医疗失效模式与效应分析方法预防失禁性皮炎的效果.docVIP

医疗失效模式与效应分析方法预防失禁性皮炎的效果 　　[摘要] 目的 运用医疗失效模式与效应分析（HFMEA）方法预防失禁性皮炎，以降低失禁性皮炎的发生率。 方法 选择南通大学附属医院神经外科ICU（以下简称“我科”）大/小便失禁住院患者181例。其中，对照组为2014年1～9月我科患者91例，采用传统的皮肤护理方法；实验组为2014年10月～2015年6月我科实施HFMEA方法的患者90例，根据HFMEA模式的流程，组建团队成立HFMEA小组，绘制流程图，评估各流程步骤中潜在的失效模式，并对失效模式进行原因分析，最后根据分析结果针对需优先解决的问题进行措施改进并实施。比较两组患者失禁性皮炎的发生率和严重程度。 结果 ①实验组90例中发生失禁性皮炎10例（11.1%），对照组91例中发生失禁性皮炎25例（27.5%），两组比较差异有高度统计学意义（P 0.01）。②实验组无和发生轻度、中度、重度失禁性皮炎的患者分别为80、8、2、0例，对照组分别为66、14、8、3例，两组差异有统计学意义（P 0.05）。 结论 应用医疗失效模式与效应分析能有效降低失禁性皮炎的发生率。 　　[关键词] 失禁性皮炎；预防；医疗失效模式与效应分析 　　[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210（2016）10（a）-0176-05 　　Effect of health care failure mode and effect analysis in preventing incontinence-associated dermatitis 　　ZHANG Xiaomei1 CHEN Xiaoyan1 ZHONG Yueping2▲ 　　1.Department of Neurosurgery ICU， Affiliated Hospital of Nantong University， Jiangsu Province， Nantong 226001， China； 2.Ward Ⅱ， Department of Neurosurgery， Affiliated Hospital of Nantong University， Jiangsu Province， Nantong 226001， China 　　[Abstract] Objective To prevent incontinence-associated dermatitis （IAD） by health care failure mode and effect analysis （HFMEA）， in order to reduce the incidence rate of IAD. Methods A total of 181 hospitalized patients with fecal/urinary incontinence in Department of Neurosurgery ICU， Affiliated Hospital of Nantong University （our department for short） were selected. 91 cases in the control group were selected in our department from January to September 2014 and given traditional skin care method. 90 cases in the experimental group were treated with HFMEA from October 2014 to June 2015 in our department. According to the process of HFMEA， HFMEA team was established to formulate the flow chart and analyzed the possible potential failure modes in various process steps. Reasons of failure modes were analyzed， and finally measures were improved and implemented against problems solved firstly. Differences in incidence and severity of IAD were compared between the two groups. Results ①After HFMEA，