HFMEA在预防胸腔闭式引流患者非计划性拔管中的作用

Role of HFMEA in preventing unplanned extubation in patients with closed thoracic drainage

目的探讨医疗失效模式与效应分析(HFMEA)在预防胸腔闭式引流患者非计划性拔管中的作用。方法将2019年1月至2021年10月在我院留置胸腔闭式引流管的289例患者作为对照组,将2021年11月至2022年6月在我院留置胸腔闭式引流管的188例患者作为试验组。两组均实施常规护理,试验组在此基础上实施HFMEA。比较两组的非计划性拔管发生率、住院时间、住院费用、满意度及舒适度。结果试验组的非计划性拔管发生率明显低于对照组,差异具有统计学意义(P<0.05)。试验组的住院时间短于对照组,住院费用低于对照组,差异具有统计学意义(P<0.05)。试验组的满意度明显高于对照组,差异具有统计学意义(P<0.05)。试验组的生理、心理精神、社会文化、环境评分及总分均高于对照组,差异具有统计学意义(P<0.05)。结论HFMEA用于胸腔闭式引流患者中可提高舒适度,降低非计划性拔管发生率,缩短住院时间,提高患者的满意度,具有较高的临床应用价值。

Objective To explore the role of healthcare failure mode and effect analysis(HFMEA)in preventing unplanned extubation in patients with closed thoracic drainage.Methods A total of 289 patients with closed thoracic drainage tube indwelling in our hospital from January 2019 to October 2021 were selected as the control group,and 188 patients with closed thoracic drainage tube indwelling in our hospital from November 2021 to June 2022 were selected as the experimental group.Both groups received routine nursing,and the experimental group received HFMEA on this basis.The incidence of unplanned extubation,hospitalization time,hospitalization expenses,satisfaction and comfort were compared between the two groups.Results The incidence of unplanned extubation in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The hospitalization time of the experimental group was shorter than that of the control group,and the hospitalization expenses was lower than that of the control group,and the differences were statistically significant(P<0.05).The satisfaction of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The scores of physiology,psychology,social culture,environment and total score in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion HFMEA can improve comfort,reduce the incidence of unplanned extubation,shorten hospitalization time and improve satisfaction in patients with closed thoracic drainage,which has high clinical application value.