Liu Ying, Li Kun-Kun, Li Lu, Chang Ning, Lun Xiang-Ling, Guan Zhi-Hua
Department of Endoscopy Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, 450000, China.
Department of Gastroenterology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, 450000, China.
BMC Nurs. 2025 Jan 14;24(1):49. doi: 10.1186/s12912-025-02692-y.
The objective of this study is to investigate the effect after the application of Failure Model and Effect Analysis (FMEA) in nursing care for patients who have undergone endoscopic submucosal dissection (ESD).
A cohort of 40 patients who underwent ESD between July and September 2023 were selected as the control group, while 42 patients who underwent ESD between October 2023 and June 2024 after implementing FMEA were selected as the observation group. A multidisciplinary team was established based on the FMEA model to analyze and create a nursing flowchart. The 3 primary processes and 13 sub-processes were thoroughly analyzed and assessed to identify potential failure models, possible causes of failure, and consequences for each sub-process. Risk Priority Numbers (RPNs) were calculated to determine priority failure models, including medication and item preparation, specimen collection, equipment/instrument/accessory preparation, and nursing coordination. Corresponding improvement measures were formulated and implemented followed by a subsequent analysis of the effects.
After implementing the improvement measures, there was a significant decrease in RPNs in the observation group when compared with the control group. A statistical significance was observed in context of medication and item preparation (P < 0.001), specimen collection (P < 0.001), equipment/instrument/accessory preparation (P < 0.001), and nursing coordination (P < 0.001).
The application of the FMEA model can effectively facilitate early nursing interventions for identified risks in patient who have undergone ESD. By instituting suitable corrective measures for aspects deemed high-risk, this approach significantly diminishes surgical nursing hazards, enhances the quality of nursing care, and guarantees patient safety.
本研究旨在探讨失效模式与效应分析(FMEA)应用于内镜黏膜下剥离术(ESD)患者护理后的效果。
选取2023年7月至9月行ESD的40例患者作为对照组,选取2023年10月至2024年6月实施FMEA后行ESD的42例患者作为观察组。基于FMEA模型组建多学科团队,分析并制定护理流程图。对3个主要流程和13个子流程进行全面分析和评估,以识别潜在的失效模式、可能的失效原因以及每个子流程的后果。计算风险优先数(RPN)以确定优先失效模式,包括用药及物品准备、标本采集、设备/器械/附件准备和护理协调。制定并实施相应的改进措施,随后分析效果。
实施改进措施后,观察组RPN较对照组显著降低。在用药及物品准备(P<0.001)、标本采集(P<0.001)、设备/器械/附件准备(P<0.001)和护理协调(P<0.001)方面差异有统计学意义。
FMEA模型的应用可有效促进对ESD患者已识别风险的早期护理干预。通过对高风险方面采取适当的纠正措施,该方法显著降低手术护理风险,提高护理质量,保障患者安全。