FMEA联合鱼骨图预防心胸外科重症监护室压力性损伤的临床研究  

Clinical study of FMEA combined with fishbone diagram in prevention of pressure injury in intensive care unit of cardiothoracic surgery

作　　者：申荣华[1] 刘燕[2] 谢静 封俊艳 SHEN Ronghua;LIU Yan;XIE Jing;FENG Junyan(Cardiac Surgery Intensive Care Unit,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Department of Cardiothoracic Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Department of Cardiothoracic Surgery,Chengde Central Hospital,Chengde 067000,China)

机构地区：[1]河北医科大学第一医院心胸外科监护室,河北石家庄050031 [2]河北医科大学第一医院心胸外科,河北石家庄050031 [3]承德市中心医院心胸外科,河北承德067000

出　　处：《现代医学》2020年第3期391-395,共5页Modern Medical Journal

基　　金：河北省医学科学研究重点课题项目(20180253)。

摘　　要：目的:探讨失效模式与效应分析法(FMEA)联合鱼骨图在预防心胸外科重症监护室压力性损伤中的效果。方法:选取在预防心胸外科重症监护室压力性损伤中采用FMEA联合鱼骨图前(2016年7月至2017年6月)后(2017年7月至2018年6月)心胸外科重症监护室收治的982例患者及15名护理人员作为研究对象。比较两时间段内高风险失效模式RPN值、压力性损伤发生率及护理人员预防压力性损伤理论知识得分情况。结果:实施FMEA联合鱼骨图预防心胸外科重症监护室压力性损伤干预,压力性损伤高风险失效模式RPN值低于未干预,压力性损伤发生率低于未干预(14.85%vs 21.59%),护理人员预防压力性损伤理论知识得分高于未干预[(92.80±4.33)分vs (82.67±3.75)分],差异均具有统计学意义(P<0.05)。结论:FMEA联合鱼骨图有利于降低压力性损伤高风险失效模式RPN值,降低心胸外科重症监护室压力性损伤发生率,提高护理人员预防压力性损伤理论知识掌握情况。Objective: To investigate the effects of FMEA and fishbone in preventing pressure injury in intensive care unit of cardiothoracic surgery.Methods: 982 patients admitted to intensive care unit of cardiothoracic surgery and 15 nursing staff in our hospital before(July 2016-June 2017) and after(July 2017-June 2018) the application of FMEA and fishbone in preventing pressure injury were selected.The RNP values of high-risk failure modes,the incidence of pressure injury,and the theoretical knowledge scores of nurses in preventing pressure injury during the two time periods were compared.Results: After implementation of FMEA combined with fishbone to prevent pressure injury in intensive care unit of cardiothoracic surgery,RNP value of high-risk model of pressure injury was lower than that before intervention,and the incidence of pressure injury was lower than that before intervention(14.85% vs 21.59%),and the theoretical knowledge of nurses preventing pressure injury scores was better than that before the intervention(92.80±4.33 vs 82.67±3.75),the differences were statistically significant(P <0.05).Conclusion: FMEA combined with fishbone is beneficial to reduce RPN value of high-risk failure mode of pressure injury,reducing the incidence of pressure injury in cardiothoracic intensive care unit as well as improving the theoretical knowledge of nurses in preventing pressure injury.

关 键 词：失效模式与效应分析 鱼骨图 压力性损伤 护理 

分 类 号：R473.6[医药卫生—护理学]