E Prado-Mel1, M Mejías Trueba2, I Reyes González2, M A Gallego Espina3, M T Martín Márquez2, E R Alfaro Lara2. 1. Servicio de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: elenapradomel@gmail.com. 2. Servicio de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España. 3. Servicio de Medicina Física y Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla, España.
Abstract
OBJECTIVE: To identify the risks in automated dispensing cabinet use in order to improve routine procedure safety. METHODS: We used the Failure Mode Effect Analysis (FMEA) methodology. A multidisciplinary team identified potential failure modes of the procedure through a brainstorming session. We assessed the impact associated with each failure mode with the Risk Priority Number (RPN), which involves three variables: occurrence, severity, and detectability. Improvement measures were established for failure modes with RPN>100 considered critical. The final RPN (theoretical) that would result from the proposed measures was also calculated. RESULTS: The process was divided into five sub-processes: automatic delivery of order replacement, to prepare order in a pyramidal cart, transport of the pyramidal cart from the pharmacy service to the automated dispensing cabinet, replacement of the automated dispensing cabinet by the pharmacy technician and dispensing/returning by nursing staff. Twenty-two failure modes, with 25 cases and with varying effects (severity 2-8) were evaluated. The sub-process with more failure modes with NPR>100 was dispensing/returning by nursing staff. CONCLUSIONS: The FMEA methodology was a useful tool when applied to automated dispensing cabinet system use. The implementation of improvement actions significantly reduced the risk.
OBJECTIVE: To identify the risks in automated dispensing cabinet use in order to improve routine procedure safety. METHODS: We used the Failure Mode Effect Analysis (FMEA) methodology. A multidisciplinary team identified potential failure modes of the procedure through a brainstorming session. We assessed the impact associated with each failure mode with the Risk Priority Number (RPN), which involves three variables: occurrence, severity, and detectability. Improvement measures were established for failure modes with RPN>100 considered critical. The final RPN (theoretical) that would result from the proposed measures was also calculated. RESULTS: The process was divided into five sub-processes: automatic delivery of order replacement, to prepare order in a pyramidal cart, transport of the pyramidal cart from the pharmacy service to the automated dispensing cabinet, replacement of the automated dispensing cabinet by the pharmacy technician and dispensing/returning by nursing staff. Twenty-two failure modes, with 25 cases and with varying effects (severity 2-8) were evaluated. The sub-process with more failure modes with NPR>100 was dispensing/returning by nursing staff. CONCLUSIONS: The FMEA methodology was a useful tool when applied to automated dispensing cabinet system use. The implementation of improvement actions significantly reduced the risk.
Keywords:
Análisis modal de fallos y efectos; Calidad; Drug distribution system; Failure mode effect analysis; Quality; Riesgos; Risk; Safety; Seguridad; Sistema de distribución de medicamentos