应用失效模式与效应分析理论预防门诊接种儿童不良反应的效果

Effects of Failure Mode and Effect Analysis on Reducing Incidence of Adverse Reactions in Vaccination Prevented Children

目的评价失效模式与效应分析(Failure Mode and Effect Analysis,FMEA)理论在降低儿童预防接种不良反应中的效果。方法选择43 826例门诊行预防接种的儿童为观察组,实施FMEA方法分析门诊预防接种护理工作流程中的失效模式及原因,并制定改善措施。以常规接种护理的41 954例预防接种儿童为对照组。比较两组优先风险数(RPN)值、不良反应发生率和服务满意度的差异。结果实施FMEA后,预防接种工作流程中诱发接种不良反应的失效模式RPN值皆降低。两组不良反应发生率(127.78/105vs 45.2/105)和服务满意度(90.31%vs97.90%)比较,差异有统计学意义(P<0.05)。结论 FMEA方法应用于预防接种护理工作,可有效降低不良反应发生率,提高服务满意度。

Objective To evaluate the effects of failure mode and effect analysis（ FMEA） on reducing incidence of adverse reactions in vaccination prevented children. Methods 43826 vaccination prevented children applying FMEA theory to analyze the main reasons of adverse reactions were divided into observation group,while 41954 cases into control group given routine nursing care. Then risk priority number,incidence of adverse reactions and service satisfaction between the groups were compared. Results After implementation of methods of FMEA,the RPN in the failure mode was all lowered. Compared with control group,incidence of adverse reactions in observation group was decreased（ P〈0. 05）,while service satisfaction raised（ P〈0. 05）. Conclusion The FMEA model can be effective in reducing incidence of adverse reactions and raising service satisfaction.