摘要
目的探讨医疗失效模式及效应分析在机构养老者入住管理中的应用,降低安全性问题发生的风险,提高老人生活质量。方法根据失效模式与效应分析方法,成立入住管理小组,采用头脑风暴法对机构养老者入住管理中的护理安全相关因素进行分析,并计算危急值,针对危急值较高的失效模式制定改进措施,实施护理安全管理措施并对效果进行评价。结果养老机构老人入院流程管理中最重要的护理安全问题是评估和再次评估不足。实施安全管理措施后,安全问题发生率从48.28%下降至8.16%,实施前后安全问题发生率差异有统计学意义(χ^(2)=11.58,P<0.05);不安全失效模式的5个环节的危急值下降,其差异具有统计学意义(t_(1)=24.09,t_(2)=19.05,t_(3)=16.31,t_(4)=18.44,t_(5)=19.66,均P<0.05)。结论运用医疗失效模式及效应分析对机构养老者入住管理中的护理安全问题实施安全管理,能充分发挥系统防御对缺陷的屏蔽作用,以保障入住老人的护理安全。
Objective To explore the application of failure mode and effect analysis(FMEA)in management of the admission process in aged-care institutions in an attempt to reduce the safety risk and improve the quality of life of the elderly.Methods According to the FMEA,an admission management team was established.The nursing safety-related factors during admission were analyzed by the brainstorming method,and the critical value was calculated.Countermeasures were developed for failure modes with high critical values.Nursing safety management measures were implemented,and its effectiveness was evaluated.Results The most important nursing safety problem in the admission management in these institutions was insufficient evaluation and re-evaluation.After the implementation of safety management measures,the incidence of safety problems significantly decreased from 48.28%to 8.16%(χ^(2)=11.58,P<0.05).The critical values of the five elements of the unsafe failure mode were decreased,with statistically significant differences(t_(1)=24.09,t_(2)=19.05,t_(3)=16.31,t_(4)=18.44,and t_(5)=19.66;all P<0.05).Conclusions Safety management targeting the nursing safety problems identified by FMEA can effectively prevent defects in the management system and ensure the safety of the elderly residing in these institutions.
作者
焦凌梅
李文
张翔
王娜
李萍
焦红梅
Jiao Lingmei;Li Wen;Zhang Xiang;Wang Na;Li Ping;Jiao Hongmei(Hainan Medical College,Haikou 571101,Hainan Province,China)
出处
《中国医疗管理科学》
2022年第5期6-11,共6页
Chinese Journal Of Medical Management Sciences
基金
2019年海南省卫生健康委员会课题“机构养老者入住初期适应性问题研究”(191320712A2006)
2021年海南省卫生健康委员会课题“传统生活方式介入机构养老者精神健康干预研究”(210132712A2011)。
关键词
失效模式及效应分析
机构养老者
入住流程管理
护理安全
Failure mode and effect analysis
Elderly people in the institutions
Management of admission process
Nursing safety
