Application of Failure Mode and Effects Analysis in risk management of drug therapy in an intensive care unit

Abstract

Objective: To utilize Failure Mode and Effects Analysis (FMEA) to manage risks in prescribed drug therapy within an Intensive Care Unit (ICU). Methodology: This action research, integrating qualitative and quantitative methods, assesses medical prescriptions in a Coronary ICU (CECOR) in Fortaleza, Brazil, using FMEA. This study involves defining the process, forming a multidisciplinary team, conducting a situational diagnosis, evaluating failure modes (FMs) with Severity (S) and Detection (D) indices, monitoring FM Prevalence (P), and calculating the Prioritization Coefficient (PC). Each FM is accompanied by pharmaceutical recommendations (RF). Continuing education activities are designed based on the PC for CECOR professionals. Results: In the situational diagnosis, 170 prescriptions and 60 FMs were assessed, with primary categories being drug interactions (39.7 %) and incompatibilities (30.0 %). Causes are multifactorial. Regarding the team’s response to an FM, it was determined that 36,7 % of the FMs would be accepted with monitoring. During prevalence monitoring, 63.3 % of FM types occurred 837 times, with high severity (50.0 %) and low detection (55.3 %). Most frequent FMs were absence of pharmaceutical form (29.4 %) and dose (8.8 %). Conclusion: FMEA facilitates identifying, classifying, and prioritizing risks in drug therapy at CECOR, underlining its effectiveness as a quality tool for enhancing patient safety.