关键词: 医疗失效模式与效应分析；重型颅脑损伤；肠内营养；流程优化

Abstract: Objective: To optimize the procedure of enteral nutrition infusion for patients with severe craniocerebral injury using Health Failure Mode and Effect Analysis (HFMEA) and explore its clinical effects. Methods: A total of 131 patients with severe craniocerebral injury admitted from July 2016 to January 2018 receiving conventional enteral nutrition infusion were selected as the control group, and 145 patients with the same diseases admitted from February 2018 to August 2019 receiving HFMEA-based enteral nutrition infusion were recruited as the observation group. The risk priority number (RPN), feeding intolerance symptoms and nutritional indicators of the two groups were compared. Results: After the process optimization, the RPN value and the incidence of feeding intolerance in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). Serum total protein, albumin, transferrin, prealbumin and total lymphocyte counts of the observation group were higher than those of the control group on the 4th, 7th and 10th day, and the differences were statistically significant (P<0.05). Conclusion: With the help of HFMEA, nurses can effectively screen the failure risks of enteral nutrition infusion in patients with severe head injury, build a targeted optimization process and cooperate with medical staff of multiple departments to significantly reduce the incidence of feeding intolerance and optimize both enteral nutrition infusion and nursing quality to improve their nutritional status and clinical outcome as a whole.

Key words: Healthcare Failure Mode and Effect Analysis; severe craniocerebral injury; enteral nutrition; process optimization