基于医疗失效模式与效应分析优化急诊抢救室心电监护仪报警应答管理流程的研究

Evaluation of the effect of optimizing the alarm response management process of ECG monitor in emergency rescue room based on medical failure mode and effect analysis

目的 探讨医疗失效模式与效应分析(health failure mode and effect analysis, HFMEA)在急诊抢救室心电监护仪报警应答管理流程中的应用效果。方法 将2023年7月-9月急诊抢救室收治的48例患者设为对照组,将2023年10月—12月急诊抢救室收治的48例患者设为观察组,对照组采用常规流程对心电监护仪报警进行应答管理,观察组采用基于HFMEA优化后的流程对心电监护仪报警进行应答管理。比较2组心电监护仪误报警率、报警应答有效率以及护士报警疲劳评分。结果 观察组心电监护仪误报警率低于对照组(χ2=156.225,P<0.001),报警应答有效率高于对照组(χ2=81.823,P<0.001),且实施HFMEA后急诊抢救室护士报警疲劳得分低于实施前(t=5.093,P<0.001)。结论 应用HFMEA对急诊抢救室监护仪报警应答管理流程进行优化,降低了心电监护仪误报警率,提高了报警应答有效率,减轻了护士的报警疲劳,从而有效防范因监护仪报警应答管理缺陷而导致的医疗风险。

Objective To explore the application effect of health failure mode and effect analysis(HFMEA)in optimizing the alarm response management process of ECG monitor in emergency rescue room.Methods A total of 48 patients admitted to the emergency rescue room between July and September 2023 were selected into the control group,while another 48 patients admitted in the following 3 months were chosen into the observation group.Routine procedures were followed to respond to the alarm of the electric monitor in the control group,while the optimized process based on HFMEA was adopted in the observation group.The false alarm rate,alarm response efficiency and alarm fatigue score of nurses were compared between the two groups.Results The false alarm rate of ECG monitor and the alarm fatigue score in the observation group were significantly lower than that of the control group(χ2=156.225,P<0.001;t=5.093,P<0.001),while the effective rate of alarm response was significantly higher than that of the control group(χ2=81.823,P<0.001).Conclusion The HFMEA-based alarm response process lowers the false alarm rate of the ECG monitor,the alarm fatigue of nurses and the nursing risk caused by the defects of the monitor alarm response management,but improves the efficiency of the alarm response.