Application Of Health Care Failure Mode And Effects Analysis To Reduce Incidence Of Slippage Of PICC

【Objective】 To explore the effective nursing methods of reducing incidence of slippage of PICC. In this study, Health care failure mode and effect analysis (HFMEA) was applied to improve PICC maintenance process by establishing and implementing standardized PICC maintenance procedures, so as to reduce the incidence of catheter slippage.[Methods] Based on the approach of HFMEA, the prevention of PICC slippage project team was set up to draw the PICC maintenance flow chart, identify the failure mode and the causes of potential risks, conduct risk assessment of FMEA. Then, some appropriate measures were carried out to solve the priority problems. Observing the incidence of PICC slippage, the incidence of catheter related complications, overall satisfaction of patients on Catheter maintenance and the evaluation of the nurses on HFMEA management before and after the implementation.[Results](1) The incidence of PICC slippage in intervention and control group were0.669and0.130per1000catheter days respectively. The incidences of PICC displacement in intervention and control group were0.561and0.584per1000catheter days respectively. The incidence of PICC slippage and displacement in intervention group were significant lower than those in control group (p <0.05).(2) The comparison of the PICC-related complications incidence, the incidence of the puncture point infection were15(13.04%) in control group and6(5.00%) in intervention group, the difference was significant statistically (p <0.05), but the incidence of the other PICC-related complication was not significant difference statistically (p>0.05).(3) The comparison of overall satisfaction of patients on catheter maintenance, the control group was3.24±0.894and the intervention group was3.80±0.751, the intervention group higher than those in the control group (p<0.05).(4) The comparison of evaluation of nurses on HFMEA management,"improving the efficiency and quality of PICC maintenance ","reducing PICC-related complications ","improving patient satisfaction","promoting PICC maintenance procedures "were recognized by nurses,the difference was statistically significant (p<0.05)[Conclusions](1) To use health Care Failure Mode and Effects Analysis to analyze every step of the PICC maintenance procedures and Implement improvement measures can effectively reduce the incidence of PICC slippage, displacement and puncture point infection, reduce risk during indwelling PICC.(2) HFMEA can optimize the process of PICC maintenance procedure and standardize the process, so as to continuous improve the nursing quality.