基于失效模式与效应分析的护理质量敏感指标数据信息化实现

Information realization of nursing quality sensitive index data based on failure mode and effect analysis

目的通过失效模式和效应分析(FMEA)对护理质量敏感指标数据信息进行监测和收集,建立护理质量敏感指标数据信息系统。方法2019年7月至2021年7月应用FMEA对上海市普陀区人民医院信息系统护理质量敏感指标数据形成过程进行风险评估,制订具体改进措施,比较实施此流程管理前后风险优先指数(RPN)值、指标数据信息化完成占比情况。结果应用FMEA进行护理质量敏感指标数据信息管理之前,指标数据元素确认、指标定义理解、记录规范、问题解决时效、信息沟通、系统数据整合等失效模式的RPN值分别为(362.00±101.56)、(539.90±174.39)、(603.20±128.71)、(395.10±184.83)、(448.90±185.58)、(334.80±107.74)分,应用之后分值均下降,分别为(17.10±9.96)、(30.90±31.66)、(42.40±28.99)、(30.30±33.94)、(16.30±17.02)、(18.90±19.27)分,应用前后比较差异有统计学意义(t值为6.18~14.74,均P<0.01);敏感指标数据信息化完成比例,由46.43%(39/84)提升至95.51%(85/89)。结论应用FMEA模式对护理质量敏感指标数据信息进行前瞻性管理,对于敏感指标信息化数据实现是有效可行的。

Objective To monitor and collect data information through failure mode and effect analysis(FMEA)and establish a data information system for nursing quality sensitive indicators.Methods From July 2019 to July 2021,FMEA was used to evaluate the formation process of nursing quality sensitive index data,formulate specific improvement measures,and compare the proportion of risk priority index(risk priority number,RPN)value and index data informatization before and after the implementation.Results Before the application of FMEA in nursing quality sensitive index data information management,the RPN value of index data element confirmation,index definition understanding,record specification,problem solving limitation,information communication and system data integration were(362.00±101.56),(539.90±174.39),(603.20±128.71),(395.10±184.83),(448.90±185.58),(334.80±107.74)points,while those after the intervention were(17.10±9.96),(30.90±31.66),(42.40±28.99),(30.30±33.94),(16.30±17.02),(18.90±19.27)points,with statistical significance(t values were 9.11 to 14.74,all P<0.05).The proportion of sensitive index data informatization increased from 46.43%(39/84)to 95.51%(85/89).Conclusions Using FMEA mode to manage the data information is effective and feasible for the realization of sensitive index information data.