标题：基于FMEA模式的精细化管理措施在ICU中心静脉导管护理中的应用

      作者：谭丽嫦，李佩兰，梁霭媛    江门市新会区人民医院重症医学科，广东 江门 529100

      卷次： 2021年32卷13期

      【摘要】 目的 探讨基于失效模式和效果分析(FMEA)模式的精细化管理措施在重症监护室(ICU)中心静脉导管护理中的应用效果，为患者的临床护理管理提供相关指导。方法 选择2019年1月至2020年1月于江门市新会区人民医院 ICU接受中心静脉导管置管的105例患者为研究对象，按照随机单双数法将患者分为对照组53例和研究组52例。对照组患者予以常规护理措施，研究组患者在对照组基础上予以基于FMEA模式的精细化管理措施。治疗结束出院前，比较两组患者的失效模式危急值(RPN)、护理质量、并发症发生情况及患者对护理的满意度。结果 研究组患者健康教育、患者因素、导管因素、置管操作因素、冲、封管操作及置管后管理失效模式RPN分别为(83.86±8.35)分、(75.62±7.56)分、(75.06±7.62)分、(71.36±7.12)分、(67.26±6.54)分、(69.22±6.84)分，明显低于对照组的(133.47±13.62)分、(119.81±12.20)分、(134.32±13.58)分、(113.69±11.27)分、(98.84±9.91)分、(108.37±10.07)分，差异均有统计学意义(P<0.05)；研究组患者的护理质量总评分为(379.43±37.82)分，明显高于对照组的(341.85±33.63)分，差异有统计学意义(P<0.05)；研究组患者的总并发症发生率为 5.77%，明显低于对照组的 20.75%，差异有统计学意义(P<0.05)；研究组患者对护理的满意度为 96.15%，明显高于对照组的 75.47%，差异有统计学意义(P<0.05)。结论 基于FMEA模式的精细化管理措施应用于ICU中心静脉导管患者可提高护理质量，并能减少并发症的发生。
      【关键词】 重症监护室；中心静脉导管；失效模式和效果分析；精细化管理；护理质量；并发症
      【中图分类号】 R473 【文献标识码】 A 【文章编号】 1003—6350（2021）13—1765—04

Application of refined management measures based on FMEA model in ICU central venous catheter care.
TANLi-chang, LI Pei-lan, LIANG Ai-yuan. Department of Critical Medicine, People's Hospital of Xinhui District of Jiangmen,Jiangmen 529100, Guangdong, CHINA
【Abstract】 Objective To investigate the application effect of fine management measures based on failuremode and effect analysis (FMEA) mode in central venous catheter care in intensive care unit (ICU), and to provide rele-vant guidance for clinical nursing of patients. Methods A total of 105 patients who received central venous catheteriza-tion in ICU, People's Hospital of Xinhui District of Jiangmen from January 2019 to January 2020 were selected as re-search subjects, and the patients were divided into the control group (n=53) and study group (n=52) according to randommethod of single or double number. The patients in the control group were given routine nursing measures, and the pa-tients in the study group were given fine management measures based on FMEA mode. During hospitalization, the criti-cal value of failure mode (RPN), nursing quality, complications and patients' satisfaction with nursing were compared be-tween the two groups. Results In the study group, the RPN of health education, patient factors, catheter factors, cathe-terization operation factors, fluting, sealing operation and post-catheterization management failure modes were (83.86±·护理·doi:10.3969/j.issn.1003-6350.2021.13.038基金项目：广东省江门市卫生健康局科学技术研究项目(编号：20A087)