输液风险管理中FMEA和RCA联合应用价值探讨

A discussion of the combined application value of FMEA and RCA in the IV in fusionrisk management

目的:探讨失效模式与效应分析(FMEA)和根本原因分析(RCA)法在儿科门诊输液风险管理中的联合应用效果,以提高护理质量,确保患儿输液安全。方法:成立分析小组,绘制输液流程图,运用FMEA方法,列出儿科门诊输液过程中可能出现的失效模式,并对其中的关键失效模式利用RCA法进行分析和评估,找出影响静脉输液安全的根本原因,实施改进措施并评估实施后的效果。结果:改进措施实施后,静脉输液流程风险顺位前4位的风险优先指数(RPN)明显下降,患者对输液护理的满意度由实施前的78.09%上升至实施后的95.03%;护士对输液护理的满意度由实施前的83.79%上升至实施后的97.80%。结论:将FMEA和RCA联合应用于儿科门诊输液风险管理,可提高护理质量,并可有效减少儿科门诊输液室护理投诉与医护纠纷。

Objective： To explore the combined application effect of failure mode and effect analysis （FMEA） and root cause analysis （RCA） in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients. Methods： For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results： After implemented the improved measures, the risk of top 4 risk priority number （RPN） in intravenous infusion flow decreased obviously. For the transfusion management, patients＇ satisfaction increased from 78.09% to 95.03% （P〈0.05）, and nurses＇ satisfaction increased from 83.79% to 97.80%（P〈0.05）. Conclusion： The combined application of FMEA and RCA in the Ⅳ infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.