Application of HFMEA mode in enteral nutrition feeding process of high risk patients with aspiration in ICU
HFMEA模式在ICU高危误吸患者肠内营养喂养流程的应用研究

摘要

目的 评估HFMEA模式在ICU高危误吸患者肠内营养流程中的应用效果。方法 144例患者随机分为实验组（n=72）和对照组（n=72）。实验组实施HFMEA流程优化（多学科风险分析、标准化操作及动态预警），对照组采用常规护理。比较两组护理第4、8天的反流、误吸及吸入性肺炎发生率。结果 实验组反流（23.3% vs 56.7%，P＜0.01）、误吸（16.7% vs 43.3%，P＜0.01）及吸入性肺炎（10.0% vs 33.3%，P＜0.01）发生率均显著降低；高风险环节依从性从65.0%提升至98.3%，护理效率提高15.2分钟/日。肠内营养支持达标率、机械通气时间及ICU住院时间等次要指标亦显著改善。结论 HFMEA模式通过系统性风险防控，显著降低并发症发生率并提升护理效率，在改善临床结局、缩短住院周期与优化资源配置方面具有多重获益，为ICU护理质量改进提供可推广的循证范式。

Abstract

Objective To evaluate the application effect of the HFMEA model in the enteral nutrition process for high-risk aspiration patients in the ICU.
Methods A total of 144 patients were randomly divided into an experimental group (n=72) and a control group (n=72). The experimental group implemented the HFMEA process optimization (multidisciplinary risk analysis, standardized operations, and dynamic early warning), while the control group received conventional nursing care. The incidence rates of reflux, aspiration, and aspiration pneumonia on days 4 and 8 were compared between the two groups.
Results The experimental group showed significantly reduced incidence rates of reflux (23.3% vs 56.7%, P<0.01), aspiration (16.7% vs 43.3%, P<0.01), and aspiration pneumonia (10.0% vs 33.3%, P<0.01). Compliance with high-risk procedures improved from 65.0% to 98.3%, and nursing efficiency increased by 15.2 minutes/day. Secondary indicators such as the achievement rate of enteral nutrition support, mechanical ventilation time, and ICU length of stay also showed significant improvement.
Conclusion   The HFMEA model, through systematic risk prevention and control, significantly reduces complication rates and improves nursing efficiency. It offers multiple benefits in improving clinical outcomes, shortening hospital stays, and optimizing resource allocation, providing a replicable evidence-based paradigm for ICU nursing quality improvement.