失效模式与效应分析在透析用中心静脉置管管理流程中的应用

The application of failure mode and effect analysis in nursing management of central venous catheter in hemodialysis patients

目的探讨失效模式与效应分析在血液透析用中心静脉置管护理管理中的作用。方法采用失效模式与效应分析法针对透析用中心静脉置管护理管理组成团队,分析诊疗流程并制作出流程图,进行失效模式与潜在风险原因分析,计算事先风险指数(RPN)值,制定与实施预防中心静脉置管并发症的改进措施;对比了实施失效模式与效应分析前后中心静脉置管一次性成功率及导管并发症发生率。结果实施后中心静脉置管一次性成功率高于实施前;并发生症发生率低于实施前,差异均有统计学意义(P<0.01)。结论失效模式与效应分析方法的应用有助于预防透析用中心静脉置管并发症发生,提高患者的透析质量,保障患者的安全。

Objective To discuss failure mode and effect analysis in nursing management of central venous catheter in hemodialysis patients. Methods We used failure mode and effect analysis in nursing management of hemodialysis patients with central venous catheter. We ana- lyzed the diagnosis and treatment process, made out the flow chart, analyzed the cause of failure mode and potential risk, calculated in ad- vance risk index （RPN） value, and improve the prevention of avoiding the center venous catheter complications ; The comparisons, that the incidence of one-time success and catheter complications, were made bettween before and after the implementation of failure mode and effect analysis.Results The incidence of one-time success and catheter complications were significantly different （P〈0.05, P〈0.01 ） before and after the implementation of failure mode and effect analysis.Conclusion The application of failure mode and effect analysis is useful in preventing the central venous catheter complications, improving the medical quality, and ensuring the safety of dialysis patients.