OBJECTIVE To explore the risk evaluation of healthcare workers contracting tuberculosis in a designated three-A tuberculosis hospital in Guangxi based on the failure mode and effect analysis (FMEA) method.

METHODS A designated three-A tuberculosis hospital in Guangxi was selected. Healthcare workers from Jan. 1, 2023 to Dec. 31, 2023 served as the control group and received routine management, i. e., implementing various tuberculosis prevention and control measures according to current guidelines. Healthcare workers from Jan. 1, 2024 to Dec. 31, 2024 served as the experimental group and were managed by the FMEA method. High-risk factors were screened through the FMEA method, and targeted intervention strategies were formulated to prioritize intervention for high-risk events. The incidence rate of tuberculosis among healthcare workers and the implementation rate of tuberculosis infection prevention and control measures before and after FMEA intervention were compared.

RESULTS The six high-risk events screened were improper use of surgical masks by patients, inadequate respiratory hygiene practices, improper use of medical protective masks by healthcare workers, lack of full process isolation management for tuberculosis patients, unreasonable sputum collection areas and improper ventilation and air disinfection measure setting or maintenance. After implementing a series of tuberculosis prevention and control measures, the incidence rate of tuberculosis infection among healthcare workers decreased from 1.63% before FMEA intervention to 0.30% (P=0.021). The implementation rate of tuberculosis infection prevention and control measures increased from 69.95% to 73.61% (P=0.003).

CONCLUSIONS Risk evaluation based on the FMEA method can identify weaknesses in tuberculosis infection prevention among healthcare workers in designated tuberculosis hospitals. Implementing multiple measures simultaneously can effectively reduce the incidence rate of tuberculosis among healthcare workers, ensure occupational safety, improve the implementation rate of tuberculosis infection prevention and control measures and achieve scientific and precise prevention and control.