失效模式与效应分析在临床输血管理中的应用效果

[目的]完善临床输血护理流程，加强临床输血安全管理。[方法]成立输血安全护理管理团队，应用失效模式与效应分析（FMEA）方法，列出输血护理流程的各个步骤，以及各步骤可能发生的失效模式，并计算失效模式的危机值（RPN），查找目前输血护理流程中存在的危险因素，针对影响安全输血的高危因素，制定改进措施并应用于临床输血过程中。比较实施FMEA 前后 RPN 值及病人安全输血效果。[结果]实施 FMEA 后取血、输血时间不合格率明显下降，护士输血查对实践考核合格率较实施前提高，影响安全输血高危因素的 RPN 值明显下降。[结论]FMEA 模式应用于临床输血护理管理中有利于提高护士评估风险意识与能力，前瞻性地发现流程中潜在的危险因素，提高病人输血护理安全。

Appl ication effect of failure mode and effects analysis in cl inical transfusion management

Objective：To improve and perfect nursing process of clinical transfusion,enhance the safety management of clinical transfusion.Meth-ods：The blood transfusion safety nursing management team was estab-lished,and the failure mode and effect analysis（FMEA）method was used. The various steps of transfusion nursing process were listed and to list failure modes may occur in all steps,and to calculate the crisis of value （RPN）of the failure modes,find out the current risk factors of transfusion nursing process,aiming at the high risk factors of influencing the safety of transfusion,to formulate improvement measures and apply it in clinical transfusion process.To compare the RPN value and safe blood transfusion effect of patients before and after implementation of FMEA.Results：After the implementation of FMEA,unqualified rate of the blood taking and transfusion time decreased,practice examination qualified rate of the nurse check blood transfusion raise before the implementation,RPN value of risk factors of influencing safe blood transfusion decreased.Conclusion：FMEA mode applied in the clinical transfusion management is conductive for im-proving nurses’assessment of risk consciousness and ability,prospectively finding out potential risk factors in the process,so as to improve the nurs-ing safety of blood transfusion.