基于FMEA的多维联合教学模式在外科护理实习生医院感染教学中的探索

Exploration of multi-dimensional joint teaching model based on FMEA in the teaching of hospital infection in surgical nursing students

目的探讨基于失效模式与效应分析(FMEA)的多维联合教学模式在外科护理实习生医院感染教学中的效果。方法选取宁波市中医院2021年7月至2022年3月的39名外科护理实习生作为对照组,另选取2022年7月至2023年3月的42名外科护理实习生作为观察组。对照组采用传统教学模式,观察组通过FMEA分析失效模式,并从发生可能性、侦测可能性、严重度三个维度计算风险优先值(RPN)选出高危因素,根据高危因素制定并实施教学改进计划。比较观察组护理实习生FMEA实施前后RPN分值,以及两组护理实习生理论测试、操作测试、手卫生执行率、手卫生准确率情况。结果观察组实施FMEA模式前RPN值1534,实施后明显下降,降至185,下降率为87.94%;观察组护理实习生的理论测试、操作测试成绩均高于对照组,差异均有统计学意义(t分别=9.51、6.35,P均<0.05)。观察组护理实习生的手卫生执行率与准确率均高于对照组,差异均有统计学意义(χ^(2)分别=5.81、6.34,P均<0.05)。结论在外科护理实习生医院感染教学中应用基于FMEA的多维联合教学模式不仅能增加护理实习生综合学习能力和感控意识,也减少了科室运行风险。

Objective To explore the effectiveness of a multi-dimensional joint teaching model based on failure mode and effect analysis(FMEA)in the teaching of hospital infection in surgical nursing interns.Methods Totally 39 surgi-cal nursing students from Ningbo Traditional Chinese Medicine Hospital from July 2021 to March 2022 were selected as the control group,and another 42 surgical nursing students from July 2022 to March 2023 were selected as the observa-tion group.The control group adopted the traditional teaching model,while the observation group analyzed failure modes through the FMEA model,and calculated the risk priority number(RPN)from the three dimensions of occurrence possi-bility,detection possibility,and severity to select high-risk factors.Based on these high-risk factors,a teaching improve-ment plan was developed and implemented.The RPN scores of nursing interns in the observation group before and after the implementation of FMEA were compared,as well as the theoretical evaluation,operation evaluation,hand hygiene im-plementation rate and hand hygiene accuracy of students in the two groups.Results The RPN value decreased from 1534 to 185,with the decrease rate of 87.94%.The scores of theory examination and operation examination of nursing students in the observation group were higher than those in the control group,and the differences were statistically signifi-cant(t=9.51,6.35,P<0.05).In addition,the imple-mentation rate of hand hygiene and the accuracy rate of hand hygiene in the observation group were higher than those in the control group(χ^(2)=5.81,6.34,P<0.05).Conclusion The application of multi-dimensional joint teaching model based on FMEA in the teaching of hospital infection in surgi-cal nursing interns not only enhances the compre-hensive learning ability and infection control awareness of nursing interns,but also reduces the operational risk of the de-partment.