Application Of FMEA In Hospitalized Patients With Dementia Behavioral And Psychological Symptoms Of Risk Management

Objective: This study was designed to investigate the failure mode and effects analysis(Failure Mode and Effects Analysis,FMEA)to prevent the application of results-based management in elderly patients with dementia hospitalized behavioral and psychological symptoms of risk,construct interventions for elderly dementia patients with behavioral and psychological symptoms in hospital risk prevention.Clinical application of FMEA,reducing the number of elderly patients with dementia hospitalized behavioral and psychological symptoms,alleviate distress caregivers,to improve family satisfaction of nursing work.Methods: 2017 30 age-April to June 2017 hospitalized for more than 80 years of age dementia symptoms of mental acts as a control group,the implementation of routine care;30 cases from August 2017 to October 2017 hospitalized there are more than 80 years of behavioral and psychological symptoms of dementia as the observation group,the implementation of routine care in the process,we found that cause defects nursing elderly patients with dementia hospitalized behavioral and psychological symptoms of frequent revision nursing FMEA team members and applied to the observation group.Elderly patients with dementia hospitalized,including determining the behavioral and psychological symptoms caused by the high incidence and high caregiver distress score of four kinds of behavior identified as research topic,and then set FMEA team,the use of brainstorming and group discussions in the form of construction of behavioral and psychological symptoms of Alzheimer's patients the potential risks evaluation system table to calculate the weight of each index weight,choose risk assessment in the right table heavy top six index system as FMEA in failure mode analyzes the influencing factors,develop improvement measures,risk priority index(risk priority Number,RPN)value,comparative six high-risk factor RPN before and after FMEA,two groups were compared agitation / aggression and the incidence of sleep / night behavior,delusions and hallucinations of caregiver distress scores during hospitalization,family satisfaction of nursing work degree.Results: The use of theoretical analysis and failure mode to identify the main cause of dementia in elderly hospitalized patients produce behavioral and psychological symptoms of risk: 1)frequent replacement caregiver 2)irregular schedules 3)living environment is unstable 4)does not meet the effective communication 5)lack of effective coping strategies 6)caregivers experience shortage,lack of responsibility.After the observation group to take appropriate measures to improve the elderly hospitalized patients with behavioral and psychological symptoms of dementia-related risks RPN total value fell to 428 from 1537 before the implementation,the incidence of four kinds of behavioral and psychological symptoms before and after the implementation of measures and nursing satisfaction by comparing observed patients sleep/night behavior,agitation/aggression incidence and hallucinations,delusions caused by the degree of caregiver distress than the control group,the families of nursing job satisfaction rate was higher(P <0.01),it indicates that FMEA can reduce elderly patients with dementia hospitalized nursing risk of behavioral and psychological symptoms.Conclusion: The use of FMEA risk prevention management,can effectively reduce the incidence of hospitalized elderly patients with behavioral and psychological symptoms of dementia,delaying disease progression;alleviate the distress of carers,improve the sense of accomplishment caregivers;improve family satisfaction of nursing to enhance the thinking ability and ability to cooperate medical staff.FMEA despite its failure modes of subjective risk factor,but inpatient health care risk management,prevention really is effective,feasible,seize the key issues to ensure the continuous improvement of quality.