失效模式与效应分析联合PDCA管理模式在手术室护理管理中的应用

Effects of failure mode and effect analysis combined with PDCA in nursing management of Operating Room

目的探讨分析失效模式与效应分析(FMEA)联合PDCA循环管理模式在手术室护理管理中的应用效果。方法采用便利抽样法选择2017年4月—2018年6月的手术患者140例作为观察组,选择2016年1月—2017年3月手术患者140例作为对照组。对照组采取常规手术室护理管理,观察组采取FMEA联合PDCA循环管理。比较FMEA联合PDCA循环管理模式实施前后5个项目风险优先指数(RPN值)变化,比较两组护理不良事件发生情况,并调查手术医师对手术室护理配合的满意度。结果观察组手术患者的手术部位标识错误、术中感染预防准备和措施不到位、术中低体温、术中压疮、术前欠缺安全访视评估RPN值均低较对照组下降。观察组不良事件发生率低于对照组(P<0.05),观察组手术医师满意率高于对照组(P<0.05)。结论在手术室护理管理中运用FMEA联合PDCA循环管理模式,有助于降低手术室护理安全隐患,保障手术护理安全,提高手术室护理质量。

Objective To explore the effects of failure mode and effect analysis(FMEA)combined with plan-do-check-action(PDCA)in nursing management of Operating Room.Methods By convenience sampling,this study selected 140 surgery patients from April 2017 to June 2018 in observation group,and selected 140 cases from January 2016 to March 2017 in observation group.Control group carried out the routine nursing management of Operating Room,while observation group implemented the FMEA combined with PDCA cycle management.Finally,this study compared 5-item risk priority number(RPN)before and after implementing FMEA combined with PDCA cycle management,the incidence of nursing adverse events between two groups and investigated the satisfaction of surgeons with nursing cooperation in Operating Room.Results In observation group,the RPN of the surgical site mark error of surgery patients,infection prevention preparation and measure not in place,hypothermia,and pressure injury during surgery and lack of safety visit assessment before surgery were lower than those in control group.The incidence of adverse events of observation group was lower than that of control group with a statistical difference(P<0.05).The surgeons'satisfaction of observation group was higher than that of control group with a statistical difference(P<0.05).Conclusions Application of FMEA combined with PDCA cycle management in nursing management of Operating Room contributes to reducing the nursing hidden danger,guaranteeing nursing safety and improving nursing quality of Operating Room.