摘要
目的:在加速康复外科(ERAS)理念下,应用医疗失效模式与效应分析(HFMEA)优化肺癌病人围术期管道管理流程并分析其应用效果。方法:成立医护融合的多学科项目改善小组,梳理管道管理全流程,进行失效模式分析,计算风险指数,制定有效的防范措施并实施。结果:实施HFMEA干预后,胸外科护士、医生以及麻醉医生ERAS相关知识知晓率显著提升,病人健康教育知晓率显著提升,差异具有统计学意义(P<0.05);观察组病人疼痛控制合格率、早期下床活动率、导管固定规范率均高于对照组,差异具有统计学意义(P<0.05);病人并发症发生率显著降低,胸腔引流管留置时间、住院时间均显著缩短,差异具有统计学意义(P<0.05)。结论:应用医疗失效模式与效应分析方法可梳理出肺癌病人围术期管道管理中存在的问题,从而有效优化管道管理策略,降低术后并发症发生率,缩短住院时间,促进病人康复进程。
Objective:Under the concept of Enhanced Recovery after Surgery(ERAS),the Medical Failure Mode and Effects Analysis(HFMEA)was applied to optimize the perioperative pipeline management process for lung cancer patients and analyze its application effect.Methods:A multidisciplinary project improvement team integrating medical and nursing care was established to streamline the entire catheter management process,conduct failure mode analysis,calculate risk indices,formulate and implement effective preventive measures.Results:After HFMEA intervention,the awareness rates of ERAS-related knowledge among thoracic surgery nurses,doctors,and anesthesiologists were significantly improved,as was the patient health education awareness rate(P<0.05).The observation group showed significantly higher rates of pain control compliance,early ambulation,and standardized catheter fixation compared to the control group(P<0.05).The incidence of complications was significantly reduced,and the duration of chest tube placement and hospital stay were significantly shortened(P<0.05).Conclusion:Applying HFMEA could identify problems in perioperative catheter management for lung cancer patients,thereby effectively optimizing catheter management strategies,reducing postoperative complication rates,shortening hospital stays,and promoting patient recovery.
作者
施钰莹
刘梦媛
束盼月
王颖
夏红香
周静
茅昌敏
SHI Yuying;LIU Mengyuan;SHU Panyue;WANG Ying;XIA Hongxiang;ZHOU Jing;MAO Changmin(Jiangsu Cancer Hospital,Jiangsu 210018 China;School of Medicine,Jiangsu University,Jiangsu 212001 China)
出处
《全科护理》
2026年第3期404-409,共6页
Chinese General Practice Nursing
基金
江苏省肿瘤医院院基金项目,编号:ZH202101。
