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目的探讨医疗失效模式与效应分析(FMEA)的精细化管理应用于临床管理中,对降低导尿管相关性尿路感染(CAUTI)的效果。方法运用随机数字法选取2015年10月~2017年2月于本院內科病房内留置导尿管的患者120例作为研究对象,其中2015年10月~2016年4月对其实行常规管理模式的56例患者作为对照组,2016年5月~2017年2月实行FMEA管理模式的64例患者作为观察组,观察所有患者于不同管理模式实行期间CAUTI发生率、发生时间以及留置导尿管时间等。结果观察组风险优先指数评分(RPN)明显低于对照组(P<0.01);CAUTI发生率低于对照组,CAUTI发生时间、留置导尿管时间短于对照组(P<0.05),观察组护士的手卫生依从性以及预防CAUTI依从率均明显优于对照组(P<0.05)。结论 FMEA管理模式可有效降低CAUTI发生率,改善预后,在临床护理方面具有一定的参考价值。
Objective To explore the effect of meticulous management of medical failure mode and effect analysis (FMEA) in clinical management on the reduction of catheter-related urinary tract infection (CAUTI). Methods A random number method was used to select 120 patients with urethral catheter indwelling ward of our hospital from October 2015 to February 2017 as the research object. Among them, from October 2015 to April 2016, they implemented the routine management mode 56 patients as control group, May 2016 ~ February 2017 FMEA management model of 64 patients as the observation group to observe all patients in different management modes during the implementation of CAUTI incidence, time and indwelling catheter time . Results The risk priority index (RPN) in the observation group was significantly lower than that in the control group (P <0.01). The incidence of CAUTI in the observation group was lower than that in the control group. The duration of CAUTI and catheterization were shorter in the observation group (P <0.05) Nurses’ hand hygiene compliance and prevention of CAUTI compliance were significantly better than those of the control group (P <0.05). Conclusion The FMEA management model can effectively reduce the incidence of CAUTI and improve the prognosis, and has certain reference value in clinical nursing.