Abstract
Objective
To explore the efficacy of healthcare-associated infection (HAI) prevention and control management that is based on Healthcare Failure Mode and Effect Analysis (HFMEA) in the prevention of puerperal infection after cesarean section converted from trial of vaginal labor.
Methods
An HFMEA team was set up. The study was conducted from July to December 2023 (pre-intervention) and January to June 2024 (post-intervention), with 115 and 118 puerperae in the pre- and post-intervention periods, respectively. By mapping out the management process of cesarean section converted from trial of vaginal labor, key failure modes related to infection prevention and control were identified. Subsequently, potential causes of these failure modes were analyzed, and improvement plans were formulated, implemented, followed by the evaluation of their efficacy.
Results
Following the optimization of the management process for cesarean section converted from trial of vaginal labor using HFMEA, the Risk Priority Number (RPN) of potential failure modes leading to puerperal infection after this procedure was significantly reduced, with a notable improvement rate. The hand hygiene compliance rate increased from 60.9% (67/110) to 80.4% (90/112), the accuracy rate of surgical hand disinfection rose from 66.7% (80/120) to 90.7% (136/150), and the incidence of puerperal infection after the procedure decreased from 7.8% (9/115) to 1.7% (2/118), with statistically significant differences (
P
= 0.031). In contrast, the surgical site infection rate decreased from 1.7% (2/115) to 0% (0/118), with no statistically significant difference (
P
= 0.155).
Conclusion
The application of HFMEA, as part of a multifaceted quality improvement initiative, was associated with a refinement of the management process for cesarean section converted from trial of vaginal labor and a lower incidence of puerperal infection. However, due to the before-and-after study design, causality cannot be definitively established.