失效模式与效应分析在ICU轮转护士实境培训考核中的应用*

目的:探讨医疗失效模式与效应分析（Healthcare Failure Mode and Effect Analysis，HFMEA）在ICU轮转护士实境培训考核中的应用与效果。方法：成立FMEA团队，对ICU轮转护士实境培训考核过程进行失效风险评估及失效模式分析，完善制定改进方案并实施。结果：在ICU轮转护士实境培训考核过程中使用持续质量改进措施后，其实境考核成绩、“优良”等次获得率、急救技能成绩明显提升（P＜0.05）。病人护理、管道护理、安全管理、护理文件书写、感染控制等5个方面的护理质量检查得分“优秀”获得率明显提升（P＜0.05）。结论：应用医疗失效模式与效应分析完善ICU轮转护士实境培训考核方案并实施，可以提高ICU轮转护士实境培训考核实效及临床工作能力和护理质量。

Application of failure mode and effect analysis on real-case-based training of rotary nurses in ICU

Objective: To study the effect of applying healthcare failure mode and effect analysis (HFMEA) on the real-case-based training of rotary nurses in ICU. Methods: Established FMEA team, we assessed the failure risk and analyzed the failure mode of training courses for rotary nurse, in order to improve the formulation scheme and carry it out. Results: The examination results showed that the excellent rate and the scores of first aids skills improved significantly (P<0.05). After continuous quality improvement (CQI) in the real-case-based training, the scores of nursing quality examination was significantly improved (P<0.05), which including patients care, canal nursing, safety management, nursing document writing and infection control. Conclusion: The application of HFMEA theory in real-case-based training scheme can improve the training effectiveness, clinical work ability and nursing quality of the ICU rotary nurse.