondence
Kai Sun, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Email: imsunkai@connect.hku.hk
Yen-Ching Chuang, Business College, Taizhou University, No.1139, Shifu Avenue, Taizhou, Zhejiang Province, China.
Email: yenching.chuang@gmail.com; yenching@yeah.net
Fuqin Tang, Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), No.999, Donghai Avenue, Economic Development Zone, Taizhou, Zhejiang Province, China.
Email: tangfq@tzzxyy.com; fuqintang2022@yeah.net
Search for more papers by this authorYingying Ruan and Qijun Hong contributed equally to this study.
Abstract
Hemodialysis is an important part of nosocomial infection prevention and control (IPC). This study aimed to identify the key potential risk areas and failure modes in hemodialysis rooms in hospitals and put forward a series of improvement measures to prevent and control the spread of the coronavirus disease 2019 (COVID-19). Hemodialysis patients are highly susceptible to COVID-19 and usually have a high incidence of severe illness and mortality after infection with COVID-19. Therefore, IPC in hemodialysis patients is of crucial strategic significance. Based on 30 domain experts’ interviews and careful analysis of prevention and control documents, we constructed a comprehensive failure system for a model that identifies the potential risks for nosocomial COVID-19 infection in the hemodialysis room. Subsequently, a thorough risk assessment of the potential failure factors identified in our model was conducted. The failure key factors corresponding to the human element in medical waste (garbage) disposal (C2) are verified to be the highest risk factors. They are as follows: The cleaning staff did not dispose of different types of medical waste (garbage) (C21), did not wear masks according to the regulations (C22), and lacked knowledge and norms of nosocomial IPC (C23). This study provides valuable insights for hospital decision-makers on the potential failure factors related to COVID-19 infections in hemodialysis rooms. By working with hospital infection specialists, the suggested improvement measures can help reduce the risk of virus exposure among hospital medical staff, patients, and cleaning staff.
CONFLICT OF INTEREST STATEMENT
The authors have no proprietary interest in any aspect of this study.
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