应用HFMEA对降低ICU气管插管非计划拔管率的效果分析  

Effect analysis of applying HFMEA to reduce unplanned extubation rate of endotracheal intubation in ICU

作　　者：秦雪燕 魏雪梅[1] 李姗姗[1] Qin Xueyan;Wei Xuemei;Li Shanshan(Affiliated hospital of North Sichuan Medical College)

机构地区：[1]川北医学院附属医院重症医学科,南充637000

出　　处：《当代护士（下旬刊）》2021年第5期17-20,共4页Modern Nurse

摘　　要：目的降低ICU气管插管非计划拔管(UEX)发生率;方法将2016年7月—12月在ICU治疗并行气管插管的成年患者作为对照组,给予常规护理措施预防气管插管(UEX);将2017年7月—12月在ICU治疗并行气管插管的成年患者作为观察组,应用医疗失效模式与效应分析(HFMEA)管理方法分析导致气管插管UEX发生的失效模式,针对风险优先值数(RPN)≥8分的风险因素制定并落实了以eCASH理念为核心的护理措施预防气管插管UEX,比较两组的气管插管UEX发生率及患者满意度;结果观察组气管插管UEX发生率为0.47‰,对照组气管插管UEX发生率为5.28‰,差异有统计学意义(χ^(2)=8.5,P<0.05),观察组患者满意度为96.5%,对照组为90.7%,差异有统计学意义(χ^(2)=11.5,P<0.05)。结论应用HFMEA能有效降低ICU气管插管非计划拔管率,提高患者满意度。Object To reduce the incidence of unplanned extubation of endotracheal intubation(UEX)in ICU;Method Adult patients treated with endotracheal intubation in ICU from July to December 2016 were taken as the control group,and routine nursing measures were given to prevent endotracheal intubation(UEX),while taken the adult patients treated with endotracheal intubation from July to December in ICU as the observation group,to which the healthcare failure mode and effect analysis(HFMEA)management,that analyzing the causes of the failure mods in the UEX and focusing on 8 points or greater of the risk priority number(RPN)was appiied.,was formulated and implemenedt the eCASH concept as the core of nursing measures to prevent the UEX.comparing two groups of patients with tracheal intubation UEX incidence and the satisfaction of patients;Result The incidence of UEX was 0.47‰in the observation group and 5.28‰in the control group,and the difference was statistically significant(χ^(2)=8.5,P<0.05).The patient satisfaction in the observation group was 96.5%,and that in the control group was 90.7%,and the difference was statistically significant(χ^(2)=11.5,P<0.05).Conclusion The application of HFMEA can effectively reduce the UEX in ICU and improve the satisfaction of patients.

关 键 词：医疗失效模式与效应分析 HFMEA 气管插管 非计划拔管 UEX 发生率 

分 类 号：R473[医药卫生—护理学]