HFMEA在急诊异位妊娠破裂患者术前安全管理流程中的应用

目的 研究运用医疗失效模式与效应分析(HFMEA)在急诊异位妊娠破裂患者术前安全管理流程中的效果。方法 选取2020年2月至2021年1月急诊收治的异位妊娠破裂出血需院内急诊手术的104例患者作为研究对象。回顾性分析2020年2月至7月采用常规急诊接诊模式的48例异位妊娠破裂患者，2020年8月至2021年1月急诊收治的56例异位妊娠破裂患者为研究组，运用HFMEA找出急诊异位妊娠破裂患者术前安全管理流程中容易产生的失效模式，分析原因，提出改进措施并实施。对比两组从急诊预检到术前在急诊滞留的时间、影响安全管理流程各失效模式的RPN值。结果 研究组在急诊滞留的时间、影响安全管理流程各失效模式的RPN值较对照组明显下降，差异有统计学意义(P<0.05)。结论 运用HFMEA能够使急诊异位妊娠破裂患者术前安全管理流程得到改善，降低安全管理中失效模式发生的风险，保障患者安全。

Application of HFMEA in Preoperative Safety Management of Emergency Patients with Ruptured Ectopic Pregnancy

Objective To study the effect of Healthcare Failure Mode and Effect Analysis (HFMEA) in the preoperative safety management process of emergency patients with ruptured ectopic pregnancy. Methods A total of 104 patients with ruptured ectopic pregnancy who required in-hospital emergency surgery from February 2020 to January 2021 were selected as the study subjects. A total of 48 patients with ruptured ectopic pregnancy who received routine emergency admission mode from February to July 2020 and 56 patients with ruptured ectopic pregnancy who received emergency treatment from August 2020 to January 2021 were retrospectively analyzed as the study group. HFMEA was used to find out the failure modes that are easy to occur in the preoperative safety management process of patients with ruptured ectopic pregnancy in the emergency department, analyze the causes, and propose improvement measures and implement them. The RPN values of each failure mode affecting the safety management process were compared between the two groups from the time of emergency pre-examination to preoperative retention in the emergency. Results The time of emergency stay and RPN value affecting each failure mode of safety management process in study group were significantly lower than those in control group, and the differences had statistical significance (P < 0.05). Conclusion The use of HFMEA can improve the preoperative safety management process of emergency patients with ruptured ectopic pregnancy, reduce the risk of failure mode in safety management, and ensure the safety of patients.