Application of failure mode and effect analysis mode in maintenance of PICC catheter in children with leukemia undergoing chemotherapy / 中国实用护理杂志

ABSTRACT

Objective:To analyze failure mode and effect analysis (FMEA) management model on the risk and satisfaction of PICC catheterization in children with leukemia undergoing chemotherapy.Methods:Totally 100 children with PICC catheterized leukemia were admitted to our hospital from June 2015 to December 2018, and their FMEA were managed. Find out the possible failure content and potential risk factors during PICC tube placement operation and maintenance, and calculate the risk value (RPN) according to the formula. Based on RPN values, specific prevention and treatment strategies were formulated and follow-up observation was monitored.Results:After the failure mode and effect analysis, the RPN scores of misevaluation, nonstandard operation, uncooperative children and insufficient preparation for use were (619.5 ± 11.7), (859.3 ± 18.7), (248.6 ± 20.6), (597.4 ± 8.4) points respectively, while those before the intervention were (1 347.5 ± 27.8), (1 127.4 ± 34.7), (427.3 ± 41.9) points, the difference was statistically significant ( t values were 9.563-14.279, P < 0.05). After the failure mode and effect analysis, the RPN scores of drug factor, child factor, ineffective sealing, infusion interruption, inadequate propaganda and maintenance were (598.4 ± 17.4), (537.2 ± 12.1), (407.3 ± 12.1), (178.4 ± 12.1), (8.4 ± 12.1) points, respectively. Before the intervention, the scores were (986.4 ± 30.7), (685.7 ± 17.8), (527.4 ± 23.6), (359.2 ± 29.4) and (148.3 ± 26.5) points, respectively. The differences were statistically significant ( t values were 11.092-19.634, P < 0.05). Conclusion:Failure mode and effect analysis applied to children with leukemia PICC pipeline placement and maintenance can improve the effectiveness of pipeline management and reduce the occurrence of pipeline maintenance risk events.