Construction And Application Of Closed-loop Management Model Of Pediatric Blood Samples Based On FMEA

Objective1.Investigate and analyze the current situation of venous blood samples of hospitalized children before examination,and comprehend the unvenous qualified manifestations and existing problems of venous blood samples of hospitalized children.2.Using failure mode and effect analysis(FMEA)to identify the risk factors before venous blood samples were examined;Discuss and analyze the key failure modes and failure causes;Formulate targeted intervention measures.3.To explore the application effect of FMEA based closed loop management mode of pediatric venous blood samples in reducing unqualified blood samples.Methods1.By convenient sampling method,blood samples collected from hospitalized children in a first-class hospital of Linyi from January 2018 to December 2018 were selected as the research objects to investigate the current research situation of blood samples of 55,124 hospitalized children and analyze relevant risk factors.2.By the theory of failure mode and effects analysis(FMEA),a research team was established to list the pediatric vein collection process research the failure mode,search the potential failure causes and failure results,calculate the risk critical value,put forward the improvement plan in combination with the closed-loop management concept,and build the closed-loop management mode of pediatric vein blood standard.3.Applying FMEA management model to clinical experiments: according to the inclusion and exclusion criteria,take the blood samples collected in the first part as the control group,adopt the routine collection process of pediatric venous blood sample,take the blood samples collected from hospitalized children from January 2019 to December 2019 as the experimental group,implement the closed-loop management mode of pediatric venous blood sample collection based on FMEA,and compare the RPN before and after implementation,incidence of unqualified blood samples,collection and distribution time of samples,satisfaction of children / family members,satisfaction index of nurses for distribution of property personnel,and evaluation of implementation effect.Results1.The survey results show that: the unqualified rate of blood samples of hospitalized children in our hospital is 0.682%,The unqualified rate of blood sample is affected by the age of the child,the Department and the level of the blood collector,among which the incidence of unqualified blood samples of children under one year old is the highest,about 1.62%,and the younger the age is,the longer the blood collection time is.The causes of the unqualified blood samples are mainly concentrated in three aspects: too few samples,agglutination and hemolysis.The main types of unqualified blood samples are blood cell analysis and clotting time samples.2.FMEA was used to identify 7 key failure modes of children’s venous blood samples before examination,namely,nurses’ operation was not standardized,health education was not in place,selection of blood collection vessels were wrong,samples were placed too long,samples were not collected the errors of children and repeated application for inspection orders.Combined with the closed-loop management concept,improvement measures were formulated and implemented to continuously optimize the pre examination process of children’s venous blood samples.3.After the process optimization compared with the control group,the RPN of the intervention group was significantly lower,the difference was statistically significant(P<0.05)The unqualified rate of venous blood samples decreased from 0.68% to 0.34%,the difference was statistically significant(P<0.05);Compared with the control group,the time of collecting and sending samples of venous blood in the intervention group was significantly shorter(P<0.05);Before and after the intervention,the satisfaction of nurses’ specimen collection increased from 50% to 97.96%,the difference was statistically significant(P<0.05);Before and after the intervention,the satisfaction of the medical staff to the specimen delivery staff increased,the difference was statistically significant(P<0.05).Conclusions1.Venous blood samples of hospitalized children are affected by many factors and conditions,and the unqualified rate is a little high.Therefore,it is urgent to formulate and implement scientific intervention measures to reduce the occurrence of unqualified blood samples in pediatrics.2.FMEA theory can effectively identify the risk factors before the examination of pediatric venous blood samples,find out the key links,and build an effective closed-loop management model of pediatric venous blood samples.3.The closed-loop management mode of pediatric venous blood specimen based on FMEA can effectively reduce the risk factors before the inspection of venous blood specimen,the incidence of unqualified blood samples,shorten the time of venous collection and specimen delivery,improve the satisfaction of family members of children,and improve the satisfaction of medical staff on the work of property distribution personnel.