FMEA在肾穿刺活检中的应用.docVIP

FMEA在肾穿刺活检中的应用 余悦满 陈月娉 李新春 赵玉婵 （广东省江门市新会区人民医院内六科 529100） 摘要 目的 应用失效模式与效应分析模式（failure mode and effect analysis，FMEA）分析经皮肾穿刺取活检术后并发症及不良反应的危险因素。方法 成立FMEA小组，运用失效模式与效应分析模式分析经皮肾穿刺取活检术后并发症的危险因素，找出可能存在的失效模式，制订预防措施和改进方法，比较实施前后危机值。结果 失效模式实施FMEA管理后危机值均较实施前显著降低。结论 应用FMEA分析经皮肾穿刺取活检术后并发症的危险因素，采取针对性措施后不良反应都有不同程度的下降，提示FMEA在经皮肾穿刺取活检术后并发症护理质量持续改进过程中的重要性。 关键词 失效模式与效应分析；肾穿刺活检术；并发症；护理 Application of FMEA in renal biopsy Yu Yue-men, Chen Yue-ping, Li Xin-chun, Zhao Yu-chan (Xinhui People’s Hospital of Jiangmen City, Jiangmen 529100, China.) [Abstract] Objective using the failure mode and effect analysis (failure mode and effect analysis, FMEA) to explore the the risk factors of complications and adverse reactions of renal biopsy which was performed percutaneous. Methods to establish FMEA groups, and find out the possible failure modes by analysing the risk factors of complications which renal biopsy was performed, then we make the preventive measures and the improved methods,the crisis value of the front and the after by carrying out the FMEA were compared. Results the crisis value of failure modes was significantly reduced after FMEA was implemented. Conclusion the adverse reactions were reduced with different rate after taking the positive measures ,when using the FMEA to analyse the risk factors of complications of the renal biopsy. It means that FMEA is important in the continuous quality improvement of renal biopsy nursing. [Key words] Failure mode and effect analysis; Renal biopsy; Complications; Nursing. 失效模式与效应分析（Failure mode and effect analysis，FMEAseverity，Sfrequence of occurrence，Olikelihood of detect，Drisk priority number，RPNRPN=O×D×S， 4. 体会 4.1 实施FMEA后，有助于小组成员对患者安全的潜在风险达成共识，发挥小组成员的集体智慧，保证完整的分析和评估，提出改善方案，从而实现了护理质量的持续提高[5]。 4.2 FMEA失效模式是一种前瞻性管理工具，实施后有效地降低经皮肾穿刺术后并发症或不良反应的发生，不断完善三级监控系统和规范护理流程，减少患者术后风险的发生。 4.3 FMEA失效模式实施后，护患关系融洽，落实床边责任制，让护士更好地为患者提供优质护理服务，降低护理不良事件发生。 参考文献： [1] 刘莉，黄素珍等，医疗失效模式与效应分析方法在腹腔镜器械清洗中的应用[J].护理管理杂志，2011，11(5)：375-376. [2] 马静.临床护理