Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 28, 2025
Open Peer Review Period: May 27, 2025 - Jul 22, 2025
Date Accepted: Jan 16, 2026
(closed for review but you can still tweet)
Investigating the Effect of Hospital Infection Control Informatization on Optimizing Microbiological Specimen Submission Before Antibiotic Therapy: Failure Mode and Effects Analysis
ABSTRACT
Background:
Antimicrobial resistance (AMR) poses a critical global health threat, with inappropriate antibiotic use being a major driver. Optimizing pathogen submission before antibiotic therapy is essential for targeted antimicrobial stewardship.
Objective:
This study aimed to systematically identify workflow risks and improve pathogen submission rates through hospital informatization.
Methods:
Failure Mode and Effects Analysis (FMEA) was conducted at a tertiary hospital in China. A multidisciplinary team identified potential failure modes across four domains: health information systems, personnel, administration, and external support. Risk Priority Numbers (RPNs) and Action Priority (AP) indices were calculated for each failure mode. Targeted interventions were implemented, including dual-verification barcode scanning, AI-driven clinical decision support alerts, EHR-integrated training modules, and automated compliance dashboards. Pre- and post-intervention pathogen submission rates (January 2023–December 2024) were analyzed using the Mann-Kendall trend test.
Results:
The top five failure modes included PDA barcode scanning failures (RPN=175), inadequate clinical decision support (RPN=140), insufficient clinician awareness (RPN=56), suboptimal oversight mechanisms, and patient-related barriers. Post-intervention, significant upward trends were observed in overall pathogen submission rates (P <0.05), with similar improvements for restricted-use (P<0.05) and special-use antibiotics (P <0.05).
Conclusions:
FMEA-based risk management combined with hospital informatization effectively optimized pathogen submission workflows. Real-time decision support, process standardization, and interdisciplinary collaboration significantly enhanced compliance. Future research should evaluate long-term impacts on AMR reduction and diagnostic integration.
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Copyright
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