Application Research Of HFMEA In The Transfer Process Of Patients With Anesthesia Recovery Room

Objectives:1 This study is based on the theory of Healthcare Failure Model and Effect Analysis(HFMEA),and takes a tertiary hospital in Henan Province as the research site.Through risk assessment of the handover process of general anesthesia patients transferred to the anesthesia recovery room after surgery,high-risk failure modes in the process are screened and analyzed,and targeted improvement strategies are proposed.2.By implementing improvement strategies,analyze the effectiveness of their application in improving the handover quality of anesthesia recovery rooms,and provide theoretical basis and practical guidance for improving the handover quality of patients transferred to anesthesia recovery rooms after clinical general anesthesia surgery.Method :This study includes the following two parts:1.The first Part: Risk recognition and improvement of the risk recognition and improvement of the risk recognition and improvement of the anesthesia recovery room by the general anesthesia of HFMEA theory.According to the guidance of the HFMEA theory,the first is to determine the theme of the analysis,and then set up Multidisciplinary project team.The third step is to draw the transfer flowchart from patients after general anesthesia to the anesthesia recovery room.The fourth step is to perform risk assessment.The patient transferred to the high-risk failure mode during the transfer process of the anesthesia recovery room,and finally formulated a improvement strategy for the transfer process of the patient transfer to the anesthesia recovery room after general anesthesia.2.The second part: Clinical application research on the improvement plan for the handover process of patients transferred to the anesthesia recovery room after general anesthesia surgery based on HFMEA theory.This study adopts a non contemporaneous historical control research method,with November 2021 to April 2022 as the pre implementation stage of improvement strategies,May 2022 to September 2022 will be set as the implementation stage of improvement strategies.And evaluate the outcome indicators such as the RPN value of high-risk projects,the occurrence rate of defects in high-risk projects,and the quality evaluation of nurse handover between both parties in the handover process before and after the implementation of the strategy.Using Excel to establish a database and SPSS22.0 software to conduct statistical analysis on all data inputs,explore the improvement effect of HFMEA based improvement plan on the handover quality of patients transferred to the anesthesia recovery room after general anesthesia surgery.Results:1.Through the evaluation of the failure risk index and the analysis of the decision tree,there are 6high-risk failure modes that need to take control measures in the end: not timely connecting the anesthesia machine(RPN = 9.25),and the patients who have not co-organized and viewed(RPN = 8.83),inadequate or errors of the patient’s condition(RPN = 8.92),omissions and omissions(RPN = 8.42)related to patients related to patients,non-standard pipeline care(RPN = 9.75)during transfer,and anesthesia town at the time of transfer Pumping nursing is not standardized(RPN = 8.25).2.According to the 6 main failure modes,the optimization plan of the handover process of patients transferred to the anesthesia recovery room after general anesthesia was formulated.The main improvement measures were:(1)to clarify the handover responsibilities and handover contents of both parties;(2)Strengthen the supervision of all links of handover;(3)Formulate targeted and specialized ISBAR standardized condition notification check sheet;(4)Formulate standard placement and handover rules for patients’ belongings;(5)Standardized various pipeline handover process and sequence;(6)To develop specifications for the connection and use of anesthesia and analgesia pumps;(7)Make classification of patients after general anesthesia and implement regional placement;(8)Establish standard operation instructions for handover process;(9)Conduct on-site training on SHARE’s integrated medical and nursing handover.3.After the implementation of the handover process optimization scheme based on HFMEA,the RPN value scores of 6 high-risk failure items decreased significantly,and the total RPN value of failure mode decreased from 53.42 points to 43.76 points before the implementation;The problem incidence of 6 highrisk failure items was significantly decreased(P<0.05),among which the problem incidence of not timely connecting anesthesia machine and other equipment was decreased from 14.83% to 6.46%(p=0.002).The incidence of problems in patients without joint arrangement and viewing decreased from 24.71% to9.89%(p<0.001).The incidence of incomplete omissions or errors in the handover of patients decreased from 11.79% to 3.8%(P=0.001).The incidence of patient-related items omission problem decreased from17.87% to 6.48%(P<0.001).The incidence of non-standard pipeline nursing of patients decreased from14.45% before improvement to 3.42%(P<0.001).The incidence of non-standard nursing of anesthesia analgesic pump decreased from 15.59% to 4.56%(P<0.001).The score of mutual evaluation of handover quality was significantly improved by both parties(P < 0.05),and the overall score of anesthesian-nurse for the transition patients increased from(7.57±0.91)points to(7.86±0.93)points(P=0.018).The overall score of the itinerant nurses on the succession was increased from(7.8±0.74)points to(8.15±0.73)points(P=0.026).Conclusion:The improvement strategy based on HFMEA has a good effect in the continuous improvement of the handover quality of patients transferred to Post Anesthesia Care Unit.It not only reduces the defect incidence and RPN value of high-risk failure items,but also standardizes the handover process and improves the handover quality of nurses from both sides.