基于HFMEA管理模式的护理在预防老年精神病患者跌倒中的应用效果

Application effects of HFMEA management mode-based nursing in prevention of falls in elderly patients with psychosis

目的:观察基于医疗失效模式与效应分析(HFMEA)管理模式护理在预防老年精神病患者跌倒中的应用效果。方法:选取2019年7月至2021年7月该院收治的88例老年精神病患者进行前瞻性研究,按随机数字表法将其分为观察组与对照组各44例。对照组采用常规护理,观察组采用HFMEA管理模式护理,比较两组各项风险优先指数(RPN)值、护理前后防跌倒知识评分、跌倒发生率和护理满意度。结果:观察组防跌倒宣教不到位,防跌倒措施未落实,安全设施不齐全,高危跌倒、坠床患者交接班和巡视不到位,以及患者发生病情变化未及时发现等RPN值均低于对照组,差异有统计学意义(P<0.05);护理后,两组跌倒危害、合适穿着、改变体位步骤、防跌倒设施的使用等防跌倒知识评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组跌倒发生率低于对照组,差异有统计学意义(P<0.05);观察组护理满意度为95.45%(42/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05)。结论:基于HFMEA管理模式护理应用于老年精神病患者可降低RPN值和跌倒发生率,提高防跌倒知识评分和护理满意度,其效果优于常规护理。

Objective:To observe application effects of healthcare failure mode and effect analysis(HFMEA)management modebased nursing in prevention of falls in elderly patients with psychosis.Methods:A prospective study was conducted on 88 elderly patients with psychosis admitted to the hospital from July 2019 to July 2021.They were divided into observation group and control group according to the random number table method,44 cases in each.The control group received routine nursing,while the observation group received HFMEA management mode nursing.The risk priority number(RPN)values,the fall prevention knowledge scores before and after the nursing,the incidence of falls and the nursing satisfaction were compared between the two groups.Results:The RPN values of the observation group were lower than those of the control group including inadequate fall prevention education,failure to implement fall prevention measures,incomplete safety facilities,high-risk falls,inadequate handover and inspection of the patients falling from bed,and failure to detect changes in the patients’condition in time,and the differences were statistically significant(P<0.05).After the nursing,the scores of fall prevention knowledge such as fall hazard,appropriate wearing,changing postures and steps and use of fall prevention facilities in the two groups were higher than those before the nursing,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of falls in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Further,the nursing satisfaction of the observation group was 95.45%(42/44),which was higher than 81.82%(36/44)of the control group,and the difference was statistically significant(P<0.05).Conclusions:The HFMEA management mode-based nursing in the prevention of falls in the elderly patients with psychosis can reduce the RPN value and the incidence of falls,and improve the score of fall prevention knowledge and the nursing satisfaction.Moreover,it is superior to the routine nursing.