失效模式和效应分析的流程化护理干预在头面部医疗器械相关压力性损伤中的预防效果分析OACSTPCD

Objective:To study the preventive effect of process-based nursing interventions based on failure mode and effect analysis(FMEA)on medical device related pressure injuries(MDRPI)of head and face.Methods:An FMEA team was formed to identify the causes of MDRPI failure modes in the head and face,the risk score of MDRPI failure mode in the head and face was calculated,the causes of MDRPI failure modes in the head and face were analyzed and nursing intervention improvements were performed.A total of 96 patients admitted to Hebei General Hospital from January 2021 to January 2022 who underwent the head and face MDRPI preventive nursing interventions were selected and divided into a control group and an observation group,with 48 patients in each group.The control group adopted conventional head and face MDRPI preventive nursing process interventions,the observation group adopted FMEA's process-based nursing interventions to prevent head and face MDRPI.The scores of high-risk failure mode risk priority numbers(RPN),the incidence of high-risk failure modes and the incidence and severity of head and facial MDRPI were compared between the two groups.Results:The RPN scores of the patients for lack of focus in risk assessment,improper use of dressings,improper fixation of pipelines,improper management of medical devices,and improper skin cleaning of high-risk failure modes in the observation group were(80.45±24.15)points,(74.86±22.63)points,(68.15±21.88)points,(79.11±20.33)points,and(65.54±21.44)points,respectively,which were lower than those in the control group,the difference was statistically significant(t=8.951,8.979,11.399,9.284,12.090,P<0.05),the incidence rates of lack of focus in risk assessment,improper use of dressings,improper fixation of pipelines,improper management of medical devices,and improper skin cleaning were 2.08%(1/48),0,2.08%(1/48),0 and 0,respectively,which were lower than those of the control group,the difference was statistically significant(x2=4.909,6.400,6.008,7.551,6.400,P<0.05).The total incidence rate of MDRPI and the severity of MDRPI stage Ⅲ in the head and face in the observation group were 8.33%(4/48)and 2.08%(1/48),respectively,which were lower than those in the control group,the difference was statistically significant(x2=7.940,4.909,P<0.05).Conclusion:The process-based nursing intervention of FMEA can effectively identify the risk of MDRPI in the head and face,and then implement targeted preventive nursing measures for patients,which can effectively reduce the occurrence and severity of MDRPI in the head and face.