基于失效模式和效果分析模式的精细化管理在ICU中心静脉导管干预中的效果  

Effect of fine management based on failure mode and effect analysis mode on central venous catheter intervention in intensive care unit

作　　者：赵春玲 刘茳 刘佳[1] ZHAO Chunling;LIU Jiang;LIU Jia(Department of Critical Care Medicine,the People’s Hospital of Langfang City,Hebei,Langfang 065000,China)

机构地区：[1]河北省廊坊市人民医院重症医学科,065000

出　　处：《河北医药》2024年第19期3026-3029,共4页Hebei Medical Journal

基　　金：河北省廊坊市科技支撑计划项目(编号:2016013173)。

摘　　要：目的探讨重症监护室(ICU)中心静脉导管干预中应用基于失效模式和效果分析(FMEA)模式的精细化管理措施的效果。方法选取2020年11月至2021年11月医院ICU接受中心静脉导管置管的患者106例纳入研究,按随机数字表法分2组,每组53例。对照组采用常规护理,研究组在对照组基础上采用基于FMEA模式的精细化管理措施,比较2组的失效模式危急值(RPN)、护理质量、并发症发生率和护理满意度。结果研究组患者因素、健康教育、置管操作因素、导管因素、冲、封管操作及置管后管理失效模式RPN分别为(119.83±12.21)、(133.45±13.63)、(113.68±11.26)、(134.35±13.57)、(98.83±9.92)、(108.36±10.05)分,低于对照组的(75.63±7.57)、(83.85±8.36)、(71.35±7.11)、(75.07±7.63)、(67.27±6.55)、(69.21±6.83)分,差异有统计学意义(P<0.05)。研究组应急护理能力、基础护理水平、服务态度、患者应用效应评分及护理质量总评分分别为(96.42±9.55)、(92.72±9.17)、(94.68±9.32)、(94.55±9.33)、(379.42±37.81)分,高于对照组的(85.37±8.52)、(85.21±8.46)、(85.32±8.41)、(85.42±8.42)、(341.86±33.62)分,差异有统计学意义(P<0.05)。研究组并发症发生率为5.66%,低于对照组的22.64%,差异有统计学意义(P<0.05)。研究组总满意度为96.23%,高于对照组的73.58%,差异有统计学意义(P<0.05)。结论ICU中心静脉导管干预中应用基于FMEA模式的精细化管理措施,可减少并发症发生率和降低各失效模式RPN,提高护理质量和护理满意度。Objective To explore the effect of applying fine management measures based on failure modes and effects analysis(FMEA)mode on central venous catheter placement in intensive care unit(ICU).Methods A total of 106 patients who received central venous catheter placement in ICU of the People’s Hospital of Langfang City from November 2020 to November 2021 were included in the study.They were randomly assigned into the control groups(n=53,routine nursing)and the study group(n=53,FMEA mode-based fine management measures+routine nursing).The risk priority number(RPN)for failure mode,nursing quality,complication rate and nursing satisfaction of the two groups were compared.Results The RPN of failure mode in patient factors(119.83±12.21 vs 75.63±7.57),health education(133.45±13.63 vs 83.85±8.36),operation factors of catheterization(113.68±11.26 vs 71.35±7.11),factor of catheter(134.35±13.57 vs 75.07±7.63),operation factors of flushing sealing(98.83±9.92 vs 67.27±6.55),and post-confinement management(108.36±10.05 vs 69.21±6.83)in the study group were significantly lower than those of the control group(P<0.05).The total scores of emergency nursing ability(96.42±9.55 vs 85.37±8.52),basic nursing level(92.72±9.17 vs 85.21±8.46),service attitude(94.68±9.32 vs 85.32±8.41),patient application score(94.55±9.33 vs 85.42±8.42)and nursing quality(379.42±37.81 vs 341.86±33.62)in the study group were significantly higher than those of the control group(P<0.05).The complication rate of the study group was significantly lower than that of the control group(5.66%vs 22.64%,P<0.05).The total satisfaction rate of the study group was significantly higher than that of the control group(96.23%vs 73.58%,P<0.05).Conclusion The application of FMEA mode-based fine management measures on central venous catheter placement in ICU can reduce the incidence of complications,reduce the RPN of each failure mode,and improve the quality of nursing and nursing satisfaction.

关 键 词：中心静脉导管 精细化管理 重症监护室 并发症 护理质量 失效模式和效果 

分 类 号：R471[医药卫生—护理学]