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). However, the observation group reported lower VAS scores at 24 and 48 hours (p 0.05), but the observation group experienced fewer postoperative complications and demonstrated higher disease knowledge (both p 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.
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