失效模式与效应分析在急诊危重患者转科流程中的应用研究

Application of FMEA in The Process of Transferring Emergency Critical Patients

目的:运用失效模式与效应分析(FMEA)改善急诊危重患者的转运流程。方法:把急诊抢救室2018年6月—12月950例转科患者纳入对照组,2019年1—6月1066例转科患者纳入观察组。对照组采取凭经验转运的方法,观察组通过FMEA分析找出转运流程可能存在的失效模式,通过计算风险指数判断优先改善的环节,实施优化方案。比较两组转运时间、不良事件发生率以及患者满意度。结果:观察组不良事件发生率5.35%,低于对照组的22.63%,差异有统计学意义(P<0.001);观察组平均转运时间19.68±4.20分钟,低于对照组33.43±6.81分钟,差异有统计学意义(P<0.05);观察组患者满意度和接受科室满意度均高于对照组的(P<0.01)。结论:基于FMEA的转科流程改善,能降低降急诊危重患者的转运风险,提高转运安全。

Objective:Use failure mode and effect analysis(FMEA)to improve the emergency transfer process for critically ill pa⁃tients.Methods:950 transferred patients from the emergency room from June to December 2018 were included in the control group,and 1066 transferred patients from January to June 2019 were included in the observation group.The control group adopted the empiri⁃cal transfer method.The observation group used FMEA analysis to find out the possibleinvalid modes of the transfer process,calculated the risk index to determine the priority improvement links,and implemented the optimization plan.The transit time,adverse event rate and patient satisfaction were compared between the two groups.Results:The incidence of adverse events in the observation group was 5.35%,which was lower than 22.63%in the control group,and the difference was statistically significant(P<0.001);the average tran⁃sit time in the observation group was 19.68±4.20 min,which was lower than the control group by 33.43±6.81 min,and the difference was statistically significant Academic significance(P<0.05);the satisfaction of patients in the observation group and the satisfaction of receiving departments are higher than those in the control group(P<0.01).Conclusion:The improvement of the transfer process based on FMEA can reduce the transfer risk of critically ill patients in emergency department and improve transfer safety.