Abstract:

Objective By optimizing the in-hospital process of extracorporeal cardiopulmonary resuscitation,the rescue time is shortened and the occurrence of adverse events is reduced. Methods In October 2018,our hospital established a medical failure mode and effect analysis management team. The healthcare failure mode and effect analysis model was applied to analyze the shortcomings of extracorporeal cardiopulmonary resuscitation emergency process,and the emergency process was optimized through literature reviews,expert discussions and consultations,so as to construct standardized extracorporeal cardiopulmonary resuscitation in-hospital emergency process and apply it to the clinic in January 2019. After 2 years of clinical application,we analyzed and compared the risk priority index before and after the optimization process,the time spent in each link and the occurrence of adverse events. Results After the optimization of the emergency process,the risk priority index dropped from（217.63±20.60） points to（102.73±39.95） points;the time spent in each link was shortened;the incidence of various adverse events decreased,and the differences were statistically significant（P<0.05）. Conclusion The application of healthcare failure mode and effect analysis to optimize the in-hospital emergency process of extracorporeal cardiopulmonary resuscitation can effectively improve the delay of first aid and reduce the occurrence of adverse events.

Key words: Healthcare Failure Mode and Effect Analysis, Extracroporeal Cardiopulmonary Resuscitation, In-Hospital Emergency, Process Optimization, Nursing Administration Research

摘要：

目的 通过对体外心肺复苏院内急救流程（以下简称“急救流程”）的优化,缩短抢救时间,减少不良事件的发生。方法 2018年10月成立医疗失效模式与效应分析管理团队,应用医疗失效模式与效应分析法分析急救流程缺陷,通过文献检索、专家会议法、专家咨询法优化急救流程并于2019年1月应用于临床。临床应用急救流程2年后分析比较急救流程优化前后风险优先指数、各环节用时及不良事件发生情况。结果 急救流程优化后急救流程风险优先指数由（217.63±20.60）分降低到（102.73±39.95）分,各环节用时缩短,各类不良事件发生率均有所下降,差异均具有统计学意义（P<0.05）。结论 应用医疗失效模式与效应分析法优化急救流程,可以有效改善急救延时,减少不良事件的发生。

关键词: 医疗失效模式与效应分析, 体外心肺复苏, 院内急救, 流程优化, 护理管理研究