【摘要】 目的运用医疗失效模式与影响分析方法(healthcare failure mode and effect analysis,HFMEA),对急诊科风险流程进行风险评估,提出改善的行动方案,做到在医疗失效之前采取相应措施对其加以预防,从而有效降低急诊护理风险事件的发生率。方法按照HFMEA工作步骤,确定主题为"急诊风险管理";组建HFMEA团队,对急诊科护士进行HFMEA及其相关知识的培训;画出流程,将急诊科风险因素定义为7个主流程及24个子流程;执行危害分析,将急诊风险因素分为主流程、子流程,并予编号,运用头脑风暴法,对每个子流程进行分析,通过项目组成员讨论与分析,确定急诊科高风险流程为院前急救流程;拟定行动计划,对院前急救这一主流程及子流程进行失效模式、失效原因、失效影响分析并提出针对性改进措施。结果经过1年的急诊院前急救流程监测,院前急救流程的工作已在控制范围内,全年未发生风险事件或差错。急诊院前急救流程风险值由原来的10分降至6分,患者满意度由实施HFMEA前的83.12%提高到92.68%。结论应用HFMEA有效减少了急诊护理风险事件的发生,提高了对风险的预见性及患者满意度。更多还原

【Abstract】 Objective To assess the high risk and sub-risk in the emergency department with healthcare failure mode and effect analysis(HFMEA),and to propose improvement solutions to effectively reduce the incidence of nursing risk events.Methods A HFMEA team was established to train nurses with HFMEA and its related knowledge,conduct hazard analysis for pre-hospital first aid which was one of the high risk process in emergency department,work out action plan with full implementation.Results After one year’s monitoring,pre-hospital first aid process was under control and there occurred no risk events or errors.The value of pre-hospital first aid process fell from 10 to 6 and patients’ satisfaction improved obviously.Conclusion The application of HFMEA contributes to the reduce of nursing risk events and the improvement of risk predictability and patients’ satisfaction.更多还原