Application Of Failure Mode And Effect Analysis In Complications Of Peripheral Venous Indwelling Needle In Operating Room

The effective establishment of peripheral venous indwelling needle is an important guarantee to ensure the smooth operation.Almost each surgical patient needs to have a venous indwelling needle after entering the operating room to facilitate anesthesia delivery,rescue and blood transfusion.However,in the clinical application of intravenous catheter,the risk of complications is extremely high due to a large number of hyperosmolar infusion of anesthetic hyperosmolar fluid,improper operation methods,and poor inspection,which affects the effect of intravenous catheter use and the duration of intravenous catheter,bringing unnecessary pain and financial burden to patients.This study mainly uses Healthcare failure mode and effect analysis(HFMEA)mode to do a good job in risk management,and conducts estimated and quantitative evaluation before failure occurs,so that complex medical risk treatment becomes more procedural and easy to perceive.High risk for HFMEA problem to find the cause and effect,according to the famous American quality management expert Deming who puts forward the management mode of dynamic circulation,the Plan(Plan),implementing(Do)and inspection(Check),Action(Action),(PDCA),make Plan cycle,to carry out the improvement measures,evaluation Plan,continuous improvement,ensure that improve the quality of nursing and patients satisfaction,reduce catheter-related complications,the pipe to get the maximum effect.Objective:1.To investigate the current situation and reasons of removal of peripherally inserted needle in the operation room.2.To explore effective nursing methods to reduce complications of peripherally inserted needle.3.To optimize the operation and maintenance process of peripheral venous indwelling needle in operating room by using medical failure mode and effect analysis,and establish standardized operation and maintenance process.Methods:1.To investigate 120 patients who underwent general anesthesia in FAW General Hospital from September 2015 to March 2016 and indwelled peripheral venous indwelling needles in the operating room as control group.From May 2016 to November 2017,120 patients underwent general anesthesia in FAW General Hospital and indwelled peripheral venous indwelling needles in the operating room as intervention group.2.Using the method of medical failure mode and effect analysis,set up a team to prevent the complications of peripheral venous indwelling needle in operating room;draw the maintenance flow chart of indwelling needle;find out the failure mode and related influencing factors,calculate the crisis value of failure mode,sort according to the order of the crisis value,and adopt the phase for the priority problems to be solved.Close measures to improve.3.Applying the HFMEA management model in clinical practice,the types and incidence of complications of peripheral venous indwelling needle in operating room before and after the implementation of HFMEA management model were compared.To explore the effect of HFMEA management model in reducing complications of peripheral venous indwelling needle in operating room by statistical analysis.Results:1.There were 16 cases of catheter obstruction in the control group,with an incidence of 13.33%,intervention group 4 cases,the incidence was 0.33%,the control level ? seepage or leakage occurred in 5 cases,the incidence was 4.17%,intervention group level ? seepage or leakage occurred in 2 cases,the incidence was 1.67%,the control level ? seepage or leakage occurred in 2 cases,the incidence was 1.67%,intervention group ? seepage or leakage occurred in 1 case,rate of 0.83%,the control of 17 cases of subcutaneous emphysema,rate of 14.17%,intervention group subcutaneous emphysema occurred in 5 cases,the incidence was 4.17%.The incidence of complications in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).2.Patients' satisfaction in the control group was 87.58±5.99,and 96.23±2.35 in the intervention group,which was higher than the control group,with statistically significant differences(P<0.05).3.This study aimed at reducing the complications of perioperative intravenous indwelling needle,and provided effective nursing and management methods for clinical practice.Conclusion:1.Healthcare failure mode and effect analysis can reduce the incidence of complications of peripheral venous indwelling needle.2.The application of medical failure mode and effect analysis can improve patients' satisfaction3.To provide effective nursing and management methods for reducing complications of peripheral venous indwelling needle in operating room.