医疗失效模式与效应分析在降低神经科非计划性拔管发生率中的应用

Application of healthcare failure mode and effect analysis in reducing incidence of unplanned extubation in neurology clinics

目的探讨医疗失效模式与效应分析(HFMEA)在神经科非计划性拔管(UEX)发生率中的应用效果。方法选取神经科留置各种管路患者100例为研究对象,HFMEA应用前(2018年9月—12月)50例患者为对照组,HFMEA应用后(2019年1月—4月)50例患者为观察组。比较2组患者失效模式危急值(RPN)和UEX发生率。结果观察组患者约束措施、管道固定、健康宣教PRN值低于对照组,差异有统计学意义(P<0.05)。观察组UEX发生率为10.00%(5/50),低于对照组的26.00%(13/50),差异有统计学意义(P<0.05)。结论HFMEA管理模式可以有效降低神经科UEX发生率,持续改进护理质量,保障患者安全。

Objective To evaluate the application of healthcare failure mode and effect analysis(HFMEA)in reducing incidence of unplanned extubation(UEX)in neurology clinics.Methods Totally 50 patients receiving catheterization between September and December 2018 were set as the control group.Another 50 patients receiving catheterization between January and April 2019 were included as the observation group.Interventions based on HFMEA were carried out to improve the quality of catheter maintenance in the observation group.The Risk Priority Number(RPN)score and incidence of UEX were compared between two groups.Results The RPN scores of constraints,catheter fixation and health education in the observation group were lower than those in the control group(P<0.05).The incidence of UEX was 10.00%(5/50)in the observation group and 26.00%(13/50)in the control group,with a significant difference(P<0.05).Conclusion The application of HFMEA is potentially effective to reduce the incidence of UEX and continuously improve the quality of nursing in neurology clinics.