失效模式与效应分析在血管外科复合手术护理配合中的应用

Application of Failure Mode and Effect Analysis in Nursing Cooperation of Combined Vascular Hybrid Surgery

目的探讨失效模式与效应分析(FMEA)在血管外科复合手术护理配合中的应用。方法运用FMEA管理工具,对血管外科实施复合手术患者所执行的护理措施进行前瞻性干预,探寻手术配合过程中潜在的风险,应用SOD计算出2组RPN值的变化,根据潜在风险因素制定并实施持续改进方案。结果血管外科复合手术护理配合中存在术前访视不够到位(RPN=360)、术前准备不够充分(RPN=1219)、手术配合不够及时(RPN=1879)、麻醉苏醒评估不足(RPN=1015)、转运交接不当(RPN=1560)等高风险失效模式,采取针对性的改进措施后,相应RPN值分别下降至70、240、320、210、246;FMEA实施前后不良事件发生率比较,差异有统计学意义(P<0.05)。结论将失效模式与效应分析方法应用于血管外科复合手术护理配合中,效果良好,有效降低了不良事件的发生率。

Objective To investigate the application of failure mode and effect analysis(FMEA)in vascular surgery combined with surgical care.Methods FMEA management tools were used to prospectively intervene in the care measures performed by patients undergoing vascular surgery,and to explore the potential risks in the process of operation.The changes of RPN values??were calculated.According to the potential risk factors,continuous improvement program was formulated.Results In the nursing cooperation of combined vascular surgery,there were high risk failure modes,such as inadequate preoperative visit(RPN=360),inadequate preoperative preparation(RPN=1219),untimely operation cooperation(RPN=1879),insufficient anesthesia recovery evaluation(RPN=1015),improper transfer and handover(RPN=1560).After taking targeted improvement measures,the corresponding RPN values were reduced to 70,240,320,210,246 respectively.After the FMEA implementation,the incidence of adverse events was different,and the difference was statistically significant(P<0.05).Conclusion?The failure mode and the effect analysis method are applied to the surgical cooperation of vascular surgery,and the effect is good and the incidence of adverse events is effectively reduced.