摘要
目的探讨失效模式和效应分析（FMEA）在诺舒阻抗控制子宫内膜切除术中的应用效果。方法将2014年6~11月诺舒阻抗控制子宫内膜切除手术患者60例设为对照组,行常规治疗护理;2014年12月至2015年5月运用FMEA管理模式后的同类手术患者60例设为观察组,由FMEA小组对诺舒围术期诊疗流程进行失效模式与潜在风险原因分析,计算事先风险指数（RPN）值,找出高危因素,落实防范措施。比较观察组FMEA实施前后高危因素的RPN值,两组麻醉期间低氧血症发生率、术中仪器故障发生率及术后体位性低血压发生率。结果观察组实施FMEA后,高危因素的RPN值下降,患者低氧血症发生率、术中仪器故障发生率、术后体位性低血压发生率均有下降,与对照组比较,差异有统计学意义（P〈0.05,P〈0.01）。结论应用FMEA对诺舒手术风险进行评估、干预,能有效规避风险,保障围术期安全。
Objective To explore the application and effect of failure mode and effect analysis（FMEA）in patients receiving endometrial ablation using NovaSure impedance-controlled system（hereafter called NovaSure surgery）.Methods Sixty patients who received the NovaSure surgery during June and November 2014 were chosen as the control group and given routine nursing,while another sixty patients during December 2014 and May 2015 were selected as the observation group and provided with FMEA based care,during which the potential risks were analyzed,risk priority numbers（RPNs）of each failure mode were calculated and countermeasures were implemented.The RPNs of the observation group were compared before and after FMEA implementation.The incidence of hypoxemia during anesthesia,intraoperative instrument failure rate and incidence of postoperative orthostatic hypotension were compared between the two groups.Results After the implementation of FMEA,the RPN values of each failure mode decreased.The incidence of hypoxemia during anesthesia,intraoperative instrument malfunction and orthostatic hypotension of the observation group were significantly lower than the control group（P〈0.05,P〈0.01）.Conclusion The application of FMEA in risk assessment and intervention in NovaSure surgery can effectively avoid risks and ensure patient safety during the perioperative period.
出处
《护理学杂志》
CSCD
2016年第6期19-23,共5页
Journal of Nursing Science
基金
江西省卫生和计划生育委员会科技计划项目(20151094)
关键词
子宫内膜切除术
诺舒阻抗控制子宫内膜切除系统
失效模式和效应分析
围术期
护理安全
endometrial ablation
NovaSure impedance-controlled endometrial ablation system
failure mode and effect analysis
perioperative period
nursing safety
