摘要
目的探讨FMEA(失效模式与效应分析)在肿瘤患者PICC风险管理中的应用效果,为肿瘤患者PICC的管理和并发症的预防提供新的风险评估方式和理论依据。方法收集新疆某肿瘤专科医院2017年1-6月病理确诊恶性肿瘤拟行首次化疗的428例患者,采用随机数字表法,随机分为试验组(214例)和对照组(214例)。对照组采用常规护理方法管理,试验组采用FMEA改进后的护理方法管理。随访6个月后,比较2组患者PICC导管相关并发症发生率、非计划性拔管率及患者满意度的差异及效果评价。结果 2组静脉炎、局部皮肤反应、导管相关性感染、导管相关性血栓、导管堵塞、导管脱落等PICC相关并发症发生情况比较,差异均有统计学意义(P<0.05);试验组非计划拔管率为4.67%(10/214),对照组非计划拔管率为14.02%(30/214),2组比较差异有统计学意义(χ2=5.824,P=0.016);试验组满意度为95.33%(204/214),对照组为87.85%(188/214),2组满意度差异有统计学意义(χ2=11.097,P<0.001)。结论 FMEA模式在肿瘤患者PICC风险管理应用中,进行风险衡量及关键措施改进可降低PICC相关并发症发生率及非计划拔管率,提高患者满意度,为肿瘤患者PICC风险管理提供科学的决策基础。
Objective To investigate the application effect of FMEA （failure mode and effect analysis） in PICC risk management of cancer patients, and provide new risk assessment methods and theoretical basis for PICC management and prevention of complications in cancer patients. Methods A total of 428 patients who underwent the first chemotherapy for pathologically confirmed malignant tumors from January to December 2017 in a tumor specialist hospital in Xinjiang were randomly divided into control group （214 cases） and experimental group （214 cases）. The control group was managed by routine nursing methods, while the experimental group was managed with FMEA′s improved care method. After 6 months of follow-up, the differences in PICC catheter-related complication rate, unplanned extubation rate, and patient satisfaction were compared between the two groups. Results The incidence of PICC-related complications such as phlebitis, local skin reaction, catheter-related bloodstream infection, catheter-related thrombus, catheter occlusion, and catheter detachment were statistically significant （P 〈0.05）. The unplanned extubation rates in the experimental group and the control group were 4.67% （10/214） and 14.01% （30/214） respectively, and the difference was statistically significant （χ＋2=5.824, P =0.016）. The satisfaction rates of the experimental group and the control group was 95.3% （204/214） and 87.8% （188/214） respectively, and the difference was statistically significant （χ＋2=11.097, P 〈0.001）. Conclusion In the application of FMEA model in the PICC risk management of cancer patients, risk measurement and improvement of key measures can reduce the incidence of PICC-related complications and unplanned extubation rate, and improve patient satisfaction, and to provide a scientific decision-making basis for PICC risk management in cancer patients. .
作者
尹哲
陈玲
曹艳
平荣
张翠萍
YIN Zhe;CHEN Ling;CAO Yan;PING Rong;ZHANG Cuiping(School of Nursing;The Third Clinical Medical College,Xinjiang Medical University,Urumqi 830011,China)
出处
《新疆医科大学学报》
CAS
2018年第8期1019-1022,共4页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金面上项目(2017D01C395)
