Using Failure Mode and Effects Analysis in Improving Nursing Blood Sampling at an International Specialized Cancer Center.

Anas Haroun,Majeda Al- Ruzzieh,Rateb Hassoneh,Ghada Abu Alrub,Najah Hussien,Omar Ayaad,Abdelrahman Masa’Ad

doi:10.31557/apjcp.2021.22.4.1247

Anas Haroun, Majeda Al- Ruzzieh + Show 5 more

Open Access

https://doi.org/10.31557/apjcp.2021.22.4.1247

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Abstract

Background:The process of blood sampling is considered one of the primary and most common nursing invasive procedures carried out daily. Any failure at any point could have a severe negative impact on patient outcomes. Purpose:This project aimed to assess and improve the nursing blood sampling process in a specialized cancer center using failure mode and effect analysis (FMEA). Methods:An observational analytical design of the nursing blood sampling process using FMEA was conducted in King Hussein Cancer Center in Amman, Jordan. Seven steps were conducted, including a review of the blood sampling process, brainstorming potential failures, listing potential effects of each failure mode, assigning a severity rating for each potential effect, assigning a frequency/occurrence rating for each failure mode, assigning a detection rating scale for each failure mode, and calculating the Risk Priority Number (RPN) for each effect. Results:Eight (out of 28) main critical failure modes with more than 200 RPN were identified in the blood sampling process. Accordingly, five themes were developed to guide the corrective actions. These themes included: process and responsibility modifications, resource and information technology utilization, patients and family engagement, safety culture, and education and training after implementation of the corrective actions. This resulted in a 58 % reduction in the RPN of major failure modes. Conclusion:Many factors lead to blood sampling errors. A critical focus should be conducted on the preparation phase due to the possible errors that may occur. Proper identification of patients and blood sample tests are the keys to a significant decrease in blood sampling errors.

Highlights

The process of blood sampling is considered one of the primary and most common nursing invasive procedures carried out daily
An observational analytical design of the nursing blood sampling process using failure mode and effect analysis (FMEA) was conducted in King Hussein Cancer Center in Amman, Jordan
Initial Risk Priority Number (RPN) Many failure modes (29 failure modes) with many causes and effects were identified in all steps of the blood sampling process

Summary

Introduction

The process of blood sampling is considered one of the primary and most common nursing invasive procedures carried out daily. Many factors may lead to blood sampling errors These factors include incorrect sample or patient identification, wrong sample labeling, inadequate training and education, lack of process standardization, inappropriate equipment and suppliers, lack of proper patient engagement, limited technological solutions, and staff overload and interruptions (De la Salle, 2019; Forest et al, 2017; Frietsch et al, 2017; Kaufman et al, 2018; World Health Organization, 2010). These themes included: process and responsibility modifications, resource and information technology utilization, patients and family engagement, safety culture, and education and training after implementation of the corrective actions This resulted in a 58 % reduction in the RPN of major failure modes. Proper identification of patients and blood sample tests are the keys to a significant decrease in blood sampling errors

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