基于医疗失效模式与效应分析的精细化管理对降低导尿管相关性尿路感染的作用

Effect of meticulous management based on medical failure mode and effect analysis in reducing catheter-associated urinary tract infection

目的探讨医疗失效模式与效应分析(FMEA)的精细化管理应用于临床管理中,对降低导尿管相关性尿路感染(CAUTI)的效果。方法运用随机数字法选取2015年10月~2017年2月于本院內科病房内留置导尿管的患者120例作为研究对象,其中2015年10月~2016年4月对其实行常规管理模式的56例患者作为对照组,2016年5月~2017年2月实行FMEA管理模式的64例患者作为观察组,观察所有患者于不同管理模式实行期间CAUTI发生率、发生时间以及留置导尿管时间等。结果观察组风险优先指数评分(RPN)明显低于对照组(P<0.01);CAUTI发生率低于对照组,CAUTI发生时间、留置导尿管时间短于对照组(P<0.05),观察组护士的手卫生依从性以及预防CAUTI依从率均明显优于对照组(P<0.05)。结论 FMEA管理模式可有效降低CAUTI发生率,改善预后,在临床护理方面具有一定的参考价值。

Objective To explore the effect of meticulous management based on medical failure mode and effect analysis （FMEA） applied in clinical management in reducing catheter-associated urinary tract infection （CAUTI）.Methods 120 patients with indwelling catheter in internal medicine ward of our hospital from October 2015 to February 2017 were selected as the study objects according to random number table method.56 cases of patients from October 2015 to April 2016 given routinue management model were set as the control group,and 64 cases of patients from May 2016 to February 2017 given FMEA management model were set as the observation group.The incidence rate and time of CAUTI,indwelling catheter time and son on were observed in all the patients given different management methods.Results The risk priority index score （RPN） of the observation group was significantly lower than that of the control group （P〈0.01）. The incidence rate of CAUTI in the observation group was lower than that of the control group,incidence time of CAUTI and indwelling catheter time in the observation group was shorter than that of the control group （P〈0.05）.The compliance of nurses＇ hands in the observation group and the compliance rate of prevention of CAUTI were all significantly better than those of the control group （P〈0.05）.Conclusion FMEA management model can effectively reduce the proba-bility of CAUTI,and improve prognosis.It has certain reference value in clinical nursing.