失效模式与效应分析在鼻咽癌同步放化疗患者围放疗期护理自我管理流程改善中的应用
Application of Failure Mode and Effect Analysis in the Improvement of Nursing Self-Management Process of Nasopharyngeal Carcinoma Patients Undergoing Simultaneous Radiotherapy and Chemotherapy

目的：探讨失效模式与效应分析在鼻咽癌同步放化疗患者围放疗期护理流程改善中的应用。现状：由于鼻咽癌同步放化疗的不良反应较为痛苦，且鼻咽癌治疗较为漫长，治疗依从性较差，护理配合度较低，目前尚无HFMEA在鼻咽癌围放疗期护理改善工作中的应用，围放疗期护理流程仍需进一步改善。方法：用2022年3月~2022年10月我院收治入院确诊鼻咽癌需进行同步放化疗患者的112例进行随机分组，对照组与实验组各56例，对照组采用常规护理流程改善，实验组采用失效模式与效应分析(FMEA)模式进行护理流程改善，对比两组护理的RPN值及切口感染率、护理满意度。结果：实验组的各项RPN值较对照组低(P < 0.05)，并发症发生率实验组(2.17%)显著低于对照组(9.33%)，实验组自我管理落实率(97.13%)显著高于对照组(53.25%)，实验组护理满意率(92.05%)显著高于对照组(85.23%)，组间差异具有统计学意义(P < 0.05)。结论：应用失效模式与效应分析在鼻咽癌同步放化疗患者围放疗期护理流程改善中的效果显著，显著降低在鼻咽癌同步放化疗患者围放疗期并发症发生几率，提高患者生存质量并提高护理满意度。
Objective: To explore the application of failure mode and effect analysis in the improvement of nursing process in patients with nasopharyngeal carcinoma (NPC) during peri-radiotherapy and chemotherapy. At present, due to the painful adverse reactions of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma, the treatment of nasopharyngeal carcinoma is rela-tively long, the treatment compliance is poor, and the degree of nursing compatibility is low, there is no application of HFMEA in the nursing improvement of nasopharyngeal carcinoma during pe-ri-radiotherapy, and the nursing process needs to be further improved. Methods: One hundred and twelve patients with nasopharyngeal carcinoma admitted to our hospital from March to October 2022 were randomly divided into control group (n = 56) and experimental group (n = 56). The con-trol group was improved by routine nursing process, and the experimental group was improved by failure mode and effect analysis (FMEA) mode. The RPN value, incision infection rate and nursing satisfaction of the two groups were compared. Results: The RPN value of the experimental group was lower than that of the control group (P < 0.05). The incidence of complications in the experi-mental group (2.17%) was significantly lower than that in the control group (9.33%). The self-management rate of the experimental group (97.13%) was significantly higher than that of the control group (53.25%). The nursing satisfaction rate of the experimental group (92.05%) was sig-nificantly higher than that of the control group (85.23%), and the difference between the two groups was statistically significant (P < 0.05). Conclusion: The application of failure mode and effect analysis can significantly improve the nursing process of nasopharyngeal carcinoma patients un-dergoing simultaneous radiotherapy and chemotherapy, significantly reduce the incidence of com-plications in patients with nasopharyngeal carcinoma undergoing simultaneous radiotherapy and chemotherapy and improve the quality of life of patients and improve