HFMEA在预防ICU气管插管非计划性拔管中的应用效果  

Application effects of HFMEA in prevention ICU unplanned extubation of tracheal intubation

作　　者：邱红[1] 张金凤[2] 刘晓兰[3] 朱华勇[2] 罗军萍[2] 刘玉洁[2] 

机构地区：[1]江西省赣州市人民医院护理部,江西赣州341000 [2]江西省赣州市人民医院质管办,江西赣州341000 [3]江西省赣州市人民医院重症医学科,江西赣州341000

出　　处：《中国当代医药》2016年第21期181-184,共4页China Modern Medicine

摘　　要：目的探讨应用HFMEA预防ICU气管插管非计划性拔管的应用效果。方法选取2013年1～12月未实施HFMEA的气管插管≥24h患者474例和2014年1～12月实施HFMEA的气管插管≥24h患者547例，针对ICU气管插管非计划性拔管组成团队，分析操作流程并制作出流程图，进行失效模式与潜在风险原因分析，比较实施前后气管插管非计划性拔管事先风险值（RPN）和发生率。结果实施后气管插管非计划性拔管的总RPN为2357．46分．显著低于实施前的3830．08分，差异有统计学意义（P〈0．05）。实施后气管插管非计划性拔管发生率为1．687％，较实施前的0．365％有明显下降，差异有统计学意义（X2=4．577，P〈0．05）。结论应用HFMEA能有效预防气管插管非计划性拔管的发生，降低医疗风险。Objective To explore the practice effects of using HFMEA in prevention ICU unplanned extubation of tracheal intubation.Methods 474 patients who unimplemented HFMEA intubation and greater than 24 h from January 2013 to December and 547 patients who implemented HFMEA intubation and greater than 24 h from January 2014 to December were selected.For ICU tracheal intubation unplanned extubation composition team,the operation process was analyzed and the flow chart was made to analyze the failure mode and cause of potential risk.The RPN and incidence rate before and after ICU unplanned extubation of tracheal intubation were compared.Results After conducting, the to- tal RPN of ICU unplanned extubation of tracheal intubation was 2357.46,obvious lower than that was 3830.08 before conducting,and the difference was statistical significance （P〈0.05）.After conducting, the incidence rate of ICU un- planned extubation of tracheal intubation was 1.687%,obvious devreased than that was 0.365 % before conducting,and the difference was statistical significance （X2=4.577,P〈0.05）.Condusion Using HFMEA can prevent the incidence of unplanned extubation of tracheal intubation effectively and decrease medical risk.

关 键 词：气管插管 非计划性拔管 重症监护室 预防 

分 类 号：R562.1[医药卫生—呼吸系统]