失效模式与效应分析护理在神经外科意识障碍患者救治流程优化中的应用效果

Application effects of failure mode and effect analysis nursing in optimization of treatment process of patients with consciousness disorders in department of neurosurgery

目的:观察失效模式与效应分析(FMEA)护理在神经外科意识障碍患者救治流程优化中的应用效果。方法:回顾性分析2018年2月至2020年6月该院收治的46例神经外科意识障碍患者的临床资料,设为对照组,2020年7月至2021年2月该院收治的54例神经外科意识障碍患者的临床资料,设为观察组。对照组接受常规护理,观察组在对照组基础上实施FMEA护理,比较两组急救时间(急诊室停留时间、救治前检查时间、病房交接时间)、护理前后意识恢复[格拉斯哥昏迷量表(GCS)、昏迷恢复量表(CRS-R)]评分、生理状态[功能障碍量表(DFS)]评分,以及清醒率、家属护理满意度。结果:观察组急诊室停留时间、救治前检查时间、病房交接时间均短于对照组,差异有统计学意义(P<0.05);护理后,两组GCS、CRS-R评分均高于护理前,且观察组高于对照组,两组DFS评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组清醒率和家属护理满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:在常规护理基础上实施FMEA护理可缩短神经外科意识障碍患者急救时间,提高GCS评分、CRS-R评分、清醒率和家属护理满意度评分,以及降低DFS评分,效果优于单纯常规护理。

Objective:To observe application effects of failure mode and effect analysis(FMEA)nursing in optimization of treatment process of patients with consciousness disorders in department of neurosurgery.Methods:The clinical data of 46 patients with consciousness disorders in department of neurosurgery admitted to this hospital from February 2018 to June 2020 were retrospectively analyzed and they were set as control group;the clinical data of 54 patients admitted to this hospital from July 2020 to February 2021 were retrospectively analyzed and they were set as observation group.The control group received routine nursing,while the observation group received FMEA nursing on the basis of that of the control group.The emergency time(emergency room stay time,pre-treatment inspection time,ward handover time),the consciousness recovery scores before and after the nursing[Glasgow coma scale(GCS),coma recovery scale(CRS-R)],the physiological state score[functional disability scale(DFS)]score,the awakening rate and the family’s nursing satisfaction were compared between the two groups.Results:The emergency room stay time,the pre-treatment inspection time,and the ward handover time in the observation group were all shorter than those in the control group,and the differences were statistically significant(P<0.05).After the nursing,the GCS and CRS-R scores of the two groups were higher than those before the nursing,and those of the observation group were higher than those of the control group;the DFS scores of the two groups were lower than those before nursing,and that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05).Further,the awakening rate and the family’s nursing satisfaction score in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:FMEA nursing on the basis of routine nursing can shorten the emergency time of neurosurgery patients with consciousness disorder,improve the GCS score,CRS-R score,wake rate and family nursing satisfaction score,and reduce the DFS score,and the effect is better than simple routine nursing.