解放军护理杂志
解放軍護理雜誌
해방군호리잡지
NURSING JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2014年
12期
55-58
,共4页
失效模式与效应分析%胸腹腔恶性积液%胸腹腔穿刺置管术%护理
失效模式與效應分析%胸腹腔噁性積液%胸腹腔穿刺置管術%護理
실효모식여효응분석%흉복강악성적액%흉복강천자치관술%호리
failure mode and effect analysis%abdominal malignant effusion catheterization%nursing
探讨失效模式与效应分析(failure mode and effect analysis,FMEA)在胸腹腔恶性积液患者穿刺置管护理中的应用效果.方法便利选择2011年3月至2012年5月安徽医科大学附属巢湖医院肿瘤内科胸腹腔穿刺置管患者51例作为试验前组,进行常规护理；选择2012年6月至2013年8月的47例患者作为试验组,用 FMEA对置管术后可能出现的失效模式进行前瞻性分析,找出导致并发症的最高危因素,制定防范优先行动计划和改进措施.结果应用 FMEA后,10个高危因素的危机值较试验前组显著降低,胸腹腔穿刺置管患者术后导管滑脱、堵塞或引流不畅、穿刺点感染的发生率均有不同程度的下降(均P＜0．05),患者对导管护理的满意度有所提升(P＜0．01).结论应用 FMEA能够准确把握胸腹腔穿刺置管术后护理的重点环节,如导管固定、风险评估等,有效减少置管术后并发症,促进护理质量的持续改进.
探討失效模式與效應分析(failure mode and effect analysis,FMEA)在胸腹腔噁性積液患者穿刺置管護理中的應用效果.方法便利選擇2011年3月至2012年5月安徽醫科大學附屬巢湖醫院腫瘤內科胸腹腔穿刺置管患者51例作為試驗前組,進行常規護理；選擇2012年6月至2013年8月的47例患者作為試驗組,用 FMEA對置管術後可能齣現的失效模式進行前瞻性分析,找齣導緻併髮癥的最高危因素,製定防範優先行動計劃和改進措施.結果應用 FMEA後,10箇高危因素的危機值較試驗前組顯著降低,胸腹腔穿刺置管患者術後導管滑脫、堵塞或引流不暢、穿刺點感染的髮生率均有不同程度的下降(均P＜0．05),患者對導管護理的滿意度有所提升(P＜0．01).結論應用 FMEA能夠準確把握胸腹腔穿刺置管術後護理的重點環節,如導管固定、風險評估等,有效減少置管術後併髮癥,促進護理質量的持續改進.
탐토실효모식여효응분석(failure mode and effect analysis,FMEA)재흉복강악성적액환자천자치관호리중적응용효과.방법편리선택2011년3월지2012년5월안휘의과대학부속소호의원종류내과흉복강천자치관환자51례작위시험전조,진행상규호리；선택2012년6월지2013년8월적47례환자작위시험조,용 FMEA대치관술후가능출현적실효모식진행전첨성분석,조출도치병발증적최고위인소,제정방범우선행동계화화개진조시.결과응용 FMEA후,10개고위인소적위궤치교시험전조현저강저,흉복강천자치관환자술후도관활탈、도새혹인류불창、천자점감염적발생솔균유불동정도적하강(균P＜0．05),환자대도관호리적만의도유소제승(P＜0．01).결론응용 FMEA능구준학파악흉복강천자치관술후호리적중점배절,여도관고정、풍험평고등,유효감소치관술후병발증,촉진호리질량적지속개진.
Objective To investigate the effect of failure mode and effect analysis (FMEA)in nursing care of catheterization for patient with thoracic and abdominal malignant effusion.Methods By convenience sampling,a total of 51 cases accepted thoracic and abdominal cavity puncture in our department from 2011 March to 2012 May were assigned to the control group,and routine nursing was delivered to the control group.47 cases from 2012 June to 2013 August were selected as experimental group.Analyze the possible reasons for the failure mode after catheter by FMEA,to find the highest risk factors that lead to complica-tions,and make priority prevention plans and improvement measures.Result After the application of FMEA,10 risk factors in the experimental group were significantly lower than that in the control group, and the incidence of postoperative catheter slippage,blockage or poor drainage and puncture site infection in two groups were both declined in varying degrees (all P<0.05),and patient satisfaction with nursing was improved.Conclusion Application of FMEA can grasp the key points of nursing care of thoracic and abdominal puncture,such as the fixation of tube,the risk assessment,and it can effectively reduce the post-operative complications of catheterization,and promote the continues improvement of nursing quality.
