CAJ | 학술논문

目的应用失效模式和效果分析降低经外周置入中心静脉导管(PICC)置管护理风险.方法以上海市闵行区中心医院100例PICC患者为实验组,应用失效模式和效果分析,计算风险顺序数(RPN)值风险排列,根据RPN值的大小判断确定计划,改善后指导临床操作和护理.以莘庄卫生服务中心、闵行区肿瘤医院PICC置管98例患者为对照组进行传统护理,分组对照.数据采用SPSS11.0统计软件进行分析处理.采用x2检验比较实施失效模式和效果分析(FMEA)管理模式PICC置管护理风险发生率的差别.结果应用FMEA可降低PICC置管后的护理风险:局部/全身感染数,渗血、出血、过敏、机械性静脉炎、置入过深、置入颈静脉、折入腋静脉、堵管、导管滑脱、送管困难、穿刺失败等的发生率,2组比较差异均有统计学意义.结论应用FMEA降低了PICC置管护理风险,减少了医疗纠纷,减轻患者痛苦,降低因PICC并发症而产生的医疗费用,提高患者满意度,提高临床护理质量.
목적 응용실효모식화효과분석강저경외주치입중심정맥도관(PICC)치관호리풍험.방법 이상해시민행구중심의원100례PICC환자위실험조,응용실효모식화효과분석,계산풍험순서수(RPN)치풍험배렬,근거RPN치적대소판단학정계화,개선후지도림상조작화호리.이신장위생복무중심、민행구종류의원PICC치관98례환자위대조조진행전통호리,분조대조.수거채용SPSS11.0통계연건진행분석처리.채용x2검험비교실시실효모식화효과분석(FMEA)관리모식PICC치관호리풍험발생솔적차별.결과 응용FMEA가강저PICC치관후적호리풍험:국부/전신감염수,삼혈、출혈、과민、궤계성정맥염、치입과심、치입경정맥、절입액정맥、도관、도관활탈、송관곤난、천자실패등적발생솔,2조비교차이균유통계학의의.결론 응용FMEA강저료PICC치관호리풍험,감소료의료규분,감경환자통고,강저인PICC병발증이산생적의료비용,제고환자만의도,제고림상호리질량.
Objective To apply failure mode and effect analysis (FMEA) to reduce nursing risk of peripherally inserted central catheter (PICC).Methods 100 patients with PICC in central hospital of Minxing District of Shanghai were named as the experimental group,failure mode and effect analysis were performed in this group to obtain the value of risk priority number (PRN) and array them according to the RPN value to work out improved plan systematically and put it into practice to guide the clinical operation and nursing care.98 PICC patients in Xinzhuang health service center and Tumor Hospital of Minhang district were set as the control group,which were subjected to traditional nursing.All statistical analysis were done by SPSS 11.0 software package,the differences of the incidence of PICC-related nursing risk between the two groups due to the implementation of FMEA was analyzed by X2 test.Results Application of FMEA could reduce the nursing risk of PICC,After the application of FMEA,the incidence of PICC-related complications such as focal or systemic infection,puncture site oozing and bleeding,skin allergies,mechanical phlebitis,too deeply placed catheter,catheterization into cervical veins and reflexed into axillary vein,catheter occlusion,catheter migration,difficult removal of catheter,puncture failure in the experimental group decreased obviously,the differences had statistical meaning.Conclusions The application of failure mode and effects analysis can reduce the nursing risk of PICC,decrease medical disputes,alleviate the suffering of patients,reduce medical costs caused by PICC-related complications,and improve the satisfaction degree of patients and the quality of nursing care.