基于HFMEA优化急诊救治流程对急性脑梗死患者急救时间及神经功能的影响

Effect of Optimization of Emergency Treatment Flow Based on HFMEA on First Aid Time and Neurological Function of Patients with Acute Cerebral Infarction

目的 观察基于医疗失效模式与效应分析(HFMEA)优化急诊救治流程对急性脑梗死(ACI)患者急救时间及神经功能的影响。方法 医院急诊自2022年4月开始实施基于HFMEA优化急诊救治流程,将实施前2020年8月至2022年3月期间急诊收治的ACI患者36例纳入对照组,将2022年4月至2023年6月期间急诊收治的ACI患者3.6例纳入观察组。比较两组急救时间、神经功能及临床救治结局情况。结果 与对.照组相比,观察组医生接诊、影像学检查出报告、溶栓、转诊时间短(P<005);.两组溶栓后24hNIHSS评分较入院时间均降低,且观察组降低更显著(P<005);观察组不良救治结局总发生率低于对照组,但组间比较未见显著差异(P>005)。结论 基于HFMEA优化急诊救治流程可有效缩短ACI患者急救时间,降低神经功能损伤,改善临床救治结局。

Objective To observe the effects of medical failure mode and effect analysis(HFMEA)based optimization of emergency treatment flow on emergency time and neurological function in patients with acute cerebral infarction(ACI).MethodsThe emergency department of the hospital began to implement the optimization of the emergency treatment process based on HFMEA from April 2022.36 ACI patients admitted to the emergency department from August 2020 to March 2022 before the implementation were included in the control group,and 36 ACI patients admitted to the emergency department from April 2022 to June 2023 were included in the observation group.The first aid time,neurological function and clinical treatment outcome were compared between the two groups.ResultsCompared with the control group,the time of doctor's visit,imaging report,thrombolysis and referral was shorter in observation group(P<0.05).The 24hNIHSS score after thrombolysis was decreased in both groups compared with the admission time,and the decrease was more significant in the observation group(P<0.05).The total incidence of adverse treatment outcomes in observation group was lower than that in control group,but there was no significant difference between groups(P>0.05).ConclusionOptimization of emergency treatment process based on HFMEA can effectively shorten the first aid time of ACI patients,reduce nerve function injury and improve clinical treatment outcome.