失效模式和效应分析在降低PICC导管非计划拔管中的应用

目的 应用失效模式和效应分析(FMEA)进行肿瘤患者PICC导管非计划拔管的风险防范管理,降低非计划拔管发生率.方法 应用FMEA模式前瞻性分析评估肿瘤患者PICC导管非计划拔管的失效模式、潜在风险因素与危害影响,选择其中优先风险数值(risk priority number,PRN)较高的失效模式,制定系统性改进方案并实施.比较实施前后非计划拔管发生率及护士PICC导管相关知识与维护技能、患者导管自护知识与技能的差异.结果 实施FMEA管理后,观察组非计划拔管发生率明显下降,护士PICC导管相关知识与维护技能优秀率明显提高,病人导管自护知识掌握程度明显提高,差异有统计学意义.结论 应用FMEA对PICC护理流程进行前瞻性系统管理,对于降低非计划拔管发生率是有效可行的.

Application of failure mode and effect analysis in reducing the unplanned extubation rates of Peripherally Inserted Central Catheter (PICC)

Objective To use failure mode and effect analysis (FMEA) to prevent and manage the risk of unplanned extubation rates of peripherally Inserted Central Catheter (PICC) of cancel patient and to reduce the unplanned extubation rates of Peripherally Inserted Central Catheter (PICC).Methods Failure mode and potential risk factors and damage of the unplanned extubation of Peripherally Inserted Central Catheter (PICC) of cancer patients were analyzed and assessed prospectively with the application of FMEA.The failure model of high risk priority number was selected and improved plan was worked out systematacially and put into practice.Then the differences of unplanned extubation rates,knowledge and maintenance skill of nurse in peripherally Inserted Central Catheter (PICC) and patients self protection skill in catheter were compared before and after the implementation of FMEA.Results After the implementation of FMEA,unplanned extubation rates of observation group decreased obviously,the excellence rate of nurses grasping knowledge and maintenance skill in peripherally Inserted Central Catheter (PICC) increased clearly,the differences had statistic meaning.Conclusions It is effective and feasible to lower unplanned extubation rates with the application of FMEA to manage PICC nursing process prospectively.