基于HFMEA理论的急救干预在急性脑梗死患者院前急救中的应用效果

Application Effect of First Aid Intervention Based on HFMEA Theory in Pre-hospital First Aid for Patients with Acute Cerebral Infarction

目的:探讨基于医疗失效模式与效应分析(HFMEA)理论的急救干预在急性脑梗死患者院前急救中的应用效果。方法:选择2020年1月—2022年1月潜江市中心医院收治的84例急性脑梗死患者为研究对象,根据随机数表法将其分为A组、B组,各42例。A组给予常规急救护理,B组在A组基础上给予基于HFMEA理论的急救干预。比较两组抢救成功率、转运不良事件发生情况及急救时间,观察两组神经功能状况及日常生活能力。结果:B组抢救成功率较A组高,且转运不良事件发生率较A组低,差异有统计学意义(P<0.05);B组急救各环节耗时均较A组短,差异有统计学意义(P<0.05);与入院时相比,两组入院后24 h美国国立卫生研究院卒中量表(NIHSS)评分均下降,出院时Barthel指数(BI)评分均提高,且B组NIHSS评分低于A组,BI评分高于A组,差异有统计学意义(P<0.05)。结论:基于HFMEA理论的急救干预能促进急性脑梗死患者抢救成功率及急救效率提高,减少转运不良事件,并可缓解神经功能缺损,改善日常生活能力。

Objective:To explore the application effect of first aid intervention based on healthcare failure mode and effect analysis(HFMEA)theory in pre-hospital first aid for patients with acute cerebral infarction.Method:A total of 84 patients with acute cerebral infarction who admitted to Qianjiang Central Hospital from January 2020 to January 2022 were selected as the study objects,and divided into group A and group B according to the method of random number table,42 patients in each group.Group A was given routine first aid nursing,group B was given first aid intervention based on HFMEA theory on the basis of group A.The rescue success rate,incidence of adverse transport events and time of first aid of two groups were compared,and the neurological function and daily living ability of two groups were observed.Result:The rescue success rate in group B was higher than that in group A,and the incidence of adverse transport events was lower than that of group A,the differences were statistically significant(P<0.05).The energy saving time of each ring in group B were shorter than those in group A,the differences were statistically significant(P<0.05).Compared with admission,the National Institutes of Health stroke scale(NIHSS)scores of two groups decreased at 24 h after admission,and the Barthel index(BI)scores of two groups increased at discharge,the NIHSS score of group B was lower than that of group A,and the BI score of group B was higher than that of group A,the differences were statistically significant(P<0.05).Conclusion:The first aid intervention based on HFMEA theory can improve the success rate and efficiency of rescue for patients with acute cerebral infarction,reduce adverse transport events,alleviate the neurological deficit,and improve the ability of daily life.