To evaluate the effectiveness of healthcare failure mode and effect analysis (HFMEA) in improving the prevention and control of multidrug-resistant organism (MDRO) infections in critically ill neurosurgical patients.

The critically ill neurosurgical patients admitted to the ICU of Beijing Tiantan Hospital were divided into the control group (1726 cases from January to December 2023) and the experimental group (1812 cases from January to December 2024) according to their admission time. The control group received routine MDRO infection prevention and control measures; the experimental group received interventions based on an optimized process developed using the HFMEA model. Outcomes compared between the two groups included the incidence of MDRO infection, risk priority number (RPN) of failure modes, compliance with MDRO isolation precautions among nursing staff, and scores of infection prevention control culture questionnaire (LCOQ-IP).

Following the implemention of the HFMEA-based optimized process, the RPN values for 10 high-risk and medium-high-risk factors were significantly reduced (P<0.05). The MDRO infection rate in the experimental group was 7.45%, significantly lower than 11.88% in the control group (P<0.001). Compliance with isolation protocols-including the use of isolation signs, hand hygiene, isolation gowns, environmental disinfection, waste management, and terminal cleaning-was significantly higher in the experimental group compared to the control group (all P<0.05). Additionally, the LCOQ-IP score among ICU healthcare workers significantly increased after the intervention compared to before (P<0.05).

The HFMEA-based optimized MDRO management process for critically ill neurosurgical patients effectively reduces the incidence of MDRO infections, improves staff compliance with isolation precautions, and enhances the perceived culture of infection prevention and control among healthcare workers.