Optimization of emergency process with the HFMEA tool and effects assessment among lumbar surgery patients with muscle weakness

Abstract

Objective To optimize the emergency process with the healthcare failure mode and effect analysis (HFMEA) tool among lumbar surgery patients with muscle weakness so as to shorten the first-aid time, standardize doctor-nurse behavior and improve the timely cure rate. Methods The emergency process from muscle weakness to hematoma evacuation in operating room was optimized based on the HFMEA. From June 2016 to May 2017, a total of 6 lumbar surgery patients with muscle weakness were in control group before optimization. From June 2017 to May 2018, a total of 7 lumbar surgery patients with muscle weakness were in experimental group after optimization. We compared the time from muscle weakness to effective cure of patients between two groups, and the detection rate for lumbar surgery patients with muscle weakness within 6 hours by nurses as well as the misjudgment probability for muscular strength assessment after lumbar surgery by nurses. Results After implementing optimal process, the time from muscle weakness to effective cure of patients decreased from (23.78±1.95) h to (5.37±0.78) h. The detection rate for lumbar surgery patients with muscle weakness within 6 hours by nurses increased from 33.3% to 100.0%. The misjudgment probability for muscular strength assessment after lumbar surgery by nurses decreased from 12.2% to 4.6%. Conclusions The application of HFMEA tool can optimize the muscular strength assessment management process for patients after lumbar surgery, standardize doctor-nurse behavior, shorten the first-aid time of muscle weakness and improve the detection rate for muscle weakness within 6 hours so as to guarantee the safety of patients. Key words: Muscle strength; Spinal nerves motor function; Lumbar vertebrae surgery; Healthcare failure mode and effect analysis; Nursing assessment