FMEA护理对呼吸衰竭机械通气患者的影响

Effect of FMEA Nursing on Patients with Mechanical Ventilation for Respiratory Failure

目的:分析失效模式与影响分析(FMEA)护理对呼吸衰竭机械通气患者的影响。方法:选取2020年7月—2022年7月南京市第一医院急诊监护室收治的116例呼吸衰竭机械通气患者作为研究对象。随机将其分为研究组(n=58)与对照组(n=58)。两组均给予对症支持治疗,对照组给予常规护理,研究组给予FMEA护理。比较两组相关指标,护理前后动脉血气指标、肺功能指标、心理状态及生活质量。结果:两组呼吸机相关性肺炎发生率比较,差异无统计学意义(P>0.05);研究组机械通气时间及ICU入住时间均短于对照组,差异有统计学意义(P<0.05)。护理后,研究组动脉血氧分压(PaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组,差异有统计学意义(P<0.05)。护理后,研究组最大呼气流量(PEF)高于护理前及对照组,内源性呼气末正压(PEEPi)低于护理前及对照组,差异有统计学意义(P<0.05)。护理后,研究组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均低于对照组,世界卫生组织生存质量测定量表(WHOQOL-100)评分高于对照组,差异有统计学意义(P<0.05)。结论:FMEA护理可以有效改善呼吸衰竭机械通气患者肺功能,减轻负性情绪,提高生活质量。

Objective:To analyze the effect of failure mode and effect analysis(FMEA)nursing on patients with mechanical ventilation for respiratory failure.Method:A total of 116 patients with mechanical ventilation for respiratory failure admitted to the Emergency Care Unit of Nanjing First Hospital from July 2020 to July 2022 were selected as the study objects.They were randomly divided into study group(n=58)and control group(n=58).Both groups were given symptomatic supportive treatment,while the control group was given routine nursing,the study group was given FMEA nursing.Related indicators,arterial blood gas index,lung function index,mental state and quality of life before and after nursing were compared between the two groups.Result:There was no significant difference in the incidence of ventilator-associated pneumonia between the two groups(P>0.05).The mechanical ventilation time and ICU stay time in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After nursing,the partial pressure of arterial blood oxygen(PaO_(2))in the study group was higher than that in the control group,and the partial pressure of arterial blood carbon dioxide(PaCO_(2))was lower than that in the control group,the differences were statistically significant(P<0.05).After nursing,the maximum expiratory flow(PEF)of the study group was higher than before nursing and the control group,and the endogenous positive end-expiratory pressure(PEEPi)was lower than before nursing and the control group,the differences were statistically significant(P<0.05).After nursing,the scores of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)of the study group were lower than those of the control group,and the score of the World Health Organization quality of life scale(WHOQOL-100)was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion:FMEA nursing can effectively improve lung function,reduce negative emotion and improve quality of life in patients with respiratory failure mechanical ventilation.