Objective To explore the application and evaluation of HFMEA (healthcare failure mode and effect analysis) and decision tree model in the management of multidrug-resistant organism (MDRO) infection in medical institutions. Methods The HFMEA risk assessment method and decision tree analysis were used to screen out high-risk factors of MDRO infections in the Third People’s Hospital of Yancheng City of Jiangsu Province from June 2023 to December 2023. Targeted improvement intervention measures were adopted and rectification was implemented from January to June 2024, with a comparative analysis conducted to assess the effects before and after the interventions. Results Among the 48 failure modes, 7 high-risk modes that need improvement were selected for intervention. By comparing the MDRO management indicators before and after intervention, it was found that the comprehensive target assessment compliance rates of nosocomial infection before and after intervention were 81.6% and 92.1% respectively, with no statistically significant difference. After the intervention, the other 6 indicators: the awareness rate of the MDRO infection risk assessment system in the department, the execution rate of the MDRO risk assessment in the department, the effective isolation rate of MDRO-infected patients, the qualified rate of the training and examination of clinical physicians on antimicrobial drugs, the qualified rate of the review of antimicrobial drug prescriptions, and the deduction rate of the department for not implementing MDRO prevention and control measures were compared with those before the intervention, and the differences were statistically significant (P<0.05). Conclusions HFMEA and decision tree model as management tools are effective in evaluating the risk of MDRO infection in medical institutions, which can optimize the management process of MDRO, promote the improvement of management measures in departments such as medical care, nursing, and pharmacy, and effectively prevent the spread and outbreak of MDRO within hospitals.
Key words
failure mode and effect analysis /
decision tree analysis /
multidrug-resistant organism /
nosocomial infection
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