b. Testing of interventions -- likely establishment of at least two new protocols would be put in place; 1) heightened diligence and/or special considerations for certain pharmaceutical combinations with concurrent educational seminars and/or training sessions; 2) additional monitoring criteria based on patient history, combination of symptoms, severity of treatment. Impossible to do double blind studies on these implications, because a repeat of the action is not wanted; but using case analysis and review, potential negative outcomes could still be tested appropriately.
c. Pre-Steps for FMEA Preparation:
a. Collection and analysis of patient records during ER visit.
b. Collection and analysis of patient file from GP or previous hospital visits.
c. Log of staff, patients, and responsibilities for shift (Resource log allocation study).
d. Notarized statements from all involved in the case.
e. Any test results done white in the ER; if autopsied, any quantitative test results.
f. Physicians and Nurses from ER meet to fill out a FMEA worksheet to help guide committee through longitudinal/chronological issues:, ex:
Function
Failure
Mode
Effects
S
(Severity
Rating)
Causes
O
(Occurrence
Rating)
Current
Controls
D
(Detection Rating)
RPN
(Risk
Priority
Number)
Reccom.
Actions
Res.
Target
Completion Date
Action Taken
What was done for patient, details and time?
What failed? When?
What effects.
Scale 1-10, 10 highest
Identification
How often?
Steps in place now
How are issues detected?
Overall risk priority in similar cases
Step-by-Step recomm.
Who is Resp.
Tactics
(Bluvband and Grabov, 2010)
d. FMEA Steps:
1. Severity -- Determine failure modes based on functional requirements and effects. Severity in this case was drug combination and lack of proper monitoring based on history. Use quantifiable methods, not qualitative. Let facts speak, not...
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