Risk Assessment of Clinical Care in Emergency Departments ByHealth Failure Modes and Effects Analysis

Abstract

This study aimed to investigate the failures of clinical care in emergency departments using the Healthcare Failure Modes and Effects Analysis (HFMEA). Materials and Methods: This was an analytical and cross-sectional study. The required data were collected qualitatively and quantitatively using focus group discussions in emergency departments. The study population consisted of all emergency department nurses. Study samples were selected by purposive sampling technique. By the HFMEA method, Risk Priority Number (RPN) was calculated to reach failure modes and those with RPN >216 were identified as the most frequent and risky errors. Results: A total number of 67 failure modes were identified for 26 clinical care processes.The errors with the highest RPN were "the lack of oxygenation during airway suctioning" and "the lack of airway suctioning during ventilator weaning process"; they related to the respiratory system care with RPN=336. The error with the lowest RPN was "the lack of signing verbal orders by two nurses"; related to the general practice with RPN=8. Conclusion: Investigating the causes and effects of these errors, controlling, and suggesting measures indicate the high efficiency of the HFMEA method. It also suggested the preventability of these errors by increasing the knowledge and awareness of the training staff by providing training courses.

Control of Clinical Laboratory Errors by FMEA Model

“…Analytical methodology of FMEA is very effective in maintaining patient safety. Laboratory staffs trained in FMEA methodology can greatly reduce time requirements and guarantee that all activities involved are coordinated increasing the accuracy of laboratory results [17][18][19].…”

“…Like any analytical method, FMEA should be thoroughly understood prior to being introduced in laboratory practice. There are five stages in its implementation which will be explained in more detail in the methodology [17][18][19].…”

“…The more steps in the process and the greater their dependency, the greater the chance of error. In this step the laboratory identifies the critical processes based on the severity of possible harmful errors and the potentially dangerous impact on patient safety [17][18][19].…”

“…Gathering specialists with different levels and types of training, with specific knowledge and experience of the selected process. A team head can lead team members through the process, and can help ensure that team members complete each step and record the results of FMEA [17][18][19].…”

“…In this step the assembled team creates an accurate diagram of potential failure modes of each listed activity using focus laboratory staff activities and reaching a common conclusion and recording it on FMEA form (Table 3) [17][18][19].…”