医疗失效模式与效应分析对无痛分娩患者的影响

Effect of healthcare failure mode and effect analysis on patients undergoing painless delivery

目的探讨医疗失效模式与效应分析(HFMEA)对无痛分娩患者的影响。方法选取2018年1—12月医院实施HFMEA前收治的无痛分娩患者1437例为对照组,选取2019年1—12月医院实施HFMEA后收治的无痛分娩患者1465例为观察组。比较HFMEA实施前后失效模式危急值(RPN)的变化情况、风险优先下降率、尿潴留发生率、留置尿管率及护理质量评分。结果观察组产前护理不当、分娩过程处置不当、产后护理不当、产妇依从性差的RPN值显著低于对照组;观察组产后首次排尿时间与阴道出血量明显小于对照组;观察组产后尿潴留发生率与留置尿管率明显小于对照组;观察组患者对医护人员的宣教评分、医护人员管理评分、问题解决效率以及服务态度评分明显高于对照组;差异均有统计学意义(P<0.05)。结论HFMEA能够排序优先解决的问题,降低产后尿潴留与留置尿管的潜在发生风险,提高产后护理质量。

Objective To explore the effect of healthcare failure mode and effect analysis(HFMEA)on patients undergoing painless delivery.Methods To select 1437 cases of patients undergoing painless delivery who were admitted before HFMEA in hospital from January to December 2018 as a control group,and 1465 cases of patients with painless childbirth who were admitted after HFMEA in hospital from January to December 2019 were selected as an observation group,and the changes of the failure mode critical value(RPN)before and after the implementation of HFMEA,the risk priority reduction rate,the incidence of urinary retention,the rate of indwelling catheters,and the nursing quality score were compared.Results The RPN values of improper prenatal care,improper handling during delivery,improper postpartum care,and poor maternal compliance in the observation group were significantly lower than those in the control group,the first urination time and vaginal bleeding in the observation group were significantly lower than those in the control group.The incidence rate of postpartum urinary retention and indwelling catheter in the observation group were significantly lower than those in the control group,and the publicity and education scores,medical staff management scores,problem solving efficiency,and service attitude scores of medical staff that were from patients in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The HFMEA can prioritize the problems to be solved,reduce the potential risk of postpartum urinary retention and indwelling catheter,and improve the quality of postpartum care.