失效模式与效应分析用于新生儿静脉留置针安全管理中的护理效果  

Nursing effect of failure mode and effect analysis on safety management of newborn venous indwelling needle

作　　者：张花[1] 盛晓郁[1] ZHANG Hua;SHENG Xiaoyu(Children's Hospital of Suzhou University,Suzhou,215000,China)

机构地区：[1]苏州大学附属儿童医院新生儿科,江苏省苏州市215000

出　　处：《护理实践与研究》2023年第2期282-285,共4页Nursing Practice and Research

摘　　要：目的分析失效模式与效应分析(FMEA)在新生儿静脉留置针患儿安全管理中的应用效果。方法选取医院新生儿科2022年1—4月收治的行静脉留置针穿刺的新生儿115例,按照组间基本特征具有可比性的原则,将静脉针留置期间行常规管理的新生儿57例纳入对照组,行FMEA管理的新生儿58例纳入观察组,比较分析两组管理情况、不良事件、风险优先指数(RPN)值。结果实施FMEA管理后,观察组皮肤损伤发生率、污染敷贴未及时更换率、操作不够规范发生率低于对照组,1次置管成功率高于对照组,留置时间长于对照组,差异有统计学意义(P<0.05)。实施FMEA管理后,观察组药物外渗、穿刺部位感染、意外拔针、堵管RPN评分低于对照组,差异有统计学意义(P<0.05)。实施FMEA管理后,观察组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论FMEA管理应用于新生儿静脉留置针患儿安全管理中,可有效提升静脉留置针管理质量及安全性。Objective To analyze the application effect of failure mode and effect analysis(FMEA)in the safety management of neonates with intravenous catheter.Methods A total of 115 neonates who were admitted to the hospital from January to April 2022 for intravenous indwelling needle puncture were selected.According to the principle of comparability among groups,57 neonates who were under routine management during intravenous needle indwelling were included in a control group,and 58 neonates who were under FMEA management were included in an observation group.The management,adverse events and risk priority number(RPN)values of the two groups were compared and analyzed.Results After the implementation of FMEA management,the incidence of skin damage,the rate of untimely replacement of contaminated plaster,and the rate of nonstandard operation in the observation group were lower than those in the control group,the success rate of once catheterization was higher than that in the control group,the retention time was longer than that in the control group,and the differences were statistically significant(P<0.05).After the implementation of FMEA management,the RPN scores of drug extravasation,puncture site infection,accidental needle pulling and tube plugging in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the implementation of FMEA management,the incidence of adverse events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of FMEA management in the safety management of neonates with venous indwelling needle can effectively improve the quality and safety of venous indwelling needle management.

关 键 词：失效模式与效应分析 新生儿 静脉留置针 管理质量 安全性 

分 类 号：R473.72[医药卫生—护理学]