【摘要】 目的:探讨失效模式与效应分析（FMEA）在重症监护室（ICU）经口气管插管病人口渴管理中的应用效果。方法:于2023年1月—10月选取我院ICU收治的经口气管插管病人203例作为研究对象，将2023年1月—5月我院ICU收治的经口气管插管病人104例作为对照组，2023年6月—10月我院ICU收治的经口气管插管病人99例作为干预组。对照组采用ICU病人常规护理措施进行护理，给予病人常规口渴干预措施；干预组在ICU病人常规护理措施基础上实施基于FMEA制订的管理和改进措施。比较两组病人口渴管理风险优先指数（RPN）值、口渴程度、唇舌口腔黏膜湿润度、谵妄发生率、非计划性拔管发生率。结果:干预后，干预组6个高危失效模式RPN值均为125以下；干预组病人口渴程度得分为（2.09±2.76）分、唇舌口腔黏膜湿润度得分（1.44±0.58）分，均低于干预前[口渴程度得分为（7.16±2.87）分、唇舌口腔黏膜湿润度得分（3.19±0.94）分]及同期对照组[口渴程度得分为（3.88±2.86）分、唇舌口腔黏膜湿润度得分（1.78±0.74）分]；干预组谵妄发生率为21.21%，低于对照组（34.62%），差异均有统计学意义（P<0.05）。结论:实施基于FMEA制订的管理和改进措施有利于规范口渴管理流程，降低ICU经口气管插管病人口渴程度，提高病人唇舌口腔黏膜湿润度，降低并发症发生率。更多还原

【Abstract】 Objective:To explore the application effect of failure mode and effect analysis(FMEA) in thirst management of patients with oral tracheal intubation in intensive care unit(ICU). Methods:A total of 203 patients with oral tracheal intubation admitted to the ICU of my hospital from January to October 2023 were selected as the study subjects,among which,the 104 patients with oral tracheal intubation admitted to the ICU of my hospital from January to May 2023 were selected as the control group,and the 99 patients with oral tracheal intubation admitted to the ICU of my hospital from June to October 2023 were selected as the intervention group. The control group received routine nursing measures for ICU patients and received routine thirst intervention measures,while the intervention group implemented management and improvement measures based on FMEA on the basis of routine nursing measures for ICU patients. Compare the risk priority index(RPN) for thirst management,degree of thirst,moisture content of mucous membranes in lips,tongue,and oral cavity,and incidence of delirium and unplanned extubation between two groups of patients. Results:After intervention,the RPN values of the six high-risk failure modes in the intervention group were lower than 125. The thirst level score of the intervention group patients was 2. 09±2. 76,and the moisture content score of mucous membranes in lips,tongue,and oral cavity was 1. 44±0. 58,both of which were lower than before the intervention(thirst level score was 7. 16±2. 87,moisture content score of mucous membranes in lips,tongue,and oral cavity was 3. 19±0. 94) and the control group during the same period(thirst level score was 3. 88±2. 86,moisture content score of mucous membranes in lips,tongue,and oral cavity was 1. 78±0. 74). The incidence of delirium in the intervention group was 21. 21%,which was lower than that in the control group(34. 62%),the differences were statistically significant(P<0. 05). Conclusion:Implementing management and improvement measures based on FMEA is beneficial for standardizing the thirst management process,reducing the degree of thirst in ICU patients with oral tracheal intubation,improving the moisture content of mucous membranes in lips,tongue,and oral cavity,and reducing the incidence of complications.更多还原