The Application Research Of Fmea In Operating Room Nursing Quality Safety Management

Research backgroundAt present,as people's requirements of medical services quality are getting higher and higher,operating room care quality safety management has become a hot issue of medical security.In clinics there have been more new technology,more advanced surgical equipment,more perfect function in recent years.In order to adapt to the development of surgery,operating room care quality also need to constantly improve?progress and coordinated develop.Otherwise,it will affect the effect of surgical treatment,even threaten the safety of patients,causing doctor-patient contradictions.Therefore,this requires us to use more scientific tools and methods to analyze the original operating room care quality management system?process and the various aspects scientifically,to find high-risk links earlier,to make improving measures and recommendations to eliminate hidden dangers.Failure model and effect analysis(FMEA)is a team-based,systematic?prospective and reliable method for analysis.By analyzing all the processes that provide the product or service,to identify possible faults,to evaluate the severity,incidence and detectability of the failure,to judge the degree of failure by means of quantitative indicators,and to make reasonable recommendations and measures to eliminate the possibility of failure or decrease the negative results to a minimum,that is the process of continuous quality improvement.The application of FMEA in medical risk control has aroused the attention of medical workers.PurposeTo discuss the application of FMEA in nursing room quality and safety management,and to construct FMEA model of nursing room quality and safety management;According to the problems existing in the operation room quality and safety,to make the related improvement measures and standardized operating room care quality and safety management;To explore the application of FMEA in the nursing room quality and safety management,and to discuss the feasibility of FMEA in the quality and safety management in the operating room.To provide a prospective basis for prevention of the risk existing in the nursing room quality and safety management,and to standardize quality and safety management,in order to achieve the purpose of ensuring the safety of patients,increasing the satisfaction of surgeon and patient,to practice the concept of quality care service.MethodsAccording to the research topic,the FMEA group including experts that have Professional background was established.The operating room nursing practical flow chart was drawed.The brainstorming method was used to analyze the nursing process of the operating room,identify the potential failure mode,analyze the reasons,calculate the risk priority index,determine the model that needed to be improved and put forward the corrective measures.According to the corrective actions,corrective and preventive measures for quality and safety management of operation room nursing were implemented The effect of FMEA was evaluated by determining the RPN,adverse events,quality assessment of equipment nurses and tour nurse job,surgeon satisfaction before and after implementation of corrective measures.Result and analyzeThe FMEA method was used to analyze the nursing process in operation room,and twenty potential failure modes,such as inadequate preoperative visit,inadequate communication,and lack of protection measures for the transfer patients,were identified,and the causes and the RPN values were calculated.Six potential failure needed to be rectified priority by using FMEA method,including:surgical infection prevention measures are not in place,sharp injury prevention measures are not in place,poor hand hygiene compliance and hand washing is not standardized,inadequate communication,improper position placement,surgery inventory is not standardized.Related corrective measures are formulated and implemented.After the implementation of the rectification measures,the RPN values of the six potential failure modes were significantly decreased,and the total RPN value of the six potential failure modes was reduced from 1154 to 486 before implementation.The lack of communication mode RPN value decreased from 175 to 80,injury prevention measures RPN value decreased from 210 to 100 are not in place,hand hygiene compliance is poor hand washing is not standard mode RPN value decreased from 210 to 80,improper body position mode of the RPN value decreased from 175 to 60,surgical infection prevention measures are not in place RPN values by 216 to 96,surgical instrument under standard model RPN value decreased from 168 to 70;The corresponding adverse events were significantly decreased(P<0.01).The qualified rate of equipment nurses job quality assessment was increased from 90%to 98%,and the qualified rate of tour nurse job quality assessment was improved from 88.33%to 97.5%,and the qualified rate was significantly improved(P<0.01).The satisfaction of the surgeon after the implementation of the improvement measures was significantly improved(P<0.05).The application of FMEA specification to improve the operation room work system and process,improve the quality monitoring system of operation room nursing,strengthen the operation room nurse professional theory and skills training,standardize the management of operation room nursing quality and safety.Conclusion and suggestionsFMEA can be used to analyze the nursing process of the operating room,and the implementation of the rectification measures can reduce the risk priority index of the failure mode,the incidence of related adverse events and improve the pass rate of the equipment nurses and tour nurses work quality evaluation,and the satisfaction of the surgeon;The application of FMEA can regulate the operating room quality safety management effectively;The application of FMEA in the operation room care quality safety management is effective and feasible,can reduce the risk of surgery to ensure the safety of patients.The implementation of FMEA should be combined with their actual situation to build a suitable FMEA management model.In the implementation of FMEA management,the use of brainstorming should be properly used to ensure the evaluation of the failure mode and the scientific nature of the quantitative process.That should also be supported by the management in order to provide adequate support for policies and resources.FMEA can also be used in conjunction with RAC,HACCP and other methods to achieve further optimization of FMEA.