Effect of Health Failure Mode and Effect Analysis in Optimizing the Management Process of Postoperative Diabetes Insipidus in Children Undergoing Neurosurgery.

Q4 Medicine

中国医学科学院学报 Pub Date : 2025-08-01 DOI:10.3881/j.issn.1000-503X.16410

Hui-Yun Zhao, Xiao-Ying Xu, Bo Wu, Shi Tang, Xin-Meng Li

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引用次数: 0

Abstract

Objective To investigate the effect of health failure mode and effect analysis(HFMEA)in optimizing the management process of postoperative diabetes insipidus in children undergoing neurosurgery.Methods Based on HFMEA,a management flowchart for postoperative diabetes insipidus in children undergoing neurosurgery was created.Brainstorming was adopted to identify failure modes in the workflow,analyze risk factors,and develop improvement measures,thereby refining the management flowchart.The amelioration and prognosis of diabetes insipidus in these children before(October 2022 to November 2023)and after(January 2024 to February 2025)implementation of the management flowchart were compared.Results The HFMEA-based management process for postoperative diabetes insipidus in children undergoing neurosurgery alleviated the symptoms of diabetes insipidus regarding the number of diabetes insipidus in the pediatric intensive care unit(P=0.006),the average daily urine output in the pediatric intensive care unit(P=0.001),the proportion of electrolyte abnormalities at discharge/transfer(P=0.037),the duration of mechanical ventilation(P=0.007),and the length of stay in the intensive care unit(P=0.001).Conclusion The HFMEA-based management process for postoperative diabetes insipidus in children undergoing neurosurgery is beneficial to the optimization of the management process,the alleviation of postoperative diabetes insipidus,and the improvement of prognosis in these children.

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健康失效模式对优化小儿神经外科术后尿崩症处理流程的影响及效果分析。

目的探讨健康失效模式与效果分析（HFMEA）在优化小儿神经外科术后尿崩症处理流程中的作用。方法基于HFMEA，建立小儿神经外科术后尿崩症的处理流程。采用头脑风暴的方法，识别工作流程中的失效模式，分析风险因素，制定改进措施，从而细化管理流程图。比较实施该管理流程前（2022年10月~ 2023年11月）和实施后（2024年1月~ 2025年2月）患儿尿崩症的改善情况及预后。结果基于hfmea的神经外科患儿术后尿崩症管理流程在小儿重症监护病房尿崩症数（P=0.006）、小儿重症监护病房平均日尿量（P=0.001）、出院/转院时电解质异常比例（P=0.037）、机械通气时间（P=0.007）、重症监护时间等方面均缓解了尿崩症症状单位(P = 0.001)。结论基于hfmea的小儿神经外科术后尿崩症管理流程有利于优化管理流程，缓解患儿术后尿崩症，改善患儿预后。

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来源期刊

中国医学科学院学报 Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

6813

期刊介绍： Acta Academiae Medicinae Sinicae was founded in February 1979. It is a comprehensive medical academic journal published in China and abroad, supervised by the Ministry of Health of the People's Republic of China and sponsored by the Chinese Academy of Medical Sciences and Peking Union Medical College. The journal mainly reports the latest research results, work progress and dynamics in the fields of basic medicine, clinical medicine, pharmacy, preventive medicine, biomedicine, medical teaching and research, aiming to promote the exchange of medical information and improve the academic level of medicine. At present, the journal has been included in 10 famous foreign retrieval systems and their databases [Medline (PubMed online version), Elsevier, EMBASE, CA, WPRIM, ExtraMED, IC, JST, UPD and EBSCO-ASP]; and has been included in important domestic retrieval systems and databases [China Science Citation Database (Documentation and Information Center of the Chinese Academy of Sciences), China Core Journals Overview (Peking University Library), China Science and Technology Paper Statistical Source Database (China Science and Technology Core Journals) (China Institute of Scientific and Technological Information), China Science and Technology Journal Paper and Citation Database (China Institute of Scientific and Technological Information)].