基于HFMEA优化胃肠肿瘤患者围手术期加速康复流程  

Improvement of Perioperative Period Enhanced Recovery Process for Gastrointestinal Tumor Patients Based on HFMEA

作　　者：毕婷婷 曾艺鹏 张汉 张乐乐 吴德俊 李诗媛 BI Tingting;ZENG Yipeng;ZHANG Han(Shanghai Pudong Hospital,Shanghai,201399,China;不详)

机构地区：[1]上海市浦东医院,上海201399

出　　处：《中国卫生质量管理》2024年第8期81-86,共6页Chinese Health Quality Management

基　　金：上海市浦东医院学科建设计划项目资助(编号:Zdzk2020-10、Tszb2023-01);2022年度上海市浦东医院院级科研基金项目(护理类)(编号:YJ2022-03);浦东新区重要薄弱学科(编号:PWZbr2022-20)。

摘　　要：目的优化胃肠肿瘤患者围手术期加速康复流程,减少术后并发症,缩短住院时间。方法对胃肠肿瘤患者加速康复流程进行危害与决策树分析,找到关键失效模式,并分析其根本原因,拟订针对性改善措施。结果胃肠肿瘤患者各项临床康复指标均有明显改善,胃癌术后并发症发生率下降至0.00%,结直肠癌术后并发症发生率下降至11.11%,下肢血管超声筛查率提升至100%,围手术期功能锻炼落实率提升至92.31%,VTE预防措施落实率提升至97.16%,术后首次下床活动时间缩短至3.08 d。结论HFMEA方法在胃肠肿瘤患者围手术期加速康复流程优化中具有显著效果。Objective To optimize the perioperative period enhanced recovery process of gastrointestinal tumor patients,reduce postoperative complications and shorten the length of hospital stay.Methods Through the hazard and decision tree analysis of the enhanced recovery process for gastrointestinal tumor patients,the key failure modes were found,the root causes were analyzed,and the improvement countermeasures were proposed.Results There were significant improvement in the clinical rehabilitation indicators of gastrointestinal tumor patients.The incidence of postoperative complications of gastric cancer fell to 0.00%,and postoperative complications of colorectal cancer fell to 11.11%,the ultrasound screening rate of lower extremities increased to 100%,the implementation rate of perioperative period function exercise was promoted to 92.31%,the implementation rate of VTE preventive measures was increased to 97.16%,and the first postoperative activity time was shortened to 3.08 days.Conclusion The health failure mode and effect analysis(HFMEA)method has a significant effect on improving the perioperative accelerated rehabilitation process in patients with gastrointestinal tumor.

关 键 词：医疗失效模式与效应分析 胃肠肿瘤 围手术期 加速康复外科 流程优化 

分 类 号：R197.323[医药卫生—卫生事业管理] R735[医药卫生—公共卫生与预防医学]