Using Healthcare Failure Mode and Effect Analysis to Reduce Intravenous Chemotherapy Errors in Chinese Hospitalized Patients

Gui, Li; Xu, Bo; He, Ruixian; Zhang, Shuxiang

doi:10.1097/ncc.0000000000000348

Cited by 17 publications

(25 citation statements)

References 14 publications

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“…Several studies have recognized the importance that HFMEA has when it comes to identifying failure modes (FMs), its causes and consequences in a variety of health-care processes, such as distribution and the administration of medicines, parenteral nutrition, and chemotherapy (31)(32)(33)(34)(35)(36)(37)(38)(39). As recently demonstrated in a study by Castro Vida et al (40), the HFMEA has been conducted in all processes and sub-processes in hospital pharmacies except for medicine-shortage management (40).…”

Section: Introductionmentioning

confidence: 99%

Risks in Antibiotic Substitution Following Medicine Shortage: A Health-Care Failure Mode and Effect Analysis of Six European Hospitals

et al. 2020

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Introduction: Medicine shortages result in great risk for the continuity of patient care especially for antimicrobial treatment, potentially enhancing resistance rates and having a higher economic impact. This study aims to identify, describe, assess, and assign risk priority levels to potential failures following substitution of antimicrobial treatment due to shortages among European hospitals. Furthermore, the study investigated the impact of corrective actions on risk reduction so as to provide guidance and improve future patient care. Methods: Health-care failure mode and effect analysis (HFMEA) was applied to hospitals in Austria (H-AT), Belgium (H-BE), Croatia (H-CR), Greece (H-GR), Spain (H-SP), and Serbia (H-SR). Multidisciplinary teams identified processes, failure modes, causes, and corrective actions related to antibiotic substitution following medicine shortages. Characteristics of study hospitals as well as severity, probability, and hazard scores (HSs) of failure modes/causes were analyzed using Microsoft Office Excel 2010 and IBM SPSS Statistics® via descriptive and inferential statistics. Results: Through HFMEA, 74 failure modes were identified, with 53 of these scoring 8 or above on the basis of assigned severity and probability for a failure. Severity of failure modes differed before and after corrective actions in H-CR, H-GR, and H-SR (p < 0.005). Their probability differed in all study hospitals (p < 0.005) when compared before and after corrective actions aimed to be implemented. The highest number of failure-mode causes was detected in H-CR (46) and the lowest in H-SP (16). Corrective actions can address failure modes and lower HSs; therein, all teams proposed the following: structuring communication among stakeholders, introducing electronic prescribing, strengthening Miljković et al. HFMEA of European Medicine Shortages pharmacists' involvement, and increasing effectiveness of the ward stock assessment. These proposed actions led to HS reductions up to 83%. Conclusion: There is a lack of structure in addressing risks associated with antibiotic substitution following shortages. Furthermore, lack of communication, data scarcity on availability of antibiotics, non-supportive information technology (IT) systems, and lack of internal substitution protocols hinder quick assessment of alternatives addressing patient needs. Nevertheless, the study shows that health-care professionals manage to secure optimal antimicrobial treatment for patients using available IT and human resources.

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Section: Introductionmentioning

confidence: 99%

Risks in Antibiotic Substitution Following Medicine Shortage: A Health-Care Failure Mode and Effect Analysis of Six European Hospitals

et al. 2020

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“…17 20 22–24 27–29 40–42 44 A considerable number of studies were carried out to assess chemotherapy procedures including paediatric chemotherapy. 30 32–35 37 39…”

Section: Discussionmentioning

confidence: 99%

“…Most studies had successfully implemented corrective measures after having FMEA discussions. 13 15–33 35–37 39–42 44–46 Although every single healthcare process has its own inherent risks, it is well known that areas such as chemotherapy, neonatology and paediatrics are areas that are more vulnerable to hazards. We learnt from the present systematic review that FMEA was effectively and widely used in such areas.…”

Section: Discussionmentioning

confidence: 99%

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Application of Failure Mode and Effect Analysis (FMEA) to improve medication safety: a systematic review

Anjalee

Rutter²,

Samaranayake

2020

Postgraduate Medical Journal

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Medication safety is a phenomenon of interest in most healthcare settings worldwide. Failure Mode and Effect Analysis (FMEA) is a prospective method to identify failures. We systematically reviewed the application of FMEA in improving medication safety in the medication use process. Electronic databases were searched using keywords ((failure mode and effect analysis) AND (pharmacy OR hospital)). Articles that fulfilled prespecified inclusion criteria were selected and were then screened independently by two researchers. Studies fulfilling the inclusion criteria and cited in articles selected for the study were also included. Selected articles were then analysed according to specified objectives. Among 27€706 articles obtained initially, only 29 matched the inclusion criteria. After adding four cited articles, a total of 33 articles were analysed. FMEA was used to analyse both existing systems and new policies before implementing. All participants of FMEA reported that this process was an effective group activity to identify errors in the system, although time-consuming and subjective.

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“…El proceso a evaluar fue seleccionado por tener un riesgo o vulnerabilidad potencialmente altos (16,17) . Observando el gran volumen de quimioterapia manipulada (125 preparaciones/día) y administrada en el hospital de referencia, se propone para la aplicación del AMFE el error en la medicación.…”

Section: Paso 1: Identificación De Las Situaciones Peligrosas Y Formaunclassified

Análise de falhas e efeitos na preparação e dispensação de quimioterápicos

Costa

Nunes

Pimenta³

et al. 2020

Enf Global

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Objetivo: Realizar un Análisis Multimodal de fallas y efectos para identificar prospectivamente los riesgos relacionados a la fase de la preparación y dispensación de medicamentos quimioterápicos en una unidad ambulatoria de un centro de referencia en oncología. Métodos: Se utilizaron las seis primeras etapas del Análisis Multimodal de fallas y Efectos: identificar las situaciones peligrosas y montar un equipo; definir el proceso a ser analizado describiendo gráficamente; aplicar lluvia de ideas buscando identificar modos de fallas; priorizar los modos de fallas y realizar análisis de riesgos; identificar las causas potenciales de los modos de fallo y volver a dibujar el proceso. Resultados: Se identificaron diecisiete modos de falla, siendo dos clasificados como de alto riesgo: cambiar la ventana de salida del medicamento y cálculo erróneo de la dosis de medicamento intratecal. Conclusiones: Se identificaron los posibles modos de falla que se relacionaban al proceso analizado, además, fue posible definir causas potenciales para la existencia de esos riesgos. Aim: Conduct a Failure Mode and Effect Analysis (FMEA) to prospectively identify the risks related to the preparation and dispensation of chemotherapy drugs at an outpatient unit of a reference center in oncology. Methods: The first six stages of Failure Mode and Effect Analysis were used to identify dangerous situations and assemble a team; define the process to be analyzed and describe it graphically; apply a host of ideas to identify failure modes; prioritize failure modes and conduct risk analysis; identify potential causes of failure modes and redesign the process. Results: Seventeen failure modes were identified, two of which were classified as high risk: changing the output window for the drug and miscalculating the intrathecal drug dose. Conclusions: The possible failure modes related to the process analyzed were identified; in addition, it was possible to define potential causes of these risks.

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Using Healthcare Failure Mode and Effect Analysis to Reduce Intravenous Chemotherapy Errors in Chinese Hospitalized Patients

Abstract: Clinicians in oncology can take effective measures to avoid chemotherapy errors using the HFMEA.

Cited by 17 publications

References 14 publications

Risks in Antibiotic Substitution Following Medicine Shortage: A Health-Care Failure Mode and Effect Analysis of Six European Hospitals

Risks in Antibiotic Substitution Following Medicine Shortage: A Health-Care Failure Mode and Effect Analysis of Six European Hospitals

Application of Failure Mode and Effect Analysis (FMEA) to improve medication safety: a systematic review

Análise de falhas e efeitos na preparação e dispensação de quimioterápicos

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