Application of failure mode and effect analysis on reducing the unplanned extubation rates for patients with severe craniocerebral injury
10.3760/cma.j.issn.1672-7088.2017.06.013
- VernacularTitle:失效模式和效果分析在降低重型颅脑损伤患者非计划性拔管率中的应用
- Author:
Yan JI
;
Yun ZHEN
;
Yunxiang ZENG
- Keywords:
Failure mode and effect analysis;
Risk priority value;
Severe craniocerebral injury;
Unplanned extubation
- From:
Chinese Journal of Practical Nursing
2017;33(6):450-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates for patients with severe craniocerebral injury. Methods FMEA model was used to analyze the main reasons of unplanned extubation patients with severe craniocerebral injury, 7 failure modes with higher RPN scores was selected. The nursing intervention for the fixation of the catheter were improved. The control group with 181 cases of patients without FMEA application were given routine care. FMEA group owning 196 cases were given the optimization process. The incidence rate of unplanned extubation of two groups was compared. Results After improvement of the nursing process of patients with severe craniocerebral injury for fixing the catheter, the RPN of 7 failure modes was lowered. Compared with the control group, the total rate of unplanned extubation in FMEA group decreased to 1.1% (9/832), less than 5.1% (40/779) of the control group. The statistical difference was significant (χ2=22.410, P < 0.01) . The rate of UEX in gastric tube, urinary catheter and central venous catheter were 3.1%(6/196), 1.0%(2/196), 0, lower than 8.8%(16/181), 4.9%(9/181), 3.9%(7/181) in the control group. The statistical difference was significant(χ2=5.718, 5.224, 7.724, P < 0.05). No statistical difference in tracheal cannula and drainage tube of head between the two groups was found(P>0.05). Conclusions The FMEA model can be effective in reducing the rate of unplanned extubation .
