Evaluating the Impact of the Failure Mode and Effects Analysis Nursing Approach on Complications of Chronic Obstructive Pulmonary Disease Patients With Respiratory Failure.

Abstract

Aims/Background Noninvasive intermittent positive pressure ventilation is a widely used approach for managing Chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Treatment procedures often result in severe complications, requiring the implementation of proactive and effective nursing measures. Therefore, this study investigated the impact of failure mode and effects analysis (FMEA) on preventing complications in COPD patients with respiratory failure and assessed its influence on negative emotions, hope level, and quality of life. Methods This retrospective study included 356 patients with COPD combined with respiratory failure who underwent treatment in the First Affiliated Hospital of Wenzhou Medical University, China, between January 2023 and December 2023. Patients receiving usual care were included in the care-as-usual (CAU) group (n = 204), and those who underwent FMEA were assigned to the FMEA group (n = 152). Baseline characteristics and clinical data were compared between the two groups. Furthermore, the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Herth Hope Index (HHI) and 36-item Short-Form were collected and comparatively analyzed between the two groups. Results The FMEA group exhibited a significantly lower incidence of facial compression injury, dry mouth, phlegm obstruction, flatulence, bronchiectasis, and aspiration pneumonia than the CAU group (p < 0.05). After the intervention, the SAS and SDS scores were significantly reduced in the FMEA group than in the CAU group (p < 0.001). The temporality and future, positive readiness and expectancy, inter-connectedness, and HHI scale total scores were significantly higher in the FMEA group compared to the CAU group (p < 0.05). The physiological function, role-physical, body pain, general health perceptions, vitality, social functioning, role-emotional, and mental health of patients were significantly higher in the FMEA group than in the CAU group (p < 0.05). Conclusion The application of the FMEA nursing approach helps reduce the risk of complications in patients with COPD combined with respiratory failure, while effectively reducing anxiety and depression, improving their hope level and enhancing their overall quality of life. These observations offer a basis for preventing complications, and provide a reference for the formulation of nursing plans for these patients in clinical practice.