Application Of HFMEA In The Emergency Diagnosis And Treatment Process Of Patients With ST-Segment Elevation Myocardial Infarction

Research PurposeIn this study,by understanding the status of emergency diagnosis and treatment of STEMI patients in the cardiovascular collaborative treatment system in the case area,using medical failure mode and effect analysis tools to identify high-risk links in the problem process from the perspective of risk assessment,and providing targeted intervention measures,the impact of HFMEA management tools is studied.The effect of emergency treatment in STEMI patients.Research Method1.Investigation on the treatment of STEMI patients:retrospective research methods are used to investigate the treatment status of patients with ST-segment elevation myocardial infarction in the case area,Including the case area cardiovascular collaborative treatment system structure,diagnosis and treatment process,critical time nodes for patient treatment,mortality,and mortality in the case area.Number of days in hospital and hospital expenses.2.Problems in the treatment of patients under the current emergency diagnosis and treatment process:Based on the understanding of the current emergency diagnosis and treatment process,the semi-structured interview method is used to interview the doctor to understand the reasons for the delay in STEMI treatment at this stage and the doctor’s emergency diagnosis and treatment process Optimized demand.3.Empirical study of HFMEA management in the emergency diagnosis and treatment process of acute myocardial infarction:Identify failure modes and high-risk links by investigating experts’ scoring methods,and give targeted HFMEA management intervention measures,and compare the effects of intervention before and after.Research Results1.A total of 110 STEMI patients were included in this study.Based on the HFMEA intervention management,they were divided into the control group(63 cases)and the study group(47 cases),and the study group and the control group were divided into two types of patients who were transferred through EMS and transferred through the primary network hospital according to different admission methods..There was no statistical difference between the study group and the control group in terms of gender,age,and disease history(history of hypertension,diabetes,and previous PCI surgery).2.In the risk assessment stage,five failure modes in the emergency diagnosis and treatment process were identified,and the critical value was significantly reduced after HFMEA management intervention for the failure.3.The effects of HFMEA intervention in patients with different admission methods are different.Compared with the control group,the emergency stay time of the patients in the study group transported by EMS[0(0,38.5)min and 0(0,0)min],the activation time of the catheterization laboratory[30(20,49.5)min and 19.5(9.25),20)min],FMC2W time[145(118,174.75)min and 107.5(98,125.75)]are significantly shortened,and hospitalization expenses are significantly reduced[(43734±19973.92)yuan and(48671.65±13506.76)yuan],the difference All are statistically significant.Compared with the control group,the time from the onset of the disease to the gate of the PCI hospital[296(118,1560)min and 176(110,350)min]and the emergency stay time[37(10,51)min and 0(0,0)min],FMC2ECG time[4(2,6)min and 3(2,4)min],informed consent time[17(8,30)min and 10(5,14)min],Catheter lab activation time[25(20,35)min and 17(8,30)min],FMC2W time[145(124,208)min and 126(108,124)min]have been significantly shortened,[(49616.75±16872.42)yuan and(58657.92±21070.25)yuan],the mortality of patients decreased,and the difference was statistically significant(p<0.05).There are also clinically significant improvements in the treatment of patients in some key time indicators and hospitalization days,but there is no statistically significant difference.Research Conclusions1.The treatment of STEMI has extremely high risks,and the treatment efficiency of the diagnosis and treatment process needs to be improved.It is necessary to predict the potential risks and intervention management in the process.2.HFMEA helps to find high-risk links in the emergency treatment process and formulate effective targeted measures.3.The implementation of HFMEA-based process improvement measures can standardize the implementation of emergency diagnosis and treatment processes,shorten the total ischemic time of patients,increase the rate of compliance with certain critical times,and reduce mortality and hospitalization costs.