Safety Management of a Clinical Process Using Failure Mode and Effect Analysis
| Autor: | Esteban Molano-Alvarez, Ignacio Saez-de la Fuente, Javier Maynar-Moliner, Silvia Chacón-Alves, José A. Sánchez-Izquierdo-Riera, Helena Marín-Mateos |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Safety Management medicine.medical_specialty Critical Care Critical Illness medicine.medical_treatment Biomedical Engineering Biophysics Bioengineering law.invention Cohort Studies Biomaterials 03 medical and health sciences 0302 clinical medicine law Health care medicine Humans Healthcare Failure Mode and Effect Analysis 030212 general & internal medicine Renal replacement therapy Medical prescription Intensive care medicine Aged Retrospective Studies business.industry Acute kidney injury 030208 emergency & critical care medicine Retrospective cohort study General Medicine Acute Kidney Injury Middle Aged medicine.disease Intensive care unit Renal Replacement Therapy Intensive Care Units Outcome and Process Assessment Health Care Female Observational study business Cohort study |
| Zdroj: | ASAIO Journal. 62:74-79 |
| ISSN: | 1058-2916 |
| DOI: | 10.1097/mat.0000000000000286 |
| Popis: | The failure mode and effect analysis (FMEA) may improve the safety of the continuous renal replacement therapies (CRRT) in the intensive care unit. We use this tool in three phases: 1) Retrospective observational study. 2) A process FMEA, with implementation of the improvement measures identified. 3) Cohort study after FMEA. We included 54 patients in the pre-FMEA group and 72 patients in the post-FMEA group. Comparing the risks frequencies per patient in both groups, we got less cases of under 24 hours of filter survival time in the post-FMEA group (31 patients 57.4% vs. 21 patients 29.6%; p < 0.05); less patients suffered circuit coagulation with inability to return the blood to the patient (25 patients [46.3%] vs. 16 patients [22.2%]; p < 0.05); 54 patients (100%) versus 5 (6.94%) did not get phosphorus levels monitoring (p < 0.05); in 14 patients (25.9%) versus 0 (0%), the CRRT prescription did not appear on medical orders. As a measure of improvement, we adopt a dynamic dosage management. After the process FMEA, there were several improvements in the management of intensive care unit patients receiving CRRT, and we consider it a useful tool for improving the safety of critically ill patients. |
| Databáze: | OpenAIRE |
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