摘要
目的分析宫腔镜日间手术中应用医疗失效模式与效应分析(HFMEA)管理模式的临床效果。方法前瞻性纳入2023年1月—2024年5月在东南大学附属中大医院接受宫腔镜日间手术的患者230例,根据随机数表法分为观察组和对照组,每组115例。对照组采用常规手术管理模式,观察组采用HFMEA管理模式,比较两组手术操作指标、术后康复时间、手术不良事件发生情况。结果观察组手术失血量低于对照组,观察组手术时间、卧床时间、住院时间短于对照组,差异有统计学意义(P<0.05)。应用HFMEA管理模式前,观察组纱布或棉球遗留在阴道、术中设备故障、术中器械损坏、患者术后跌倒、标本送检登记错误、标本送检项目遗漏、标本存放不合格的RPN值分别为190.5分、248.7分、222.5分、210.8分、198.7分、280.1分、295.4分;应用HFMEA管理模式后,观察组纱布或棉球遗留在阴道、术中设备故障、术中器械损坏、患者术后跌倒、标本送检登记错误、标本送检项目遗漏、标本存放不合格的风险优先数(RPN)值分别为45.2分、110.6分、109.8分、36.5分、102.5分、78.2分、81.5分,RPN下降比分别为76.27%、55.53%、50.65%、82.69%、48.41%、72.08%、72.41%。观察组的手术不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论HFMEA管理模式的应用效果显著,改善了行宫腔镜日间手术患者的疾病预后,促进了患者疾病的顺利恢复,值得应用。
Objective To analyze the clinical effect of applying the healthcare failure mode and effect analysis(HFMEA)management mode in hysteroscopic day surgery.Methods A total of 230 patients who underwent hysteroscopic day surgery in the hospital from January 2023 to May 2024 were prospectively included and divided into the observation group and the control group(115 cases in each group)according to the random number table method.The control group adopted the conventional surgical management mode,while the observation group adopted the HFMEA management mode.The surgical operation indicators,postoperative recovery time,occurrence of adverse surgical events,etc.of the two groups were compared.Results The surgical blood loss in the observation group was lower than that in the control group.The operation time,bed rest time and hospital stay in the observation group were shorter than those in the control group,and the diff erences were statistically signifi cant(P<0.05).Before applying the HFMEA management model,The RPN values of gauze or cotton balls left in the vagina,intraoperative equipment failure,intraoperative instrument damage,postoperative patient falls,incorrect specimen submission registration,omitted specimen submission items,and unqualifi ed specimen storage in the observation group were 190.5 points,248.7 points,222.5 points,210.8 points,198.7 points,280.1 points,and 295.4 points respectively.After applying the HFMEA management model,The risk priority numbers(RPN)values of gauze or cotton balls left in the vagina,intraoperative equipment failure,intraoperative instrument damage,postoperative falls of patients,incorrect specimen submission registration,omission of specimen submission items,and unqualifi ed specimen storage in the observation group were 45.2 points,110.6 points,109.8 points,36.5 points,102.5 points,78.2 points,and 81.5 points respectively.The RPN decline ratios were 76.27%,55.53%,50.65%,82.69%,48.41%,72.08%,and 72.41%respectively.The total incidence of adverse surgical events in the observation group was lower than that in the control group,and the diff erence was statistically signifi cant(P<0.05).ConclusionThe application eff ect of the HFMEA management model is remarkable,which has improved the disease prognosis of patients undergoing hysteroscopic day surgery and promoted the smooth recovery of their diseases.It is worth recommending.
作者
朱宁琳
石玥
ZHU Ninglin;SHI Yue(Hysteroscopic Operating Room,Zhongda Hospital Affi liated to Southeast University,Nanjing Jiangsu,210009,China;Gynecology Ward,Zhongda Hospital Affi liated to Southeast University,Nanjing Jiangsu,210009,China)
出处
《中华养生保健》
2025年第19期93-97,共5页
CHINESE HEALTH CARE
关键词
宫腔镜
日间手术
医疗失效模式
效应分析管理模式
术后康复
手术不良事件
hysteroscopic
day surgery
healthcare failure mode
effect analysis management mode
postoperative rehabilitation
adverse surgical events
