基于FMEA模式在优化重型颅脑损伤患者急救流程中的应用效果

Application effect of FMEA model in optimizing the first aid process of patients with severe craniocerebral injury

目的探讨基于失效模式和效应分析(FMEA)模式对优化急诊重型颅脑损伤患者急救护理流程的抢救效果。方法选取2019年5月—2020年4月安徽医科大学附属六安医院急诊科就诊的100例重型颅脑损伤患者为研究对象,其中2019年4月—10月就诊的50例患者作为对照组,给予常规急救护理;2019年11月—2020年4月就诊的患者作为观察组,给予基于FMEA模式的流程优化后护理。比较抢救效果及并发症情况,记录美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷(GCS)评分及护理满意度。结果观察组抢救总有效率高于对照组(P<0.05);护理后,两组NIHSS评分均降低,且观察组低于对照组;而GCS评分均升高,观察组高于对照组(P<0.05);观察组的检查返回时间、会诊到达时间、抢救室滞留时间均短于对照组(P<0.05);观察组急救护理操作评定、护理服务态度、护理效果均高于对照组(P<0.05)。结论基于FMEA模式优化的急救护理流程可有效提高急诊重型颅脑损伤患者的抢救效果及神经功能,减少护理期间不良反应,提高满意度,可在临床推广使用。

Objective To explore the effect of failure mode and effect analysis(FMEA)on optimizing emergency nursing process of severe craniocerebral injury patients.Methods A total of 100 patients with severe craniocerebral injury in the Department of Emergency Lu’an Hospital of Anhui Medical University from April to October 2019 were selected as the research subjects,50 patients treated from April to October 2019 were treated as the control group and received routine emergency care were given,patients treated from November 2019 to April 2020 were treated as the observation group and optimized care based on FMEA mode were given.The rescue effect and complications were compared.The national Institute of health stroke(NIHSS)score,glasgow coma score(GCS)and nursing satisfaction were recorded.Results The total effective rate of the observation group was higher than the control group(P<0.05);after nursing,NIHSS scores of both groups were decreased,and observation group was lower than control group;GCS scores of both groups were increased,the GCS score of observation group was higher than that of control group(P<0.05);the inspection return time,consultation arrival time and rescue room stay time of the observation group were shorter than those of the control group(P<0.05);the emergency nursing operation evaluation and nursing care of the observation group were significantly lower than those of the control group(P<0.05),the evaluation of emergency nursing operation,nursing service attitude and nursing effect in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The optimized emergency nursing process based on FMEA model can effectively improve the emergency rescue effect and neurological function of patients with severe craniocerebral injury,reduce adverse reactions during nursing,and improve the satisfaction,which can be widely used in clinical practice.