Failure mode and effect analysis: improving intensive care unit risk management processes

2017 ◽  
Vol 30 (3) ◽  
pp. 208-215 ◽  
Author(s):  
Roohollah Askari ◽  
Milad Shafii ◽  
Sima Rafiei ◽  
Mohammad Sadegh Abolhassani ◽  
Elaheh Salarikhah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Failure Modes ◽  
Tissue Injury ◽  
Tertiary Hospital ◽  
Control Measures ◽  
Effect Analysis ◽  
Content Type ◽  
Continuous Quality

Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services – their frequency and severity – were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.

scholarly journals Important quality aspects in the transfer process

2014 ◽  
Vol 27 (2) ◽  
pp. 123-139 ◽  
Author(s):  
Marie Häggström ◽  
Kenneth Asplund ◽  
Lisbeth Kristiansen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Transfer Process ◽  
Content Type ◽  
Transitional Process ◽  
Continuous Quality ◽  
Icu Discharge ◽  
Before And After

Purpose – Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward. Design/methodology/approach – The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden. Findings – A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU. Research limitations/implications – The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality. Practical implications – The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality. Originality/value – The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.

Endotracheal tube manipulation during cardiopulmonary resuscitation in the neonatal intensive care unit

2021 ◽  
Author(s):  
Kaashif A. Ahmad ◽  
Cody L. Henderson ◽  
Steven G. Velasquez ◽  
Jaclyn M. LeVan ◽  
Katy L. Kohlleppel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care

Fuzzy risk assessment for electro-optical target tracker

2016 ◽  
Vol 33 (6) ◽  
pp. 830-851 ◽  
Author(s):  
Soumen Kumar Roy ◽  
A K Sarkar ◽  
Biswajit Mahanty
Keyword(s):  
Failure Mode ◽  
Failure Modes ◽  
Linear Equations ◽  
Mode Analysis ◽  
Failure Behavior ◽  
Membership Functions ◽  
Design And Development ◽  
Effect Analysis ◽  
Content Type ◽  
Criticality Analysis

Purpose – The purpose of this paper is to evolve a guideline for scientists and development engineers to the failure behavior of electro-optical target tracker system (EOTTS) using fuzzy methodology leading to success of short-range homing guided missile (SRHGM) in which this critical subsystems is exploited. Design/methodology/approach – Technology index (TI) and fuzzy failure mode effect analysis (FMEA) are used to build an integrated framework to facilitate the system technology assessment and failure modes. Failure mode analysis is carried out for the system using data gathered from technical experts involved in design and realization of the EOTTS. In order to circumvent the limitations of the traditional failure mode effects and criticality analysis (FMECA), fuzzy FMCEA is adopted for the prioritization of the risks. FMEA parameters – severity, occurrence and detection are fuzzifed with suitable membership functions. These membership functions are used to define failure modes. Open source linear programming solver is used to solve linear equations. Findings – It is found that EOTTS has the highest TI among the major technologies used in the SRHGM. Fuzzy risk priority numbers (FRPN) for all important failure modes of the EOTTS are calculated and the failure modes are ranked to arrive at important monitoring points during design and development of the weapon system. Originality/value – This paper integrates the use of TI, fuzzy logic and experts’ database with FMEA toward assisting the scientists and engineers while conducting failure mode and effect analysis to prioritize failures toward taking corrective measure during the design and development of EOTTS.

VIKOR power law-based customer-oriented FMEA with complete unique risk priority numbers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Randula L. Hettiarachchi ◽  
Pisut Koomsap ◽  
Panarpa Ardneam
Keyword(s):  
Case Studies ◽  
Power Law ◽  
Design Methodology ◽  
Service Sector ◽  
Failure Modes ◽  
Risk Priority Number ◽  
Effect Analysis ◽  
Content Type ◽  
Industrial Sectors ◽  
Inherent Problem

PurposeAn inherent problem on risk priority number (RPN) value duplication of traditional failure modes and effect analysis (FMEA) also exists in two customer-oriented FMEAs. One has no unique value, and another has 1% unique values out of 4,000 possible values. The RPN value duplication has motivated the development of a new customer-oriented FMEA presented in this paper to achieve practically all 4,000 unique values and delivering reliable prioritization.Design/methodology/approachThe drastic improvement is the result of power-law and VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR). By having all three risk factors in a power-law form, all unique values can be obtained, and by applying VIKOR to these power-law terms, the prioritization is more practical and reliable.FindingsThe proposed VIKOR power law-based customer-oriented FMEA can achieve practically all 4,000 unique values and is tested with two case studies. The results are more logical than the results from the other two customer-oriented FMEAs.Research limitations/implicationsThe evaluation has been done on two case studies for the service sector. Therefore, additional case studies in other industrial sectors will be required to confirm the effectiveness of this new customer-oriented RPN calculation.Originality/valueAchieving all 1,000 unique values could only be done by having experts tabulate all possible combinations for the traditional FMEA. Therefore, achieving all 4,000 unique values will be much more challenging. A customer-oriented FMEA has been developed to achieve practically all 4,000 unique risk priority numbers, and that the prioritization is more practical and reliable. Furthermore, it has a connection to the traditional FMEA, which helps explain the traditional one from a broader perspective.

Bacterial resistance in the intensive care unit of developing countries: Report from a tertiary hospital in Kazakhstan

2019 ◽  
Vol 17 ◽  
pp. 35-38 ◽  
Author(s):  
Dmitriy Viderman ◽  
Evgeni Brotfain ◽  
Yekaterina Khamzina ◽  
Gulnara Kapanova ◽  
Agzam Zhumadilov ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Developing Countries ◽  
Intensive Care ◽  
Bacterial Resistance ◽  
Tertiary Hospital

scholarly journals Control Measures Against Serratia marcescens Colonization at the Neonatal Intensive Care Unit of UOEH Hospital

2003 ◽  
Vol 25 (1) ◽  
pp. 89-101 ◽  
Author(s):  
Takako IKENO ◽  
Tadao TANABE ◽  
Tetsuro MURATANI ◽  
Noriko NAKANO ◽  
Tomoko KOTAKE ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Serratia Marcescens ◽  
Neonatal Intensive Care ◽  
Control Measures

scholarly journals A nosocomial cluster of vancomycin resistant enterococci among COVID-19 patients in an intensive care unit

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Stefanie Kampmeier ◽  
Hauke Tönnies ◽  
Carlos L. Correa-Martinez ◽  
Alexander Mellmann ◽  
Vera Schwierzeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Whole Genome Sequence ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Abstract Background Currently, hospitals have been forced to divert substantial resources to cope with the ongoing coronavirus disease 2019 (COVID-19) pandemic. It is unclear if this situation will affect long-standing infection prevention practices and impact on healthcare associated infections. Here, we report a nosocomial cluster of vancomycin-resistant enterococci (VRE) that occurred on a COVID-19 dedicated intensive care unit (ICU) despite intensified contact precautions during the current pandemic. Whole genome sequence-based typing (WGS) was used to investigate genetic relatedness of VRE isolates collected from COVID-19 and non-COVID-19 patients during the outbreak and to compare them to environmental VRE samples. Methods Five VRE isolated from patients (three clinical and two screening samples) as well as 11 VRE and six vancomycin susceptible Enterococcus faecium (E. faecium) samples from environmental sites underwent WGS during the outbreak investigation. Isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). Results WGS revealed two genotypic distinct VRE clusters with genetically closely related patient and environmental isolates. The cluster was terminated by enhanced infection control bundle strategies. Conclusions Our results illustrate the importance of continued adherence to infection prevention and control measures during the COVID-19 pandemic to prevent VRE transmission and healthcare associated infections.

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