BACKGROUND: Ensuring about the patient's safety is the f irst vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conduct...BACKGROUND: Ensuring about the patient's safety is the f irst vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care.METHODS: In this study, in combination(qualitative action research and quantitative crosssectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis(HFMEA). To classify the failure modes from the "nursing errors in clinical management model(NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics(total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used.RESULTS: In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identifi ed by HFMEA. 25(11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors(54.7%) and knowledge and skill(9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy.CONCLUSION: "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team communication" and "preventive management of equipment's" were on the agenda as the guidelines.展开更多
The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;mo...The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;moreover it was used to prevent the occurrence of adverse events and look at what could go strong at each step. This study aimed to utilize FMEA in central blood bank in Khartoum to evaluate the potential risk and adverse event that may occur during the donation process. According to the severity, occurrence and the detection of each failure mode, the risk priority number (RPN) was calculated to determine which of the failures should take priority to find a solution and applying corrective action to reduce the failure risk. The statistical package for social sciences (SPSS) version 11 was used as descriptive and analytical statistics tool. The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error, and in this study a satisfactory outcome was reached.展开更多
目的探讨改良早期预警评分(modified early warning score,MEWS)联合SBAR[现状(situation)、背景(background)、评估(assessment)、建议(recommendation)]沟通模式在高危新生儿中的应用效果,为临床提供一种有效评估患儿病情变化的沟通...目的探讨改良早期预警评分(modified early warning score,MEWS)联合SBAR[现状(situation)、背景(background)、评估(assessment)、建议(recommendation)]沟通模式在高危新生儿中的应用效果,为临床提供一种有效评估患儿病情变化的沟通方法。方法采用前-后对照研究方法,选取2022年8月至9月入住本院新生儿科病房的高危新生儿270例作为研究对象。以8月入院的高危新生儿为对照组,9月入院的高危新生儿作为试验组,每组分别纳入135例患儿。对照组患儿按照常规护理实施病情观察,试验组患儿在对照组基础采用MEWS联合SBAR沟通模式实施病情观察。比较两组高危新生儿预警事件发生情况,护士预警事件与医生处理事件的一致率,医生对护士工作的满意率。结果两组均完成研究。对照组中63.6%的预警事件是由护士发现,试验组中92.6%的预警事件是由护士发现,两组比较,差异具有统计学意义(χ2=16.622,P<0.001)。试验组护士预警事件与医生处理事件的一致性(Kappa系数=0.926)高于对照组(Kappa系数=0.641);试验组医生对护士在专科知识、抢救应急能力、掌握病情情况、及时观察病情变化、医护配合、工作积极性、沟通能力、心理素质方面的满意率均高于对照组(80.0%~95.0%v30.0%~55.0%),两组比较,差异具有统计学意义(均P<0.05)。结论MEWS与SBAR沟通模式联合应用,有助于护士准确评估患儿病情变化,及时有效完成医护沟通,提高护士观察、沟通和处理能力,也提高了医生对护士工作的满意度。展开更多
文摘BACKGROUND: Ensuring about the patient's safety is the f irst vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care.METHODS: In this study, in combination(qualitative action research and quantitative crosssectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis(HFMEA). To classify the failure modes from the "nursing errors in clinical management model(NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics(total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used.RESULTS: In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identifi ed by HFMEA. 25(11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors(54.7%) and knowledge and skill(9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy.CONCLUSION: "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team communication" and "preventive management of equipment's" were on the agenda as the guidelines.
文摘The recognition and management of risk in donation process and blood product is critical to ensure donor and patient safety. To achieve this goal, the failure mode and effects analysis (FMEA) is a convenient method;moreover it was used to prevent the occurrence of adverse events and look at what could go strong at each step. This study aimed to utilize FMEA in central blood bank in Khartoum to evaluate the potential risk and adverse event that may occur during the donation process. According to the severity, occurrence and the detection of each failure mode, the risk priority number (RPN) was calculated to determine which of the failures should take priority to find a solution and applying corrective action to reduce the failure risk. The statistical package for social sciences (SPSS) version 11 was used as descriptive and analytical statistics tool. The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error, and in this study a satisfactory outcome was reached.
文摘目的探讨改良早期预警评分(modified early warning score,MEWS)联合SBAR[现状(situation)、背景(background)、评估(assessment)、建议(recommendation)]沟通模式在高危新生儿中的应用效果,为临床提供一种有效评估患儿病情变化的沟通方法。方法采用前-后对照研究方法,选取2022年8月至9月入住本院新生儿科病房的高危新生儿270例作为研究对象。以8月入院的高危新生儿为对照组,9月入院的高危新生儿作为试验组,每组分别纳入135例患儿。对照组患儿按照常规护理实施病情观察,试验组患儿在对照组基础采用MEWS联合SBAR沟通模式实施病情观察。比较两组高危新生儿预警事件发生情况,护士预警事件与医生处理事件的一致率,医生对护士工作的满意率。结果两组均完成研究。对照组中63.6%的预警事件是由护士发现,试验组中92.6%的预警事件是由护士发现,两组比较,差异具有统计学意义(χ2=16.622,P<0.001)。试验组护士预警事件与医生处理事件的一致性(Kappa系数=0.926)高于对照组(Kappa系数=0.641);试验组医生对护士在专科知识、抢救应急能力、掌握病情情况、及时观察病情变化、医护配合、工作积极性、沟通能力、心理素质方面的满意率均高于对照组(80.0%~95.0%v30.0%~55.0%),两组比较,差异具有统计学意义(均P<0.05)。结论MEWS与SBAR沟通模式联合应用,有助于护士准确评估患儿病情变化,及时有效完成医护沟通,提高护士观察、沟通和处理能力,也提高了医生对护士工作的满意度。
