Objective To investigate the application effect of Root Cause Analyses and Actions(RCA2)in em-braced child with hypothermia scald in pediatric intensive care unit.Methods A RCA2 team was established to analyze the root causes of a case of hypothermia scald caused by embrace nursing in a child with congenital heart disease after surgery,and to formulate improvement plans and implement them.Results The standardized procedures and scoring criteria of the children with embrace nursing were standardized,and the risk of embraced children after surgery was re-duced.Conclusion RCA2 can effectively avoid the occurrence of adverse nursing events and ensure the quality and safety of medical care.
Root Cause Analyses and ActionsPediatric Intensive Care UnitInfantEmbrace NursingPatient Safety
NETL
NSTL
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