失效模式与效应分析在降低麻醉恢复室全麻患者非计划拔管率中的应用

Application of Failure Mode and Effect Analysis in Reducing Unplanned Extubation Rate of General Anesthesia Patients in Post Anesthesia Care Unit

目的:探讨失效模式与效应分析在降低麻醉恢复室(PACU)全麻患者非计划拔管(UEX)发生率中的应用价值。方法:选取2016年7月-2018年6月本院术后插管患者80例。根据患者入院时间将2016年7月-2017年6月收治的患者40例作为对照组,将2017年7月-2018年6月收治的患者40例作为研究组。对照组实行PACU常规风险管理模式,研究组实行失效模式与效应分析管理模式。比较两组UEX发生率、RPN评分及患者满意程度。结果:研究组UEX发生率为2.5%,低于对照组的15.0%(P<0.05);入室时、恢复室观察、离室时,研究组RPN评分均明显低于对照组,比较差异均有统计学意义(P<0.05);研究组总满意度为100%,高于对照组的90.0%(P<0.05)。结论:全麻患者实施失效模式与效应分析管理模式,能够有效降低UEX事件的发生,保证PACU患者的安全,提高整体的护理质量。

Objective:To investigate the application value of failure mode and effect analysis in reducing the unplanned extubation rate of general anesthesia patients in post anesthesia care unit.Method:A total of 80 patients with postoperative intubation in our hospital from July 2016 to June 2018 were selected.According to the time of admission,40 patients from July 2016 to June 2017 were taken as control group,and 40 patients from July 2017 to June 2018 were taken as study group.The control group adopted PACU routine risk management model,and study group implemented failure mode and effect analysis management mode.The incidence of UEX,RPN score and patient satisfaction between two groups were compared.Result:The incidence of UEX in study group was 2.5%,which was lower than 15.0%in control group(P<0.05).The RPN scores of study group were significantly lower than those of control group at the time of entering,restoring and leaving the room,the differences were statistically significant(P<0.05).The total satisfaction rate of study group was 100%,which was higher than 90.0%of control group(P<0.05).Conclusion:The implementation of failure mode and effect analysis management mode for general anesthesia patients can effectively reduce the occurrence of UEX events,ensure the safety of PACU patients and improve the overall quality of nursing.