Clinical risk assessment in intensive care unit

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Clinical Risk Management

Background:

• Clinical risk management is crucial for enhancing healthcare quality and patient safety.
• It involves identifying and mitigating risks that could lead to patient harm.
• This study aimed to apply Failure Mode and Effect Analysis (FMEA) in an Intensive Care Unit (ICU).

Purpose of the Study:

• To identify and assess potential failure modes within the ICU of Razi Hospital.
• To evaluate risks using the Failure Mode and Effect Analysis (FMEA) methodology.
• To improve patient safety through proactive risk identification and management.

Main Methods:

• A qualitative-quantitative research approach was employed.
• Focus Discussion Groups (FDGs) were conducted with knowledgeable individuals familiar with ICU processes.
• Data was systematically analyzed using the FMEA technique.

Main Results:

• Forty-eight distinct clinical errors and failure modes were identified.
• The highest Risk Probability Number (RPN) was associated with "Ventilator's alarm malfunction (no alarm)" (RPN=288).
• The lowest RPN was for "not washing the NG-Tube" (RPN=8), indicating a lower-priority risk.

Conclusions:

• Many identified clinical errors are preventable through collaborative efforts.
• Effective clinical risk assessment and management are fundamental to delivering high-quality healthcare.
• Proactive identification and mitigation of failure modes can significantly enhance patient safety in ICUs.