FMEA在降低颈椎前路术后呼吸道梗阻发生率应用.docVIP

FMEA在降低颈椎前路术后呼吸道梗阻发生率应用 　　【摘要】 目的 探?失效模式和效应分析（FMEA）在降低颈椎前路手术患者呼吸道梗阻发生率中的应用效果。方法 选择2012年1月～2014年4月在本院行颈椎前路手术的120患者为对照组， 选取2014年5月～2015年10月在本院行颈椎前路手术的120患者为观察组。对照组按围手术期护理常规进行护理， 观察组运用FMEA对颈椎前路术后患者可能发生呼吸道梗阻的失效模式进行前瞻性分析、评估， 找出导致呼吸道梗阻的最高危因素和高危护理流程， 制定预防和改进措施并实施。计算实施改进措施前后风险优先数（RPN）值， 比较两组呼吸道梗阻发生率、住院时间和患者满意度。结果 实施改进措施后， 观察组各项RPN值均较对照组明显降低。观察组呼吸道梗阻发生率为0.83%， 对护理满意度为95.83%， 住院时间为（10.03±2.56）d， 对照组呼吸道梗阻发生率为6.67%， 对护理满意度为76.67%， 住院时间为（13.57±3.84）d， 观察组患者呼吸道梗阻发生率低于对照组（P0.05）；观察组护理满意度高于对照组（P0.01）；观察组住院时间短于对照组（P0.01）。结论 应用FMEA对颈椎前路手术患者进行评估、分析和采取相关措施， 能有效防范风险， 降低呼吸道梗阻发生率， 提高护理质量， 保证患者安全。 　　【关键词】 失效模式和效应分析；颈椎前路手术；呼吸道梗阻；护理 　　DOI：10.14163/j.cnki.11-5547/r.2017.09.082 　　Application of FMEA in reducing incidence of postoperative respiratory tract obstruction after anterior cervical operation LI Ling-yun， JIANG Yao-ying， LIU Jie-zhen， et al. Department of Spinal Surgery， Guangzhou City First People’s Hospital， Guangzhou 510180， China 　　【Abstract】 Objective To investigate application effect by failure mode and effect analysis （FMEA） in reducing incidence of respiratory tract obstruction after anterior cervical operation in patients. Methods There were 120 patients receiving anterior cervical operation in our hospital during January 2012～April 2014 as control group and 120 patients receiving anterior cervical operation in our hospital during May 2014～October 2015 as observation group. The control group received conventional perioperative nursing. The observation group received prospective analysis and evaluation of respiratory tract obstruction failure mode by FMEA for anterior cervical operation patients to determine the highest risk factor and high risk nursing process for respiratory tract obstruction， and to formulate and implement prevention and improvement measures. Calculation was made on risk priority number （RPN） value before and after implement of improvement measures. Comparison was made on incidence of respiratory tract obstruction， hospital stay time and patients satis