The Application Of Healthcare Failure Mode And Effects Analysis (HFMEA)to Improve Administration Of Oral Medication

Objective:The application of Healthcare Failure Mode and Effects Analysis (HFMEA)to improve administration of oral medication in nursing and the exploration of HFMEA in risk prevention.Method:In the frame of Healthcare Failure Mode and Effects Analysis (HFMEA);to establish an oral administration risk prevention team, to draw a flow chart of administration of oral medication; to identify failure modes and the causes; to take actions to amend the failure modes and to make risk-control plans. To observe the RPN of administration of oral medication before and after the implementation of new measures, overall patient satisfaction, rate of oral administration error on the administration of oral medication as well as the clinical application of HFMEA.Results:1.Twenty of the project’s team members acquired the RPN scores of failure modes. Among the 13 failure modes, six of them have RPN scores over 20. The failures are as follows:1) dosage errors; 2) oral medicine cups incorrectly placed; 3) medicines wronged placed; 4) medicine distribution errors; 5) patients’ non-compliance and discontinuation or decrease in intake of medications without permission; 6) patients leaving wards without permission, therefore missing doctor’s advice about medicine intake. To take actions against the happening of failure modes, we should:1) to enhance the nurses’ theoretical knowledge and heighten their senses of responsibilities and organize workshops for them to learn relative laws and regulations.2) to change the medicine dispense methods without affecting medicine’s pharmacological effects; 3) to strengthen professional training and be familiar with the names, dosages and shapes of popular medicines and to correctly use medicine labels; 4) to correctly put medicine cups in the medicine delivery cart; 5) to reinforce the implementation of work shifts.6) to well communicate with admitted patients. 2. Through the application of HFMEA management mode, decreases in the RPN scores were observed in the six failure modes, compared with control group. The control group of dosage errors (20.64+6.71), observation group (14.51 ±3.82);the control group of wrongly placed medicine cups (12.29 ± 3.27), observation group (8.71 ± 2.19); the control group of wrongly placed medicine (20.47 ± 7.84), observation group (12.11 ± 2.87); the control group of medicine dispense errors (19.12±9.82) observation group (13.19+3.81); the control group of patients non-compliance and discontinuation or decrease in intake of medications (15.18+ 6.91), observation group (10.14±2.8); the control group of patients leaving wards without permission (12.03±4.8), observation group (8.12±1.83). In terms of patients satisfaction, the control group has the scores of 92.67%, and the observation group has the scores of 97.57%,. In terms of medicine dispense errors, the control group has an error rate of 2.08%, whilst the observation group has 0.89%,The difference was statistically significant (P<0.05).Conclusion:1. Health care Failure Modes and Effects Analysis can reduce the risk in the administration of oral medication;2. The application of HFMEA can optimize the process for the administration of oral medication and improve overall patient satisfaction and lower the error rate.