医疗失效模式与效应分析在脑卒中跌倒防范中的应用

Application of medical failure modes and effects analysis in preventing the stroke from fall

[目的]探讨医疗失效模式与效应分析(FMEA)在脑卒中跌倒防范中的应用。[方法]2017年7月—2017年12月应用FMEA分析神经内科收治的60例脑卒中病人跌倒发生原因,并找出潜在失效模式,探讨改进流程,制定改进措施,并与FMEA未实施前脑卒中病人跌倒情况进行比较。[结果]FMEA管理实施后病人预防跌倒设施不全、健康教育依从性差、防跌倒措施未落实、健康教育未实施、评估分值与实际不符等风险因子危急值(RPN)明显低于实施前(P<0.05)。实施后脑卒中病人跌倒预防知识知晓率、跌倒预防依从率、治疗满意率均高于实施前(P<0.05),而跌倒发生率低于实施前(P<0.05)。[结论]FMEA能有效降低脑卒中住院病人跌倒RNP分值及跌倒发生率,确保脑卒中病人住院安全性,提高病人治疗满意率。

Objective:To explore the application of medical failure mode and effect analysis(FMEA)in stroke fall prevention.Methods:From July 2017 to December 2017,FMEA was used to analyze the causes of falls in 60 stroke patients admitted to the neurology department,and to identify the potential failure modes,explore improvement procedures,develop improvement measures,and implement foreheads with FMEA.The comparison was made with falls in patients without pre FMEA stroke.Results:The RPN value of risk factors such as incomplete fall prevention facilities,poor health education compliance,failure prevention measures,health education without property market,assessment scores,and actual differences after implementation were lower than those before the implementation(P<0.05).After implementation,the fall prevention knowledge awareness rate,fall prevention compliance rate and treatment satisfaction rate of stroke patients were higher than those before the implementation(P<0.05),and the fall incidence was lower than that before the implementation(P<0.05).Conclusions:FMEA could effectively reduce the RNP score and the incidence of falls in hospitalized patients with stroke,ensure the safety of hospitalization for stroke patients,and improve the patient satisfaction rate.