失效模式与效应分析模型在经鼻内镜下垂体瘤切除术风险管理中的应用

目的 探讨失效模式与效应分析(FMEA)模型在经鼻内镜下垂体瘤切除术风险管理中的应用价值.方法 根据干预方式的不同将64例实施经鼻内镜下垂体瘤切除术的垂体瘤患者分为对照组和FMEA组,每组32例,对照组患者实施常规护理干预,FMEA组患者实施基于FMEA模型的护理干预.比较两组患者的关键流程风险优先指数(RPN)、手术...

Application of failure mode and effect analysis in risk management of endoscopic transnasal resection of pituitary tumors

Objective To investigate the application value of failure mode and effect analysis(FMEA)in risk management of endoscopic transnasal resection of pituitary tumors.Method A total of 64 patients who underwent endoscopic transnasal resection of pituitary tumors were divided into the control group and the FMEA group,with 32 cases each according to their varying interventions.The control group received the routine nursing intervention,while the FMEA group received nursing intervention based on FMEA.The critical process risk priority number(RPN),surgery-related indicators,and the incidence of intraoperative errors were compared between the two groups.Result The RPN scores of failure modes in the FMEA group such as lack of effective coping strategies,lack of teamwork,inappropriate use of instrument equipment,lack of safe postoperative patient handovers,improper patients positioning,and inadequate surgical infection prevention measures were significantly lower than those of the control group,and the differences were statistically significant(P<0.01).The handover time,operation time,and hospital stay of the FMEA group were significantly shorter than those of the control group,and the hospitalization expense was significantly lower than that of the control group,the differences were statistically significant(P<0.01).The incidence of intraoperative errors in the control group was 12.50%(4/32),which was higher than 0%(0/32)in the FMEA group,and the difference was statistically significant(P<0.05).Conclusion The FMEA model’s employment to manage and intervene in the intraoperative risks of endoscopic transnasal resection of pituitary tumors can improve the effect and safety of surgery and is effective and practical for reducing intraoperative risks and promoting the rehabilitation of patients.