医疗失效与效应分析管理在PICU气管插管非计划性拔管中的应用

Application of healthcare failure mode and effect analysis management in unplanned extubation of PICU tracheal intubation

目的探讨医疗失效与效应分析(HFMEA)在儿童重症监护室(PICU)气管插管非计划性拔管(UEX)中的应用效果。方法本院于2017年6月开始实施HFMEA管理,将2016年7月至2017年6月85例实施气管插管常规护理的患儿纳入对照组,将2017年7月至2018年6月实施HFMEA管理的85例患儿纳入观察组,比较两组失效优先风险指数(RPN)值与UEX发生情况。结果观察组失效、操作规范、固定措施、约束方法、患儿病情和年龄、舒适管理RPN值低于对照组(P<0.05);观察组UEX发生率低于对照组(P<0.05)。结论HFMEA管理能够降低PICU气管插管患儿UEX发生率,降低失效RPN。

Objective To explore the application effect of healthcare failure mode and effect analysis(HFMEA)management in unplanned extubation(UEX)of pediatric intensive care unit(PICU)tracheal intubation.Methods To implement the HFMEA management in June 2017,and included 85 cases of children patients who underwent routine nursing of tracheal intubation from July 2016 to June 2017 into a control group,and 85 cases of children patients who were implemented HFMEA management from July 2017 to June 2018 were included into an observation group.The failure risk priority number(RPN)value and the occurrence of UEX were compared between the two groups.Results The observation group had lower failures,operating standards,fixed measures,restraint methods,children patients'condition and age,and comfort management RPN values than those of the control group(P<0.05).The incidence of UEX in the observation group was lower than that in the control group(P<0.05).Conclusion The HFMEA management could reduce the incidence of UEX and reduce the failure RPN in children patients with PICU tracheal intubation.