運用HFMEA手法精進加護病房高耗能電器安全維護管理

Use of HFMEA Techniques to Improve Both Safety Maintenance and Management of Energy-intensive Electrical Appliances. In the Intensive Care Unit

消防署2020年全國火災統計分析資料指出「電氣因素」是造成人員死亡比例最高之原因。試想若火災發生在人力少的時段、病人無法自我逃生、維生系統龐雜且高耗能儀器多之加護病房？因此提升用電安全管理為預防火災刻不容緩之要務。
本計畫運用失效模式與效應分析(HFMEA)，先行繪製出高耗能電器安全維護管理系統圖，釐清4項系統、11項次系統及15項子系統，並進行潛在失效模式分析及危害分析，針對「環境、設備、人員及規定」4個構面研擬行動方案。經過行動方案推動後，加護病房2020年高耗能電器請修率為6.12%，較前期下降3.18%；風險係數RPN平均改善率57%；2020~2021年2月無火災預防性通報事件；同仁管理維護認知教育訓練由改善前82分提升至改善後90分；高耗能電器維修成本大幅下降58%，透過失效模式與效應分析，發掘高耗能電器管理維護失效原因，進而落實標準化作業流程，提高同仁對高耗能電器的認知並精進其管理、檢查與維護工作，有效的減少異常事件發生，降低可能的風險與危害。

The 2020 national fire statistics from the National Fire Agency, Ministry of the Interior, indicate that electrical factors in intensive care units (ICU) accounted for the highest proportion of deaths among patients. If a fire occurs when few staff members are available to respond, patients are likely to be unable to evacuate the premises. Additionally, the procedures surrounding energy-intensive electrical appliance and equipment use in ICUs are not always clear Therefore, improving safety when using and maintaining electric appliances would likely greatly reduce the risk of ICU fires.
We used Healthcare Failure Mode and Effect Analysis (HFMEA) to create a diagram depicting both safety maintenance and the management system for energy-intensive electrical appliances. Four systems, 11 subsystems, and 15 subsystems were evaluated using potential failure mode analysis and hazard analysis to address environmental concerns, medical equipment insufficiencies, personnel expertise, and safety regulations.
After announcing the devised action plan, the request rate for energy-intensive electrical appliances in ICUs in 2020 was 6.12%, a decrease of 3.18% from the previous year. Moreover, the average improvement rate in risk priority numbers was 57%, and cognitive education training scores for personnel increased from 82 to 90 points. Finally, maintenance costs for energy-intensive electrical appliances significantly decreased by 58%.
By using HFMEA, our team identified the factors that lead to management and maintenance failures when using energy-intensive electrical appliances in ICUs. Subsequently, we implemented standardized operating procedures that effectively reduced the occurrence of abnormal events and in turn reduced potential risks and hazards.