摘要
目的构建急诊危重症患者院内转运流程,降低院内转运过程中不良事件发生率。方法组建项目团队,根据医疗失效模式与效应分析(HFMEA)方法,列出转运过程中每个流程步骤及子流程,进行危急值计算及决策树分析,拟定行动计划与结果评价,对流程执行者进行培训与考核,考核合格后实施转运。比较流程方案实施前与实施后转运过程中不良事件的发生率。结果实施后患者转运过程中输液管滑脱或堵塞、血压下降、意外拔管、氧气供给不足、氧饱和度下降发生率显著低于实施前(均P<0.01)。结论运用HFMEA构建急诊危重症患者院内转运流程,可以提高急诊危重症患者院内转运的安全性。
Objective To decrease adverse events during intrahospital transport of critically ill patients from the emergency center to other departments by improving the transport process. Methods Based on the Healthcare Failure Mode and Effect Analysis （HFMEA） technique, we built a project team, defined each process and sub-process during transportation, calculated risk priority number and analyzed the decision tree, then formulated action plan and effect evaluation strategies. And we also provided training for staffs who involved in transportation and those who passed the examination were allowed to implement transportation. The inci- dence of adverse events during transportation was compared before and after the intervention. Results The incidence rates of slippage or blockage of infusion catheter, drop in blood pressure, accidental extubation, insufficient oxygen supply and drop in oxygen satu- ration were significantly decreased after the intervention （P〈0; 01. fo all）. Conclusion Application of the HFMEA in optimizing in- trahospital transport of critically ill patients, can improve safety of transportation.
出处
《护理学杂志》
CSCD
2016年第21期51-55,共5页
Journal of Nursing Science
基金
上海市护理学会科研课题(2014M5-B23)
关键词
急诊科
危重症患者
院内转运
医疗失效模式与效应分析
安全管理
emergency department
critically ill patient
intrahospital transport
Healthcare Failure Mode and Effect Analysis
safety management
作者简介
丁万红：女，硕士在读，副主任护师，护理部副主任
通信作者：夏海鸥，hsxia@fudan．edu．cn
