The Application Of Failure Mode And Effect Analysis To Reduce Anxiety Of Preschool Parents During Operation

Objective:The purpose of this study was to investigate the anxiety status of preschool children’s parents during the surgery and to analysis the causes of the occurrence of anxiety.The failure mode and effect analysis(FMEA)was used to improve working process,enrich the nursing measures,establish new working methods to prevent the anxiety of preschool children’s parents.Assess the effect of the implementation.This study was aimed to relieve the psychological stress of preschool children’s parents during surgery and to improve nursing satisfaction.Method:The experiment is divided into two periods.In first period,parents of preschool children with regular operation in OR of a grade A tertiary hospital of Changchun was given cross-sectional investigation for one month.The survey included the general demographic data of preschool children and their parents,the preschool parents’ anxiety level one day before the operation and during the operation,the blood pressure and heart rate of the parents one day before the operation and during the operation,and the data simulation score.A team of FMEA was set up.After training,the current working process was combed,and the reasons for the anxiety of preschool parents during operation were discussed.The key failure modes were screened out,and the reasons for failure mode were analyzed.We improve the high-risk links and the working process,put forward new nursing measures.In second period,we work by strengthening preoperative visits,encouraging accompanying anesthesia,immediately reporting operation information,improving the environment,and distracting parents of children。Implement them and carry out quality control.preschool parents with regular operation was given cross-sectional investigation for one month again.The content of the investigation was same.Compare the two groups’ anxiety score,blood pressure,heart rate and satisfaction before and after FMEA.Evaluate the effect of FMEA.Result:(1)In first period,a total of 125 questionnaires were given out in the stage of investigation,while 110 valid questionnaires were taken back,the effective recovery rate was 88.0%.The anxiety score of the parents one day before the operation and anxiety score of the parents during the operation were44.33±1.69 and 55.29±2.61.The systolic blood pressure,diastolic blood pressure and heart rate of their parents one day before the operation and during the operation were 121.30±11.27 mmHg,75.19±9.11 mmHg,74.73±5.77/min and 128.15± 11.24 mmHg,80.10±9.00 mmHg,79.66±5.67/min.The satisfaction score of the parents was 87.65±6.15.(2)FMEA was used to analyze the nursing process,which found that the nine top factors that cause preschool children’s parents’ anxiety were: parents lack of knowledge about disease and surgery(RPN=497.50),preschool education is not comprehensive enough(RPN=409.50),worry about the lives of other family members(RPN=271.83),formalized preoperative methods(RPN=190.33),worry about the children’s cooperation during the operation(RPN=190.00),worry about the cost of surgery(RPN=171.33),worry about the risk and effect of surgery and prognosis(RPN=162.00),worry about the risk of anesthesia(RPN=146.83),lack of communication skills in the operating room nurses(RPN=128.17).The content of the interview is not comprehensive(RPN=211.63),the content of the interview is formalized(RPN=186.69),the communication effect with the parents of the child is poor(RPN=182.90),parents worries about the risk,effect and prognosis of the surgery(RPN= 157.83),parents lack of disease and surgical knowledge(RPN=147.85),parents worries about medical expenses(RPN=146.35),the nurse’s assessment ability is insufficient(RPN=137.34),service awareness is weak(RPN=134.08),unfamiliar environment(RPN=133.42).(3)In second period,after implementation of FMEA and nursing intervention,a total of 136 questionnaires was given out,122 valid questionnaires were recovered,the effective recovery rate is 89.7%.The anxiety score of the parents one day before the operation and during the operation were 44.54±1.40 and 47.00±1.64.The systolic blood pressure,diastolic blood pressure and heart rate of their parents one day before the operation and during the operation were 121.34±11.56 mmHg,74.68±9.50 mmHg,74.67±5.40/min and 124.24± 11.51 mmHg,78.66±9.37 mmHg,77.25±5.63/min.The satisfaction score of the parents was 92.86±5.59.(4)After the implementation of FMEA and nursing intervention.The RPN of top nine factors lead to the failure mode were decreased respectively from 497.50、409.50、271.83、190.33、190.00、171.33、162.00、146.83、128.17 to 339.50、48.00、211.83、57.17、133.33、127.33、119.67、100.67、94.83.Conclusion:(1)The anxiety of preschool parents is obvious one day before operation and during operation,especially during operation.It is urgent to take measures to intervene and relieve their psychological stress.(2)The FMEA can effectively analyze the deficiency in current work,the nine top factors that cause preschool parents’ anxiety were:the content of the interview is not comprehensive,the content of the interview is formalized,the communication effect with the parents of the child is poor,parents worries about the risk,effect and prognosis of the surgery,parents lack of disease and surgical knowledge,parents worries about medical expenses,the nurse’s assessment ability is insufficient,service awareness is weak,unfamiliar environment.Parents lack of knowledge about disease and surgery,preschool education is not comprehensive enough,worry about the lives of other family members,formalized preoperative methods,worry about the child’s cooperation during the operation,the cost of surgery,the risk and effect of surgery and prognosis,the risk of anesthesia,lack of communication skills in the operating room nurses.(3)The use of FMEA and work by strengthening preoperative visits,encouraging accompanying anesthesia,immediately reporting operation information,improving the environment,and distracting parents of children can effectively reduce the anxiety of preschool parents during operation,moderate blood pressure,heart rate during operation,and improve their satisfaction level.(4)The FMEA can optimize working process,enrich nursing measures and improve the quality of service.