眼科成批患者眼内注药术风险防控  

Risk Management of Intraocular Injection in Batch Ophthalmological Patients

作　　者：薛琳[1] 赵彩敏[1] 贲阳 王钟莹 汤佳骏 吴遐[1] 普鹰[1] XUE Lin;ZHAO Caimin;BEN Yang;WANG Zhongying;TANG Jiajun;WU Xia;PU Ying(Department of Nursing,Shanghai General Hospital,Shanghai 200080)

机构地区：[1]上海市第一人民医院护理部,上海200080

出　　处：《解放军医院管理杂志》2021年第7期651-655,共5页Hospital Administration Journal of Chinese People's Liberation Army

摘　　要：目的有效识别眼科成批患者眼内注药术流程中的潜在风险,为科学优化流程,提高护理管理质量提供依据。方法运用医疗失效模式和效应分析工具,对某三甲医院眼科中心,成批患者眼内注药术管理流程进行分析,从严重度(severity, S)和发生概率度(frequency of occurrence, O)赋值评估每个子流程。利用决策树进行分析,找出关键环节及原因,制定并实施改善方案。结果应用HFMEA模式改善后,危险评量(S×O)、手术信息错误识别发生率(踪近错误)及平均手术时间较改善前有所下降,差异具有统计学意义(P<0.05);患者对眼内注射药物知识的知晓度及医护满意度均有所提高,差异具有统计学意义(P<0.05)。结论运用HFMEA对眼科成批患者眼内注药术流程进行风险管理,提高护理管理质量,保障患者手术及用药安全;同时可提高工作效率,提高医护患三方满意度。Objective To provide evidence for scientifically optimizing the process of nursing management and effectively improving its quality through effective identification of potential risks in the process of intraocular injection for ophthalmological patients in batches. Methods By adopting Healthcare Failure Mode and Effect Analysis(HFMEA) management, each sub-process was evaluated in terms of severity(S) and frequency of occurrence(O) in the analysis of intraocular injection process for ophthalmological patients in batches. The decision tree analysis was carried out to identify the key links and reasons and to formulate and implement improvement plans. Results After the implementation of HFMEA mode, the scores of risk assessment(S×O), the incidence of operation information misidentification(near miss) and the average operation time decreased(P<0.05). There was significant improvement in patients’ knowledge about drugs of intraocular injection and in their satisfaction with medical care(P<0.05). Conclusion The application of HFMEA mode in risk management of intraocular injection for ophthalmological patients in batches can effectively help avoid the failure of nursing work in operation room, improve the work efficiency, and promote the degree of medical staff and patients’ satisfaction of medical care.

关 键 词：HFMEA 风险防控 眼内注药术 患者安全 

分 类 号：R197.32[医药卫生—卫生事业管理]