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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care

Xixi Li1, Mei He, Haiyan Wang

  • 1Nursing Administration, Mianyang Central Hospital, Mianyang, Sichuan, P.R. China.

Medicine
|February 3, 2018
PubMed

Insights

Failure Mode and Effect Analysis (FMEA) significantly reduced catheter-related bloodstream infections (CRBSIs) in intensive care units. This proactive approach improved patient safety and nursing quality by addressing high-risk failure modes.

Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety
  • Medical Device Management

Background:

  • Catheter-related bloodstream infections (CRBSIs) pose a significant risk in intensive care units.
  • Proactive error reduction strategies are crucial for enhancing patient care.
  • Existing processes for central venous catheterization require systematic risk assessment.

Purpose of the Study:

  • To evaluate the effectiveness of Failure Mode and Effect Analysis (FMEA) in reducing CRBSIs.
  • To identify and mitigate high-risk failure modes in central venous catheterization.
  • To assess the impact of FMEA on patient safety and healthcare costs.

Main Methods:

  • Implementation of FMEA with a multidisciplinary team of 15 medical staff.
  • Identification and scoring of 25 potential failure modes using Risk Priority Number (RPN).
  • Prioritization of failure modes with RPN ≥100 for immediate corrective actions and reassessment.

Main Results:

  • Identified high-priority risks including unqualified sterilization, leukopenia, and poor hand hygiene.
  • Corrective measures led to a significant reduction in RPNs, with up to 80% decrease for specific failure modes.
  • Averaged CRBSI incidence decreased from 5.19% to 1.45%, with a subsequent 3-month period of zero infections.

Conclusions:

  • FMEA is an effective tool for reducing CRBSIs and improving central venous catheterization safety.
  • Implementation of FMEA enhances nursing quality and can lead to decreased medical expenses.
  • Proactive risk management through FMEA contributes to better patient outcomes in critical care settings.

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