Application of FMEA on reducing the unplanned extubation rates in patients with neurosurgical catheterization
10.3760/cma.j.cn115682-20201106-06090
- VernacularTitle:失效模式与效应分析在降低神经外科置管患者非计划拔管率中的应用
- Author:
Chunling ZHENG
1
;
Huiyu JIN
;
Xiujie ZHAO
;
Shuzhen DING
;
Dongjian QI
Author Information
1. 解放军总医院第六医学中心神经外科，北京 100048
- Keywords:
Neurosurgery;
Catheterization;
Failure mode and effect analysis;
Unplanned extubation;
Risk Priority Value
- From:
Chinese Journal of Modern Nursing
2021;27(6):822-825
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates in patients with neurosurgical catheterization.Methods:FMEA theory was used to analyze the causes of unplanned extubation in neurosurgical patients with catheterization. The Risk Priority Number (RPN) was calculated and the failure modes with higher RPN were selected. The causes were analyzed, and the improvement measures were formulated to optimize the nursing plan. A total of 585 patients admitted to the Department of Neurosurgery of the Sixth Medical Center of PLA General Hospital from January 2018 to December 2019 were recruited as the FMEA group, the 631 patients admitted before FMEA application, from January 2016 to December 2017, were recruited as the control group. The control group was given routine nursing of Neurosurgery pipeline, and the FMEA group was given FMEA intervention on this basis. The difference of unplanned extubation rate between the two groups was compared.Results:The total incidence of unplanned extubation in FMEA group was 1.48% (21/1 417) , which was lower than 5.11% (72/1 408) in control group, with statistical significance ( P<0.001) . The unplanned extubation rates of gastric tube, urinary tube and operation related drainage tube in FMEA group were lower than in control group, and the differences were statistically significant ( P<0.05) . There was no significant difference in the incidence of unplanned extubation of endotracheal intubation and deep vein catheterization between the two groups ( P>0.05) . Conclusions:The FMEA model can be effective in reducing the rate of unplanned extubation for patients in neurosurgery, which is worthy of clinical application.
