Analyse des risques a priori en unité de rétrocession hospitalière : focus sur le processus de dispensation

Darcissac, C.; Duvert, Louis; Hoegy, Delphine; Chappuy, Mathieu; Pivot, C.; Janoly‐Dumenil, Audrey

doi:10.1016/j.pharma.2019.06.006

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…12 In this study, the a priori analysis of risks associated with the medication-use process for temperature-sensitive drugs was carried out by the FMECA method because it is the most suitable method for the hospital setting, according to several previous studies. 9,[13][14][15] It has been recommended by the French Haute Autorité de Santé (National Authority for Health) 16 as a reference method for risk analysis and has been recommended by several other health organizations, in particular the Institute for Healthcare Improvement, 17 the Institute for Safe Medication Practices Canada, 18 and the American Association of Physicists in Medicine. 19 The FMECA method is based on the concept of brainstorming.…”

Section: Discussionmentioning

confidence: 99%

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Sakly

Chakroun²,

Jeddou

2022

CJHP

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Background: In the hospital setting, the medication-use system for temperature-sensitive drugs is a high-risk process. Objectives: To analyze the risks associated with the hospital-based medication-use process and to propose corrective and preventive actions for the most critical failure modes. Methods: A multidisciplinary team was trained to analyze the medication-use process for temperature-sensitive drugs and to identify potential failures using a risk analysis method known as failure mode, effects, and criticality analysis (FMECA). The medication-use process, from initial supply to administration to patients, was investigated using “the 5 Ws and How” method (Who? What? Where? When? Why? How?), and the causes of the failure modes were analyzed using Ishikawa diagrams. The most critical failure modes were selected using the Pareto law, and relevant improvement actions were proposed. Results: This analysis identified 41 failure modes for the 9 stages of the medication-use process, of which only 36 were deemed assessable by the participants. Eighteen (50%) of these failure modes were critical, according to the Pareto law, with criticality indices between 12 and 60. The stage of tidying up and storage in patient care units had the highest number of critical failures (n = 5). A total of 48 corrective actions were proposed. Conclusion: The proposed action plan prioritized 3 areas for improvement: the documentation system, staff training, and equipment acquisition. A second FMECA should be carried out to reassess the medication-use process after implementation of these improvement actions. The second FMECA, allowing detection of residual risks and identification of new risks, will be part of a continuous improvement process. RÉSUMÉ Contexte : Le circuit des médicaments thermosensibles en milieu hospitalier fait partie des processus à risque. Objectifs : Analyser a priori les risques liés à ce circuit et proposer des actions correctives et préventives contre les modes de défaillances les plus critiques. Méthodes : Une équipe pluridisciplinaire a été formée pour analyser le circuit des médicaments thermosensibles et identifier les défaillances par la méthode de l’analyse des modes de défaillances, de leurs effets et de leurs criticités (AMDEC). Le processus, qui va de l’approvisionnement jusqu’à l’administration des médicaments aux patients, a été décortiqué en utilisant la méthode « Qui? Quoi? Où? Quand? Comment? Pourquoi? » (QQOQCP) et les causes des défaillances ont été analysées à l’aide de diagrammes d’Ishikawa. Les défaillances les plus critiques ont été sélectionnées par la loi de Pareto, et des mesures d’amélioration pertinentes ont été proposées. Résultats : Cette analyse a mis en évidence 41 modes de défaillances pour les 9 étapes du circuit, dont uniquement 36 sont jugés évaluables par les membres de l’équipe pluridisciplinaire. Dix-huit modes sur 36 (soit 50 %) sont critiques selon la loi de Pareto, avec des indices de criticité répartis entre 12 et 60. L’étape comprenant le nombre le plus élevé de défaillances critiques est celle du rangement et du stockage dans les services de soins, avec 5 défaillances. Au total, 48 mesures correctives ont été proposées. Conclusions : Le plan d’action proposé priorisait 3 domaines d’amélioration : le système de documentation, la formation du personnel et l’acquisition d’équipements. Une deuxième AMDEC devrait être réalisée pour réévaluer le circuit après la mise en œuvre des mesures d’amélioration. La deuxième AMDEC permettra la détection des risques résiduels et l’identification de nouveaux risques et s’inscrira dans une démarche d’amélioration continue.

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Section: Discussionmentioning

confidence: 99%

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Sakly

Chakroun²,

Jeddou

2022

CJHP

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“…ISMP Canada then applied the FMEA to pharmacy practice, proving that the FMEA was an effective and reliable method to proactively examine complex processes in this field and could be used to highlight the high-risk subprocesses that required targeting to minimize future failures and, consequently, improve patient safety (25). Several studies have proved that the FMEA is useful for the reduction of risks related to pharmacies and medication (26)(27)(28)(29)(30)(31)(32), however, no such study has been conducted for online pharmacies.…”

Section: Introductionmentioning

confidence: 99%

Use of failure mode and effect analysis to reduce patient safety risks in purchasing prescription drugs from online pharmacies in China

et al. 2022

Front. Med.

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BackgroundOnline pharmacies have gradually penetrated the market, but pose risks to patients' health. Failure Mode and Effect Analysis (FMEA) is an effective and reliable method for reducing pharmacy and medication risks. The purpose of this study was to conduct a prospective risk analysis of the process of purchasing prescription drugs from online pharmacies in China to guarantee drug quality and patient safety.MethodsThe FMEA was performed at Sichuan University, China. A multidisciplinary team was assembled comprising a leader, four regulators, four pharmacists, two experts, etc. The process was composed of eight subprocesses: searching for prescription drugs, submitting medication requirements, completing patient information forms, dispensing, delivering, etc. Brainstorming was used to identify and prioritize failure modes, propose corrective actions, and reduce risks. Risk priority numbers were the main criterion and were obtained by multiplying three scores: severity, occurrence and detectability, which were scored by the team The team proposed corrective actions for each selected failure mode.ResultsA total of forty-one potential failure modes were identified, and the causes, effects, and corrective actions of the 30 top failure modes were analyzed. The highest risk value was assigned to “photocopies of paper prescriptions uploaded were reused by patients.” Three failure modes for the S value of 5 were: “drugs are eroded and polluted by moisture or insects in the process of transportation,” “the qualification information of the pharmacies were absent or fake,” and “pharmacists fail to check prescriptions in accordance with Prescription Administrative Regulation.” Of the top failure modes, 36.67% were from Step 5, delivering the drug. After taking corrective measures to control risks, the risks reduced by 69.26%.ConclusionThe results of this study proves that the FMEA is a valuable tool for identifying and prioritizing the risks inherent in online pharmacies. This study shows that there are many potential risks in the process of purchasing prescription drugs from online pharmacies, especially in the drug delivery stage. Enhanced training and the introduction of smart devices may minimize risks. Online pharmacies and Chinese regulators should consider these findings for risk mitigation and the improvement of regulations pertaining to online pharmacies.

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“…Il parait judicieux de renouveler l'AMDEC afin d'assurer le suivi des actions menées et surveiller l'émergence de nouveaux risques. risque financier, non négligeable [2] Ainsi, dans un objectif de sécurisation de la prise en charge médicamenteuse des patients, une analyse des risques présente un intérêt.…”

Section: Introductionunclassified

Analyse Des Risques a Priori En Unite De Retrocession Au Sein De L’unite De Gestion Des Produits a Statuts Particuliers a L’hmimv De Rabat : Processus De Dispensation

Lechheb¹

2022

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Analyse des risques a priori en unité de rétrocession hospitalière : focus sur le processus de dispensation

Cited by 6 publications

References 18 publications

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Application of Failure Mode, Effects, and Criticality Analysis to the Medication-Use Process for Temperature-Sensitive Drugs in a University Hospital

Use of failure mode and effect analysis to reduce patient safety risks in purchasing prescription drugs from online pharmacies in China

Analyse Des Risques a Priori En Unite De Retrocession Au Sein De L’unite De Gestion Des Produits a Statuts Particuliers a L’hmimv De Rabat : Processus De Dispensation

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