失效模式与效应分析对全腹腔镜胃癌手术患者压力性损伤的预防效果

李倩, 张瑞, 李一丁, 洪流

李倩, 张瑞, 李一丁, 洪流. 失效模式与效应分析对全腹腔镜胃癌手术患者压力性损伤的预防效果[J]. 实用临床医药杂志, 2022, 26(22): 94-97. DOI: 10.7619/jcmp.20221732
引用本文: 李倩, 张瑞, 李一丁, 洪流. 失效模式与效应分析对全腹腔镜胃癌手术患者压力性损伤的预防效果[J]. 实用临床医药杂志, 2022, 26(22): 94-97. DOI: 10.7619/jcmp.20221732
LI Qian, ZHANG Rui, LI Yiding, HONG Liu. Effect of failure mode and effect analysis in prevention of stress injury in patients with total laparoscopic gastric cancer surgery[J]. Journal of Clinical Medicine in Practice, 2022, 26(22): 94-97. DOI: 10.7619/jcmp.20221732
Citation: LI Qian, ZHANG Rui, LI Yiding, HONG Liu. Effect of failure mode and effect analysis in prevention of stress injury in patients with total laparoscopic gastric cancer surgery[J]. Journal of Clinical Medicine in Practice, 2022, 26(22): 94-97. DOI: 10.7619/jcmp.20221732

失效模式与效应分析对全腹腔镜胃癌手术患者压力性损伤的预防效果

基金项目: 

国家自然科学基金项目 82073210

详细信息
    通讯作者:

    洪流, E-mail: hongliu180@126.com

  • 中图分类号: R735.2;R47

Effect of failure mode and effect analysis in prevention of stress injury in patients with total laparoscopic gastric cancer surgery

  • 摘要:
    目的 

    观察失效模式与效应分析(FMEA)对全腹腔镜胃癌手术患者压力性损伤的预防效果。

    方法 

    选取2020年4—12月收治的213例全腹腔镜胃癌手术患者作为研究对象,将2020年4—9月收治的107例患者纳入对照组,将2020年10—12月收治的106例患者纳入观察组。对照组实施常规预防压力性损伤的护理操作规程,观察组实施经FMEA优化的预防压力性损伤的护理操作规程,比较2组患者的压力性损伤发生率、高危失效模式发生率和风险优先指数(RPN)分值。

    结果 

    观察组6项高危失效模式(对全腹腔镜胃癌手术流程不熟悉,术中巡回护士未动态监测,体位垫及防压力性损伤措施使用不规范,术中手术医生、洗手护士的手放置不当,术中体位发生变化时护理不到位,医务人员转运患者时操作不规范)的RPN分值均低于对照组,差异有统计学意义(P < 0.05); 观察组6项高危失效模式发生率、压力性损伤发生率均低于对照组,差异有统计学意义(P < 0.05)。

    结论 

    FMEA能够高效筛查出影响全腹腔镜胃癌手术患者发生压力性损伤的高危失效模式,并优化手术护理配合流程,大幅提高手术护理配合质量。

    Abstract:
    Objective 

    To observe the failure mode and effect analysis (FMEA) in preventing pressure injury in patients undergoing total laparoscopic gastric cancer surgery.

    Methods 

    A total of 213 patients with gastric cancer undergoing total laparoscopic surgery admitted from April to December 2020 were as study objects. A total of 107 patients admitted from April to September 2020 were included in control group, and 106 patients admitted from October to December 2020 were included in observation group. The control group was routinely treated with surgical nursing cooperation procedures to prevent pressure injury, while the observation group implemented the optimized nursing operation procedures by FMEA for prevention of stress injury. The incidence of pressure injury, the incidence of high-risk failure mode, and the risk priority number (RPN) of the two groups were compared.

    Results 

    The RPN scores of six high-risk failure mode (unfamiliar with the procedure of total laparoscopic gastric cancer surgery, no dynamic monitoring of intraoperative itinerant nurses, non-standard use of position pads and anti-pressure injury measures, improper hand placement of intraoperative surgeons and hand-washing nurses, inadequate nursing when the intraoperative position was changed, and non-standard operation of medical personnel when transferring patients) in the observation group were lower than those in the control group (P < 0.05). The incidence rates of six high-risk failure modes and stress injury in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05).

    Conclusion 

    FMEA can effectively screen the high-risk failure modes affecting pressure injury in patients undergoing total laparoscopic gastric cancer surgery, optimize the surgical cooperation nursing process, and greatly improve the quality of surgical nursing.

  • 表  1   2组高危失效模式RPN分值比较(x±s

    组别 对全腹腔镜胃癌手术流程不熟悉 术中巡回护士未动态监测 体位垫及防压力性损伤措施使用不规范 术中手术医生、洗手护士的手放置不当 术中体位发生变化时护理不到位 医务人员转运患者时操作不规范
    对照组(n=107) 200.6±25.6 176.2±28.3 212.1±32.1 140.2±23.6 168.2±35.0 296.2±45.3
    观察组(n=106) 87.2±12.1* 79.3±14.3* 99.8±13.6* 86.21±11.3* 83.1±10.2* 132.1±12.7*
    与对照组比较, *P < 0.05。
    下载: 导出CSV

    表  2   2组高危失效模式发生情况比较[n(%)]

    高危失效模式 对照组(n=107) 观察组(n=106)
    对全腹腔镜胃癌手术流程不熟悉 26(24.3) 0*
    术中巡回护士未动态监测 27(25.2) 5(4.7)*
    体位垫及防压力性损伤措施使用不规范 26(24.3) 0*
    术中手术医生、洗手护士的手放置不当 50(46.7) 3(2.8)*
    术中体位发生变化时护理不到位 26(24.3) 1(0.9)*
    医务人员转运患者时操作不规范 26(24.3) 2(1.9)*
    与对照组比较, *P < 0.05。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-06-02
  • 网络出版日期:  2022-12-01

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