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Impact of Failure Mode and Effects Analysis-Oriented Multidisciplinary Collaborative Nursing Model on Bleeding
Lingxia Fan1, Xiaoping Guo1, Yanzhuo Ma1
1980th Hospital of the Joint Logistics Support Force of the Chinese People 's Liberation Army, Shijiazhuang, China.
Insights
A new Failure Mode and Effects Analysis (FMEA)-oriented multidisciplinary collaboration (MDC) nursing model significantly reduced bleeding after transradial coronary angiography (TRA). This approach also improved nursing efficiency and patient outcomes, offering a standardized clinical solution.
Area of Science:
- Cardiology
- Interventional Cardiology
- Nursing Science
Background:
- Transradial artery coronary angiography (TRA) is a common procedure for diagnosing coronary artery disease.
- Postoperative bleeding at the puncture site remains a significant clinical challenge, with reported incidences ranging from 3.1% to 16.7%.
- Fragmented care and inadequate multidisciplinary collaboration (MDC) contribute to this complication, and proactive risk management tools like Failure Mode and Effects Analysis (FMEA) have not been integrated into MDC for bleeding prevention.
Purpose of the Study:
- To assess the effectiveness of an FMEA-oriented MDC nursing model in preventing postoperative bleeding following TRA.
- To evaluate the impact of this model on nursing efficiency and overall patient outcomes.
- To provide a standardized clinical approach for managing TRA-related bleeding risks.
Main Methods:
- A single-center randomized controlled trial (RCT) involving 280 patients undergoing TRA between March 2024 and March 2025.
- Patients were randomized 1:1 to either an experimental group receiving FMEA-oriented MDC care or a control group receiving conventional care.
- The experimental group's care included joint assessment, standardized intraoperative collaboration, and graded monitoring.
Main Results:
- The experimental group exhibited a significantly lower 24-hour bleeding incidence (4.3% vs. 13.6%, p=0.005).
- Key improvements included shorter hemostasis time (38.2 ± 8.5 vs. 54.6 ± 10.2 min, p<0.001) and reduced length of hospital stay (LOS) (3.1 ± 0.8 vs. 4.5 ± 1.2 days, p<0.001).
- Higher satisfaction scores from both healthcare providers and patients were reported in the experimental group, alongside lower postoperative anxiety and depression scores (SAS/SDS, p<0.001).
Conclusions:
- The FMEA-oriented MDC nursing model effectively reduces postoperative bleeding complications after TRA.
- This innovative model enhances nursing efficiency, leading to improved patient satisfaction and psychological well-being.
- The study demonstrates a standardized and effective clinical solution for mitigating bleeding risks associated with TRA procedures.
Background:
Transradial artery coronary angiography (TRA) is widely used for coronary disease diagnosis, but postoperative puncture site bleeding (incidence: 3.1%-16.7%) remains a major clinical challenge. Fragmented care and poor multidisciplinary collaboration (MDC) contribute to this issue, while Failure Mode and Effects Analysis (FMEA)-a proactive risk tool-has not been integrated into MDC for TRA bleeding prevention.
Aims:
To evaluate the efficacy of an FMEA-oriented MDC nursing model on TRA postoperative bleeding, nursing efficiency, and patient outcomes.
Methods:
A single-center randomized controlled trial (RCT) enrolled 280 TRA patients (March 2024 to March 2025), randomized 1:1 to the experimental group (FMEA-oriented MDC care: joint assessment, standardized intraoperative collaboration, graded monitoring) or control group (conventional care).
Primary Outcome:
24-h bleeding incidence (EAPCI criteria).
Secondary Outcomes:
hemostasis time, length of hospital stay (LOS), healthcare provider-patient satisfaction, and psychological status (SAS/SDS).
Results:
The experimental group had lower 24-h bleeding incidence (4.3% vs. 13.6%, χ2 = 7.832, p = 0.005), shorter hemostasis time (38.2 ± 8.5 vs. 54.6 ± 10.2 min, t = 13.264, p < 0.001) and LOS (3.1 ± 0.8 vs. 4.5 ± 1.2 days, t = 10.587, p < 0.001). Higher satisfaction scores (healthcare provider: 93.5 ± 4.2 vs. 77.8 ± 6.5; patient: 92.1 ± 3.8 vs. 80.5 ± 5.3; both p < 0.001) and lower postoperative SAS/SDS scores (both p < 0.001) were observed in the experimental group.
Conclusion:
The FMEA-oriented MDC model reduces TRA postoperative bleeding, improves nursing efficiency and satisfaction, and alleviates patient anxiety/depression, providing a standardized clinical solution.
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