The Application Of Failure Mode And Effect Analysis In The Collection Of Venous Blood Specimen

Objectives1 Explored the work flow of failure mode and effect analysis in the application of venous blood specimen collection,built the failure mode of blood specimen collection,analyzed the failure causes of blood specimen collection,and developed several targeted intervention measures.2 Investigated the effects of the work flow of failure mode and effect analysis applied in venous blood specimen collection on the blood specimen qualified rate,patients' anxiety,happiness and satisfaction.Methods1 Apply FMEA to improve the processes of venous blood specimen collection.Selected the clinical staff working in the department of blood sampling of armed police logistics college affiliated hospital as our objects from October to December,2015.We established the theme based on the failure mode and effect analysis theory and steps,formed a team,trained the team members,drew the flow chart and made description,analyzed the possible hazard of venous blood specimen collection process.We used self-designed venous blood specimen collection process failure mode and effect analysis table to survey the objects in our study.For the description of the data,count data was expressed as frequency and percentage,the measurement data was described as mean and standard deviation.2 From January 2015 to December 2015,based on the included and excluded standard,we used the convenience sampling method to sample the patients in the center of the armed police logistics college affiliated hospital orthopedic ward three as the research objects.Quasi-trial research was designed.According to the research results of last stage,we made the process improvement measures of blood specimen collection and applied them in the intervention group.The effects were evaluated using the rate of qualified blood specimen,the score of patients' self-evaluation anxiety,the score of happiness scale and patients' satisfaction for venous blood specimen collection.For count data,Chi-square test and independent sample t test were conducted to compare the difference between the intervention group and thecontrol group.For measurement data,firstly,Kolmogorov-Smimov test was conducted to test normality,and then,two independent samples t test was used to test normal distribution data,nonparametric statistics method(Mann Whitney U test)was used to test abnormal distribution data and ranked data.Results1 Apply FMEA to improve the results of venous blood specimen collection process.?Consulting object: the medical staffs,A total of 16,which contains clinical nurses,nursing management,clinical laboratory doctors,hospital logistics personnel,are all familiar with the work of clinical venous blood specimen collection.Age 22 to43 years old,the average(32±1.38)years;One person holds doctor's degree,two hold master's,four people took undergraduate course,nine people had college experience,one from technical secondary school;Five people have Intermediate title,ten people primary title,one no title;3-9 years working life,the average(6.62±2.01)years.? Confirm the venous blood specimen collection process and draw the flow chart.? List 20 failure modes of venous blood specimen collection process,and calculate the risk priority number(RPN).According to the RPN value and the degree of intervention,choose the failure modes of RPN value ranking in the first nine: inaccurate teaching,happening of haemolysis 1(in the operation of blood collection),happening of haemolysis 2(during the process of inspection),mismatching of bar codes and treatment,incorrect blood collecting method,insufficient blood collection,improper selection of patients,improper selection of blood vessels,and unclear logistics personnel handover.They are priority failure modes of blood specimen collection process.2 The research results of venous blood specimen collection process based on the application of failure mode and effect analysis.?Comparison between two groups of patients before and after the intervention in the clinical index and social psychological assessment index: comparison of venous blood specimen qualified cases between intervention group and control group,difference was statistically significant;comparison of hospitalized patients anxiety self-assessment scale scores between intervention group and control group,difference was statistically significant;comparison of intervention group anxiety self-assessment scale scores between Early admission and hospitalization,difference was statistically significant.?Comparison of venous blood specimen qualified cases between intervention group and control group,difference was statistically significant(P<0.05);comparison of control group anxiety self-assessment scale scores between Early admission and hospitalization,difference was statistically significant(P<0.05);comparison of control group happiness scale scores between Early admission and hospitalization,difference was not statistically significant(P>0.05);comparison of the venous blood specimen collection satisfied cases between intervention group and control group,difference was statistically significant(P<0.05).?Comparison of priority failure modes RPN value before and after the intervention,difference was statistically significant(P<0.05).Conclusions1 Improved venous blood specimen collection process includes six steps,17 subroutine,according to the RPN value and the degree of intervention,nine high potential risk failure modes were found: inaccurate teaching,happening of haemolysis 1(in the operation of blood collection),happening of haemolysis 2(during the process of inspection),mismatching of bar codes and treatment,incorrect blood collecting method,insufficient blood collection,improper selection of patients,improper selection of blood vessels,and unclear logistics personnel handover.2 The application of failure mode and effect analysis method can effectively improve the blood specimen collection operation technology,reduce the risk of venous blood work,improve the blood specimen qualified rate;This application can also reduce hospitalization anxiety tendency,help patients with psychological health;It can improve patient's satisfaction of venous blood sampling operation.