Impact of Failure Mode and Effects Analysis-Oriented Multidisciplinary Collaborative Nursing Model on Bleeding Prevention and Prognosis in Patients Undergoing Transradial Artery Coronary Angiography: A Randomized Controlled Trial.

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.