摘要
目的 探讨基于失效模式与效应分析(FMEA)的护理风险干预在髋关节置换术患者深静脉血栓(DVT)预防中的应用效果,为临床预防DVT提供新思路。方法 选取2022年7月-2023年7月入住昆明市延安医院骨科行髋关节置换术患者100例为研究对象,按照组间基线资料具有可比性的原则将患者分为对照组和观察组,每组50例。对照组实施常规术后护理管理,观察组在对照组基础上采用FMEA的护理风险干预。比较观察组实施干预前后风险优先数(RPN),记录并比较两组患者干预前后凝血指标,统计两组患者术后下肢DVT发生率以及护理满意程度。结果 观察组患者实施基于FMEA的护理风险干预后各失效模式RPN值均低于干预前,差异有统计学意义(P<0.05);观察组患者术后下肢DVT发生率低于对照组,差异有统计学意义(P<0.05);观察组患者实施基于FMEA的护理风险干预后D-二聚体(D-D)以及纤维蛋白原(FIB)低于对照组干预后,活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)高于对照组干预后,差异有统计学意义(P<0.05);观察组患者实施基于FMEA的护理风险干预后对护理服务的满意程度高于对照组,组间比较差异有统计学意义(P<0.05)。结论 基于FMEA的护理风险干预在髋关节置换术患者DVT预防中应用,通过识别潜在失效模式、分析原因并采取改进措施,不仅能有效降低术后下肢DVT的发生风险,改善凝血功能指标,还能提高患者对护理服务的满意程度,为患者提供更安全、有效的护理服务。
Objective To explore the application effect of failure mode and effect analysis(FMEA)-based nursing risk intervention in the prevention of deep venous thrombosis(DVT)in patients undergoing hip replacement surgery,providing new ideas for the clinical prevention of DVT.Methods A total of 100 patients who underwent hip replacement surgery in the Department of Orthopedics at Kunming Yan'an Hospital from July 2022 to July 2023 were selected as research subjects.According to the principle of comparability of baseline data between the groups,the patients were divided into a control group and an observation group,with 50 cases in each group.The control group received routine postoperative nursing management,while the observation group received FMEA-based nursing risk intervention on the basis of the control group.The risk priority number(RPN)in the observation group was compared before and after the intervention.The coagulation indicators of both groups of patients were recorded and compared before and after the intervention.The incidence of postoperative lower limb DVT and nursing satisfaction of the two groups of patients were statistically analyzed.Results After the FMEA-based nursing risk intervention was implemented in the observation group,the RPN values of each failure mode were lower than those before the intervention,the differences were statistically significant(P<0.05).The incidence of postoperative lower limb DVT in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After the FMEA-based nursing risk intervention was implemented,the D-dimer(D-D)andfibrinogen(FIB)in the observation group were lower than those in the control group,and the activated partial thromboplastin time(APTT)and prothrombin time(PT)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).After the FMEA-based nursing risk intervention was implemented,the satisfaction with nursing services in the observation group was higher compared to the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion The application of FMEA-based nursing risk intervention in the prevention of DVT in patients undergoing hip replacement surgery,through identifying potential failure modes,analyzing causes and taking improvement measures,can not only effectively reduce the risk of postoperative lower limb DVT and improve coagulation function indicators,but also increase patient satisfaction with nursing services,providing safer and more effective nursing services.
作者
张亚芳
刘宇泓
杨萍芬
彭楚冬雪
莫林
金艳
ZHANG Yafang;LIU Yuhong;YANG Pingfen;PENG Chudongxue;MO Lin;JIN Yan(Kunming Yan'an Hospital,Kunming 650051,China)
出处
《护理实践与研究》
2025年第10期1495-1501,共7页
Nursing Practice and Research
基金
昆明市卫生健康委员会卫生科研课题项目(编号:2022-14-02-006)。
关键词
失效模式与效应分析
髋关节置换术
深静脉血栓
凝血功能
护理满意程度
Failure mode and effect analysis
Hip replacement surgery
Deep venous thrombosis
Coagulation function
Nursing satisfaction
