失效模式与效应分析在PICC风险管理中的应用

Application of Failure Mode and Effect Analysis in PICC Risk Management

目的探讨医疗失效模式与效应分析(Healthcare Failure Mode and Effect Analysis,HFMEA)在PICC风险管理中的应用效果。方法运用HFMEA评估PICC置管操作及维护流程,分析导管堵塞、导管脱出、导管血栓、血行感染、导管异位和自行拔管6种失效模式发生的潜在原因。评估每种模式发生的可能性、严重性和可检测性,计算风险指数(RPN),开展PICC风险管理,以降低失效模式发生率。结果在PICC风险管理中应用失效模式与效应分析后,PICC患者6种失效模式的RPN值均显著下降,差异具有统计学意义(p<0.001);PICC患者的非计划性拔管率从26.25%降低到6.25%。结论 HFMEA模式在PICC患者风险管理应用中切实有效。通过预先评估潜在风险、采取有效措施避免可能发生的失效模式,对提升护理质量和患者满意度具有积极意义。

Objective To explore the effect of Healthcare Failure Mode and Effect Analysis(HFMEA) in PICC risk management. Methods HFMEA was used to evaluate the Peripherally Inserted Central Catheter(PICC) catheterization and maintenance procedures, and to analyze the potential causes of six failure mode, including catheter obstruction, catheter prolapse, catheter thrombosis, hematogenous infection, catheter ectopia, and self-extubation. The probability, severity, and detectability of each failure mode were estimated, and Risk Priority Number(RPN) was calculated. PICC risk management was employed to reduce the incidence of failure modes. Results After applying HFMEA in PICC risk management, the RPN values of the six failure modes all significantly decreased, and the difference was statistically significant(p<0.001). The unplanned extubation rate of PICC patients was reduced to 6.25% from 26.25%. Conclusion HFMEA is effective in PICC risk management. Evaluating potential risks and taking effective measure to prevent failure modes is conductive to improving nursing quality and patient satisfaction.