失效模式与效应分析在脊柱结核患者PICC置管术中的应用  

Application of Failure Mode and Effect Analysis in PICC Intubation of Patients with Spinal Tuberculosis

作　　者：魏墚铉 彭小玉 李静 王文艺 李凤娟 霍雪娥 杨娴[1] 吕旷 

机构地区：[1]贵阳市第一人民医院,贵州贵阳550002 [2]中国科技开发院广西分院,广西南宁530022 [3]陕西省结核病防治院,陕西西安710100

出　　处：《大众科技》2019年第1期35-37,共3页Popular Science & Technology

摘　　要：目的:探讨失效模式与效应分析(FMEA)在脊柱结核患者经外周静脉穿刺中心静脉导管(PICC)置管术中的应用效果。方法:抽取2016年1月至2016年12月贵阳市第一人民医院住院并行PICC置管术的脊柱结核患者83例,以入院时间为序随机分为观察组和对照组各43例和40例。观察组在常规护理基础上运用FMEA方法分析失效模式及其原因,并通过选择失效模式RPN值>125的8个高危因子对其原因进行分析,同时制定相应的改进措施并实施;对照组只采取常规护理方法进行护理,对照评价两组患者的应用效果。所有数据采用SPSS17.0统计软件统计分析,所得不良事件发生率采用χ2检验。结果:观察组8个高危因子经改进措施实施后,其RPN值分别为12、42、0、24、36、90、60、24,均低于对照组(210、432、160、478、144、576、336、180);观察组PICC不良事件发生率为4.7%,明显低于对照组的22.5%(χ2=5.42,P<0.05),其差异具有统计学意义。结论:将FMEA运用于行PICC置管术的脊柱结核患者的护理工作中效果良好,能有效降低RPN值和不良事件发生率,确保护理工作质量。Objective:To investigate the effect of application of failure mode and effect analysis(FMEA)in PICC intubation of patients with spinal tuberculosis.Methods:Eighty-three patients with spinal tuberculosis who received PICC intubation surgery in First People’s Hospital of Guiyang from January 2016 to December 2016 were randomly divided into the experimental group(43 cases)and the control group(40 cases)according to the admission time.In the observation group,FMEAmethod was used to analyze the failure mode and its causes on the basis of routine nursing,and 8 high risk factors with RPN value of >125 in the failure mode were selected to analyze the causes,and corresponding improvement measures were developed and implemented.The control group only took the routine nursing method to carry on the nursing.The application effect of the two groups was compared and evaluated.SPSS17.0 statistical software was used for statistical analysis of all the data.The incidence of adverse events was assessed by χ^2 test.Results:After the implementation of the improvement measures for the 8 high risk factors in the observation group,their RPN values were 12,42,0,24,36,90,60 and 24,respectively,all lower than those in the control group(210,432,160,478,144,576,336,180).The incidence of adverse events in the observation group was 4.7%,which was significantly lower than that in the control group(2=5.42,P<0.05),and the difference was statistically significant.Conclusion:The application of FMEA to the nursing work of spinal tuberculosis patients undergoing PICC intubation has a good effect,which can effectively reduce the RPN value and the incidence of adverse events,and ensure the quality of nursing work.

关 键 词：失效模式 效应分析 脊柱结核 PICC置管 

分 类 号：R472[医药卫生—护理学]