Construction and application research of a nursing checklist for the transfer of critically ill cardiovascular patients based on FMEA theory
基于FMEA理论的心血管危重症患者转运护理查检表的构建及应用研究

摘要

目的 构建基于FMEA理论的心血管危重症患者转运护理查检表，以提高心血管重症患者转运安全性。方法 在综合梳理国内外相关文献的基础上，初步拟定了心血管危重症患者转运护理执行单的初稿；随后采用德尔菲专家咨询法，经过两轮对10位心血管领域专家的意见征询，修订并确立了该转运护理执行单的最终版本，并对其信度和效度进行了验证。选取2022年4月至2022年10月广州某三甲医院心血管重症病区80例需转运的心血管危重症患者作为研究对象，分为对照组（40例，实施常规转运方案）和试验组（40例，实施常规转运方案+基于FMEA理论的心血管危重症患者转运护理执行单）。比较两组患者在转运过程中不良事件的发生率差异。结果 心血管危重症患者转运护理执行单共包含转运前、中、后三个部分，涵盖3项一级指标、17项二级指标和74项三级指标。基于FMEA理论的心血管危重症患者转运护理执行单的信度系数为0.823，内容效度（CVI）为0.877。研究结果显示，试验组在转运期间的不良事件发生率为12.50%，显著低于对照组的37.50%，组间差异具有统计学意义（P＜0.05）。结论 心血管危重症患者转运护理执行单信效度良好，其应用能提升转运安全性，显著减少患者转运不良事件的发生率。

Abstract

Objective To construct a nursing checklist for the transfer of critically ill cardiovascular patients based on FMEA (Failure Mode and Effects Analysis) theory, aiming to enhance the safety of transferring critically ill cardiovascular patients.
Methods Based on a comprehensive review of relevant domestic and foreign literature, the first draft of the transfer and nursing execution form for critically ill patients with cardiovascular diseases was initially drafted. Subsequently, the Delphi expert consultation method was adopted. After two rounds of soliciting opinions from 10 experts in the field of cardiovascular diseases, the final version of the transfer care execution sheet was revised and established, and its reliability and validity were verified. From April 2022 to October 2022, 80 critically ill patients with cardiovascular diseases who needed to be transferred in the cardiovascular intensive care unit of a tertiary hospital in Guangzhou were selected as the research objects and divided into the control group (40 cases, implementing the conventional transfer plan) and the experimental group (40 cases, implementing the conventional transfer plan + the transfer nursing execution sheet for critically ill patients with cardiovascular diseases based on the FMEA theory). Compare the differences in the incidence of adverse events during the transfer process between the two groups of patients.
Results The execution form for the transfer and care of critically ill cardiovascular patients consists of three parts: before, during and after the transfer, covering 3 first-level indicators, 17 second-level indicators and 74 third-level indicators. The reliability coefficient of the execution sheet for the transfer care of critically ill cardiovascular patients based on the FMEA theory is 0.823, and the content validity (CVI) is 0.877. The research results show that the incidence of adverse events in the experimental group during the transfer period was 12.50%, significantly lower than 37.50% in the control group, and the difference between the groups was statistically significant (P < 0.05).
Conclusion   The reliability and validity of the implementation of transfer nursing for critically ill patients with cardiovascular diseases are good. Its application can enhance the safety of transfer and significantly reduce the incidence of adverse events during patient transfer.