失效模式与效应分析在儿科门诊输液风险管理中的应用

The application of Failure Mode and Effect Analysis in the pediatric outpatients transfusion risk management

目的:探讨失效模式与效应分析(FMEA)在儿科门诊输液风险管理中的应用效果。方法:应用FMEA方法对儿科门诊输液过程中可能出现的失效模式进行分析、评估,找出影响静脉输液安全的原因,通过计算RPN值,找出问题,并按照PDCA循环制订方案,落实改进措施,评估实施后的效果。结果:FMEA改进措施实施后,静脉输液流程风险顺位前10位的RPN值明显下降,下降幅度为87.19～509.81;患者满意度由实施前的63.2%上升至实施后的90.4%(P<0.05);护士满意度由实施前的69.6%上升至实施后的100%(P<0.05)。结论:将FMEA应用于儿科门诊输液风险管理,能在风险事件发生前对其进行有效预测、评估,使隐性风险得到量化,并针对不同等级的风险,采取有效的应对措施,可降低儿科门诊静脉输液意外事件的发生率。

Objectives： To explore the application effect of Failure Mode and Effect Analysis （FMEA） in pediatric outpatient transfusion risk management. Methods： FMEA was used to analyze and evaluate the failure modes that may occur in the pediatric outpatient transfusion flow. We identified the reasons by calculating RPN, draw up and carried out the plan of improvement measures according to PDCA circle, and evaluated the implementation effect. Results： When the improverment measures have been implemented, the top 10 RPN of intravenous infusion flow risk decreased obviously, the fall scope ranging from 87.19 to 509.81. Patients＇ satisfaction increased from 63.2% to 90.4% （P〈0.05）. Nurses＇ satisfaction increased from 69.6% to 100% （P〈0.05）. Conclusion： The application of FMEA in the pediatric outpatient transfusion risk management could predict and evaluate the risk before the events occur, qualify all the hidden risks, classify the risks, take effective preventive measures, and reduce the occurrence of risk events in pediatric outpatients infusion.