Effects of healthcare failure mode and effects analysis on needlestick injuries prevention in nurses

Abstract

Objective To explore the effects of healthcare failure mode and effects analysis (HFMEA) on needlestick injuries prevention in nurses. Methods A total of 1 082 nurses were selected from January to December 2015 in a grade three hospital and 1 105 nurses from January to December 2016. From January to December 2016, the needle withdrawal process when finishing infusion was managed with HFMEA. The potential failure mode of needlestick injuries was found by brainstorming method. The risk priority number (RPN) was assessed according to the harm score matrix. A total of 9 failure modes (RPN≥8) were reformed and carried with quality control. The score of RPN and the incidence of needle puncture standardization were compared before and after HFMEA. Results After applying HFMEA, the RPN of failure modes of needlestick injuries during needle withdrawal process all dropped to targeted value (under 8) . The total RPN decreased from (81.08±26.68) to (48.46±12.48) (t'=2.854, P<0.05) . Except for centrally separating needle head, RPN of other failure modes all significantly reduced (P<0.05) . The RPN involving poor technique, rescue and emergency needle withdrawal, nonstandard medical wastes classification, low adaptability degree of patients, push-back needle head in infusion bag, needle cap sheathed by both hands all declined more obvious. The standardized incidence of needlestick injuries in total flow decreased from 0.062 cases per FTE year before implementing HFMEA to 0.038 cases per FTE year (χ2=6.698, P<0.01) . Conclusions Application of HFMEA in management of needle withdrawal process in nurses can prospectively control nonstandard operative behavior and optimize process so as to effectively reduce the risk of needlestick injuries. Key words: Nursing staff; Needlestick injuries; Healthcare failure mode and effects analysis; Infection control