Ye J. et al., 2026: Using the Medical Failure Mode and Effect Analysis Nursing Plan to Optimise the Surgical Outcomes of Patients Undergoing Extracorporeal Shock Wave Lithotripsy in the Emergency Department: Retrospective Study.

Ye J, Huang J, Wang G, Bai Y, Yang Y.
Arch Esp Urol. 2026 Mar;79(2):265-273. doi: 10.56434/j.arch.esp.urol.20267902.32

Abstract

Objective: This study aimed to evaluate whether a Healthcare Failure Mode and Effect Analysis (HFMEA)-based nursing plan improves surgical outcomes for patients undergoing emergency extracorporeal shock wave lithotripsy (ESWL) for urinary tract stones.

Methods: A retrospective analysis was conducted on 127 patients who underwent ESWL between July 2024 and June 2025. According to the nursing protocol received, the patients were divided into a control group (n = 67) receiving routine emergency perioperative care and an observation group (n = 60) receiving HFMEA nursing. Postoperative recovery indicators, pain levels (at 12, 24 and 48 hours), psychological state, follow-up outcomes and disease knowledge were compared.

Results: The two groups had comparable baseline characteristics (p > 0.05). Although the time to first flatus was similar between groups (p > 0.05), stone expulsion time was significantly shorter in the observation group (p < 0.05). Regarding pain, Visual Analog Scale (VAS) scores at 12 hours postoperatively were not significantly different (p > 0.05). However, the observation group reported lower VAS scores at 24 and 48 hours (p < 0.05). Hospital Anxiety and Depression Scale scores decreased in both groups after treatment, with lower scores in the observation group (p < 0.05). No significant difference in 1-month stone clearance rate was found (p > 0.05), but the observation group experienced fewer postoperative complications and demonstrated higher disease knowledge (both p < 0.05).

Conclusions: Implementing an HFMEA nursing plan for patients undergoing emergency ESWL may promote recovery, improve mental state, reduce complications and enhance patient education. This strategy warrants clinical promotion.