基于HFMEA理念的动态急救护理在突发性脑出血患者中的应用

Application of Dynamic Emergency Nursing Based on HFMEA Concept in Patients with Sudden Cerebral Hemorrhage

目的探讨突发性脑出血患者中实施基于医疗失效模式与效应分析(HFMEA)理念的动态急救护理的临床价值。方法选取2020年10月—2022年10月内蒙古自治区人民医院收治的108例突发性脑出血患者作为研究对象,按干预方式的不同将其分为对照组和观察组,每组54例。对照组应用常规急救护理,观察组应用基于HFMEA理念的动态急救护理,分析并比较两组急救所需时间、脑出血量、神经功能缺损程度、预后情况与并发症发生率。结果观察组发病到院时间、急诊科初步处理所需时间、送至相关科室时间与急救所需时间相比于对照组更短,差异有统计学意义(P<0.05)。观察组脑出血量相比于对照组更少,差异有统计学意义(P<0.05)。护理后两组美国国立卫生院卒中量表(NIHSS)评分均下降、格拉斯哥预后(GCS)评分均上升,且观察组变化幅度相比于对照组更明显,差异有统计学意义(P<0.05)。观察组并发症发生率相比于对照组更低,差异有统计学意义(P<0.05)。结论在突发性脑出血患者中,基于HFMEA理念的动态急救护理的应用能够缩短患者急救所需时间,减少脑出血量,减轻神经功能缺损程度,降低并发症发生风险,从而改善预后,值得临床应用。

Objective To explore the clinical value of implementing dynamic emergency nursing based on the concept of healthcare failure mode and effect analysis(HFMEA)in patients with sudden cerebral hemorrhage.Methods 108 patients with sudden cerebral hemorrhage admitted to Inner Mongolia Autonomous Region People's Hospital from October 2020 to October 2022 were selected as the research subjects,and were divided into two groups according to different intervention methods.The control group(n=54)received routine emergency care,while the observation group(n=54)received dynamic emergency care based on the HFMEA concept.The time required for emergency care,cerebral hemorrhage volume,degree of neurological impairment,prognosis,and incidence of complications were analyzed for the two groups.Results Compared with the control group,the observation group had shorter onset to hospital time,initial treatment time in the emergency department,delivery time to relevant departments,and emergency treatment time(P<0.05).The observation group had less cerebral hemorrhage compared to the control group(P<0.05).After nursing,the National Institutes of Health Stroke Scale(NIHSS)scores decreased in both groups,while the Glasgow Outcome Scale(GCS)scores increased in both groups.The observed group had a more significant change compared to the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion In patients with sudden cerebral hemorrhage,the application of dynamic emergency care based on HFMEA concept can shorten the time required for emergency treatment,reduce the amount of cerebral hemorrhage,alleviate the degree of neurological impairment,reduce the risk of complications,and improve prognosis,which is worthy of clinical promotion.